Home›Emergency Medicine› Alexithymia and interoceptive disturbances show consistent links with functional neurological disorder
Alexithymia and interoceptive disturbances show consistent links with functional neurological disorderPsychological traits linked to autonomy may help explain FND
Frontiers in MedicinePublished August 15, 2026Study authors: Luuk Stroink, Klaas Huijbregts, Andrej Rakic, Ralph de Vries, Marleen Rijkeboer, Marrie H. J. BekkerDOI ↗Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic
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Key Takeaway
Consider that alexithymia and interoceptive disturbances are consistently associated with FND, but evidence is indirect and heterogeneous.
This systematic review examined psychological characteristics conceptually related to autonomy-connectedness in individuals with functional neurological disorder (FND). The review focused on insecure attachment, suggestibility, alexithymia, interoception, sense of agency, harm avoidance, and openness to experience. The authors synthesized available evidence to assess associations between these characteristics and FND.
Consistent associations with FND were found for alexithymia and interoceptive disturbances. These findings suggest that difficulties in identifying and describing emotions and altered perception of bodily signals may be relevant in FND. However, the review did not report effect sizes or quantitative data, so the strength of these associations remains unspecified.
Findings for insecure attachment, sense of agency, and harm avoidance/openness to experience were more heterogeneous. Evidence for suggestibility was limited. The authors noted that autonomy-connectedness itself has not been directly investigated in FND populations, and the evidence is indirect and hypothesis-generating.
Limitations include methodological heterogeneity across studies and the absence of direct assessments of autonomy-connectedness in FND populations. The authors caution that conclusions should be interpreted cautiously due to this heterogeneity and lack of direct assessment. The review provides indirect support for autonomy-connectedness as a conceptual framework for understanding vulnerability-related characteristics in FND, but causality cannot be inferred.
How this fits prior evidence
This systematic review extends prior coverage by linking FND to specific psychological characteristics beyond dissociative symptoms. While earlier findings noted higher dissociative symptoms in FND, this review adds consistent associations with alexithymia and interoceptive disturbances. It also addresses a gap by examining autonomy-connectedness-related traits, though direct assessment is lacking. The heterogeneous findings for attachment and agency contrast with the more consistent dissociative correlations, highlighting the need for cautious interpretation.
Living with Functional Neurological Disorder (FND) can feel confusing because the condition involves a breakdown in how the brain sends and receives signals. Researchers looked into whether certain psychological traits related to autonomy—how much a person feels in control of their own life—could help explain why some people are more vulnerable to this condition.
The review found consistent links between FND and two specific areas: alexithymia (difficulty identifying or describing emotions) and interoceptive disturbances (trouble sensing internal body signals). Other factors like sense of agency, harm avoidance, and insecure attachment showed mixed results across different studies. Evidence regarding suggestibility was also limited.
Because these findings come from a review of various studies rather than a direct test on FND patients, the results are still early. The researchers note that while these links provide a helpful framework for understanding the condition, more direct research is needed to confirm exactly how these traits impact daily life.
What this means for you:
Consistent links between difficulty sensing body signals and emotional awareness were found in people with FND.
Common questions
What is alexithymia and how does it relate to FND?
Alexithymia is a term for difficulty identifying or describing your own emotions. This study found consistent associations between alexithymia and Functional Neurological Disorder (FND). It suggests that people with FND may have more trouble processing their feelings, which could be part of the broader picture of how the condition affects the brain.
What are interoceptive disturbances in this study?
Interoception is your ability to sense internal body signals, such as your heartbeat or breathing. The research found consistent associations between these types of disturbances and FND. This means people with the condition may have a harder time processing information from inside their own bodies.
Are these findings certain for everyone with FND?
The results should be interpreted cautiously. Because this was a review of different studies rather than a direct assessment of people with FND, the evidence is considered indirect and hypothesis-generating. Some factors, like suggestibility, had limited evidence, and other traits showed mixed results across different research groups.
Preliminary evidence suggests that individuals with Functional Neurological Disorder (FND) may exhibit reduced autonomy-connectedness, a psychological construct referring to the capacity to remain connected with one’s own needs and emotions while maintaining meaningful relationships with others. Autonomy-connectedness consists of three interrelated dimensions: self-awareness, sensitivity to others, and the capacity to manage new situations. Although autonomy-connectedness itself has not yet been directly investigated in FND populations, several psychological characteristics associated with FND appear conceptually related to these dimensions, including insecure attachment, suggestibility, alexithymia, altered interoceptive awareness, disturbed sense of agency, and harm avoidance or low openness to experience. This systematic review examined empirical studies investigating psychological characteristics conceptually related to autonomy-connectedness in individuals with FND. Specifically, we reviewed studies on insecure attachment, suggestibility, alexithymia, interoception, sense of agency, and harm avoidance/openness to experience. Across studies, the most consistent associations were found for alexithymia and interoceptive disturbances, whereas findings regarding attachment, sense of agency, and harm avoidance/openness to experience were more heterogeneous. Evidence regarding suggestibility was limited. Overall, the findings provide indirect and hypothesis-generating support for the potential relevance of autonomy-connectedness as a conceptual framework for understanding vulnerability-related characteristics in FND. However, conclusions should be interpreted cautiously given the methodological heterogeneity across studies and the absence of direct assessments of autonomy-connectedness in FND populations.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023232760.
