The Moderating Role of Interoceptive Awareness in the Relationship Between Difficulties in Emotion Regulation and Somatic Symptoms

Difficulties in emotion regulation have been associated with greater somatic symptom severity. However, the role of interoceptive awareness in this relationship remains unclear. This study examined whether overall interoceptive awareness and its specific dimensions moderate the association between difficulties in emotion regulation and somatic symptoms. The sample comprised 394 adults recruited from the general population through online participant recruitment platforms. Participants completed the Difficulties in Emotion Regulation Scale-16, Somatic Symptom Scale-8, and Multidimensional Assessment of Interoceptive Awareness. Moderation analyses were conducted using PROCESS Model 1, controlling for age, gender, and chronic physical illness. These findings showed that difficulties in emotion regulation were positively associated with somatic symptoms (r = 0.53, p < 0.001). Overall interoceptive awareness significantly moderated this association (B = 0.069, SE = 0.020, p < 0.001, ΔR2 = 0.020), such that the association became stronger at higher levels of interoceptive awareness. Following Bonferroni correction, significant moderating effects were also observed for noticing, emotional awareness, self-regulation, and body listening, whereas not distracting, not worrying, attention regulation, and trusting were not significant. Overall, the findings suggest that greater interoceptive awareness may be associated with a stronger relationship between emotion regulation difficulties and somatic symptoms.