Aphantasia Beyond Imagery: Interoception, Neurodevelopment, and Early Experience

BackgroundCongenital aphantasia involves a lifelong absence of voluntary visual imagery. Although imagery holds potential for understanding neurocognitive organisation, it remains underexplored in neurology and psychiatry. Variation in imagery capacity appears linked to differences in interoceptive processing and neurodevelopmental factors. This study used the Plymouth Sensory Imagery Questionnaire (PSI-Q) to measure imagery vividness and clarify these individual differences. Current work suggests aphantasia may reflect a broader profile shaped by altered bodily awareness and early-life influences.MethodsAn online sample included individuals with core aphantasia (PSI-Q = 0; n = 329), hypofantasia (0<PSI-Q≤4; n = 748), typical imagery (4<PSI-Q≤9; n = 215), and hyperphantasia (9≤PSI-Q≤10; n = 124). Participants completed questionnaires on autonomic symptoms (BPQ-SF), cardiac symptomatology (AFS), childhood trauma (CTQ), ADHD traits, autistic traits (AQ-10), anxiety (GAD-7), POTS symptoms (MAPS), and hypermobility.ResultsAphantasia groups and the hyperphantasia group reported reduced autonomic symptoms relative to controls on the BPQ supradiaphragmatic subscale. Similar reductions appeared for the aphantasia groups on AFS Heart Symptoms and Chest Discomfort, while the hypofantasia group showed greater tiredness on relevant AFS subscales. Core aphantasia and hypofantasia groups displayed elevated ADHD and autistic traits. On the CTQ, both groups reported higher emotional neglect; hypofantasia also showed a trend toward higher emotional abuse but lower physical abuse. Hypermobility was linked to hyperphantasia.ConclusionsCongenital aphantasia aligned with reduced bodily awareness, higher neurodevelopmental traits, and greater exposure to emotional adversity. Hyperphantasia additionally related to hypermobility. Mental imagery, measured with the PSI-Q, may indicate broader neurocognitive and interoceptive patterns.