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Abstract

Interoception as a mechanism linking cannabis use and anomalous experiences: Evidence from longitudinal self-report and experimental task-based assessment

Aims: Cannabis use has been associated with anomalous experiences (unusual perceptions, thoughts or feelings), which are common in the general population and may indicate vulnerability to psychosis. The mechanisms underlying this association remain unclear. This research examined whether interoception, the perception and interpretation of internal bodily signals, helps clarify this relationship, while addressing a measurement challenge: distinguishing between self-reported and task-based assessments of interoceptive abilities and their relationship with body ownership, the experience of one’s body as belonging to oneself.

Methods: Study one (N=423) used a two-wave longitudinal survey assessing cannabis use, anomalous experiences, and self-reported interoceptive accuracy, attention, and. Study two (N=82) used a quasi-experimental laboratory design combining questionnaires with task-based assessments: the heartbeat counting task, the heart rate discrimination task, and a mixed reality body ownership/disownership task. Alcohol use, anxiety, and depressive symptoms were assessed as covariates.

Results: In study one, interoceptive accuracy, but not attention or sensibility, mediated the longitudinal association between problematic cannabis use and anomalous experiences (b=0.16, 95%CI[0.04,0.33]). Exploratory analyses suggested serial pathways through interoceptive accuracy and anxiety/depression. Study two examined whether these self-report findings converge with task-based interoceptive accuracy and body ownership/disownership responses, showing an association between heartbeat counting accuracy and self-body disownership delay effects (β=.215, p=.05).

Conclusions: Interoceptive processes may help explain the association between cannabis use and anomalous experiences. The findings highlight the need to distinguish perceived interoceptive accuracy from task-based performance. Integrating self-report measures with experimental assessments across subjective, behavioural, and bodily self-processing levels of analysis may provide a precise account of embodied mechanisms underlying cannabis-related anomalous experiences and inform prevention and early intervention approaches.