The role of interoception in dissociation etiology: a network analysis of dissociation, trauma, sleep, and interoception

A transtheoretical framework for dissociation acknowledges emotional regulation. However, interoception—closely linked to emotional and autonomic regulation—remains underexplored, despite growing evidence connects it to dissociation and its correlates. This study applied a network analysis to examine multidirectional associations among dissociation, trauma exposure, post-traumatic symptoms, sleep quality, and interoception. A cross-sectional design was employed in a community sample of 574 adults (18–60 years) from Upper Silesia, Poland. Participants completed validated self-report measures of dissociative experiences (Dissociative Experiences Scale; Somatoform Dissociation Questionnaire), interoception (Multidimensional Assessment of Interoceptive Awareness; Body Perception Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), trauma exposure (Life Events Checklist for DSM-5), post-traumatic stress symptoms (International Trauma Questionnaire), and demographic and health variables.The network was estimated using a graphical Gaussian model with the graphical LASSO algorithm. Absorption showed the highest strength and expected influence, affective dysregulation the greatest closeness and betweenness, while autonomic reactivity and emotional awareness also emerged as highly central nodes. Contrary to theoretical expectations derived from post-traumatic and sociocognitive models, neither trauma exposure nor sleep quality occupied central positions in the network.These findings suggest that dissociation may be more tightly embedded in interoceptive and autonomic regulatory processes than in trauma exposure per se. Atypical interoception may represent a transdiagnostic mechanism linking posttraumatic and sociocognitive accounts of dissociation, while aligning with attachment-based perspectives emphasizing disrupted bodily and affective co-regulation. These results provide a rationale for incorporating interoceptive-focused interventions in the treatment of dissociative symptoms.