Interoceptive Profiling Identifies Separable Somatic and Alexithymic Contributors to Mental Health

Interoceptive dysfunction is a transdiagnostic risk factor for mental illness, yet it remains unclear whether self-reported interoceptive accuracy and attention combine into distinct configurations with separable clinical consequences. In 833 adults, k-means clustering identified three interoceptive profiles with divergent mental health outcomes. A Hypervigilant profile (high attention, moderate accuracy) showed the greatest somatic symptom burden and pain catastrophizing; an Uncertain profile (low accuracy, moderate attention) showed the highest alexithymia; and an Efficient profile (high accuracy, low attention) showed the lowest overall psychopathology. Structural equation modeling revealed a computational dissociation: alexithymia followed an additive deficit model driven primarily by low accuracy, whereas somatic symptoms followed a multiplicative amplification model in which elevated attention weakened accuracy’s protective effect. These findings suggest that mental health risk depends not on interoceptive dimensions in isolation, but on how they combine within individuals, highlighting targets for profile-specific intervention.