Emotions involve complex sets of physiological, behavioral and experiential responses and play an essential role in our lives. In many cases, emotions may play an adaptive role in survival and development, but emotions can also hinder mental functioning or environmental adaptation when they are too intense or not suitable in a given context (Smith & Lazarus, 1990). It is therefore appropriate to adjust the type, intensity, duration and expression of emotions depending on one's particular regulatory goals—a group of processes known as emotion regulation (ER; Gross, 1998). Individual differences in the regulation of negative emotions have been explored, including their potential impact on mental health (John & Gross, 2007). Assessing how individuals vary in their habitual use of certain ER strategies can at least partially explain why individuals react differently and experience different emotions, when faced with similar situations and environments (Joormann & Gotlib, 2010; Wang et al., 2021). The ability to implement suitable strategies based on context has increasingly been suggested as a primary indicator of emotion regulation ability (Bonanno & Burton, 2013; Cheng et al., 2014). Using strategies flexibly, in ways that are matched to specific situations and contexts, may be more beneficial for successful emotion regulation versus rigidly utilizing the same strategies regardless of contextual demands (Aldao & Nolen-Hoeksema, 2013; Bonanno & Burton, 2013).

Previous studies have suggested that various factors—spanning demographics, personality and cognition—can predict or influence individual differences in emotion regulation (John & Gross, 2007). Recent research suggests that the perception of bodily signals, referred to as interoception, underlies individual differences in emotional awareness and thus influences the process of emotion regulation (Gross, 2015; Herbert et al., 2007). Interoception is not a single process but rather forms a broader taxonomy with several dimensions, including interoceptive accuracy, attention, and sensibility (Garfinkel et al., 2015; Khalsa et al., 2018). For instance, Murphy et al. (2019) distinguish between interoceptive accuracy and attention-, each of which can be assessed using either self-reported or more objective methods. More specifically, objective measures of interoceptive accuracy would involve behavioural tests of participants’ ability to monitor bodily signals precisely (e.g., reporting how many times their heartbeats within a given time period, which is then compared to actual heart-rate-monitor data), but participants can also be asked to subjectively report on the accuracy of their interoceptive abilities. Interoceptive attention more specifically refers to how much space in one's attention interoceptive signals take up and is typically measured using either experience sampling metrics or self-reported attention to bodily signals (Murphy et al., 2019). Still others have used the term interoceptive sensibility to refer to the combination of subjective beliefs about one's interoceptive accuracy and attention, but the rest of this paper will focus on subjectively reported interoceptive attention.

Several prominent theories propose a close relationship between interoception and processing of emotions (Craig, 2002; Damasio, 1996; James, 1884), which is in line with studies demonstrating that individuals reporting highly differentiated bodily and emotional experiences were more efficient in regulating their emotions (Barrett et al., 2001; Barrett et al., 2004). Trainings for interoception, such as those using mindfulness approaches, are now being adopted as interventions to help individuals better process and cope with emotions (e.g., Aaron et al., 2020; Remmers et al., 2016). Additionally, an emerging body of empirical studies has observed modulation of ER by interoception (Füstös et al., 2013; Kever et al., 2015; Lischke et al., 2020; Pollatos et al., 2015; Schuette et al., 2021; Zamariola et al., 2019a; Zamariola et al., 2019b). For instance, measured by the Heartbeat Counting Task (Schandry, 1981), higher objective interoceptive accuracy has been shown to help successful downregulation of negative emotions (Füstös et al., 2013; Kever et al., 2015; Pollatos et al., 2015; Weiss et al., 2014). However, this advantage of high interoceptive accuracy has not always been consistently documented, when using large samples or different measures of ER (Schuette et al., 2021; Zamariola et al., 2019a). Instead, they found positive correlations between ER and self-reported interoceptive attention measured by the Noticing subscale of Multidimensional Assessment of Interoceptive Awareness (MAIA; Mehling et al., 2012; Schuette et al., 2021; Zamariola et al., 2019b). Previous research has shown that interoceptive accuracy was relatively difficult to improve by training (Borneman & Singer, 2017), while interoceptive attention, like mindfully attending to the breath, can be trained more easily (Roemer et al., 2015). Although interoceptive attention is likely a useful target for interventions aiming to improve ER ability and mental health, it has been less examined in this context compared to interoceptive accuracy. Additionally, the measurement of ER in these above empirical studies mostly involved reappraisal and suppression strategies (Füstös et al., 2013; Kever et al., 2015; Lischke et al., 2020; Pollatos et al., 2015). In the present study, we further explore the relations between interoceptive attention and diverse ER strategies.

In addition to potential direct effects, researchers have proposed that interoception may influence ER through emotional awareness, the ability to actively attend to one's emotions (Füstös et al., 2013; Schuette et al., 2021). Indeed, a large body of studies have found that individuals with higher interoceptive accuracy report increased emotional awareness (Pollatos et al., 2005). Further, emotional awareness and recognition are involved in all three stages of ER proposed by Gross (2015)—namely identification, selection, and implementation. When developing the Difficulties in Emotion Regulation Scale (DERS), Gratz and Roemer (2004) identified emotional awareness as one of the essential factors for successful ER, and theories indicate emotional awareness as a fundamental aspect of ER (Barrett et al., 2001). Thus, the current study aims to test for a potential mediating role of emotional awareness in the relation between interoceptive attention and habitual use of various ER strategies.

In addition to influencing ER strategy use broadly, it has been suggested that interoceptive information can be important in facilitating the flexible use of specific ER strategies to meet specific contextual demands (Ardi et al; 2021; Bonanno & Burton, 2013). For instance, Birk and Bonanno (2016) demonstrated that internal feedback including bodily information and emotional awareness guided participants to switch to an optimal ER strategy when emotional stimuli changed and predicted a higher level of well-being. However, there is still a lack of research that directly tests modulation of flexible ER strategy use by interoceptive attention in real-life settings.

Emotion regulation in daily life is a dynamic process that requires multiple strategies adopted together or in succession (Aldao et al., 2014). It is likely that people choose, abandon, and update ER strategies dynamically in response to their ever-changing environment (Aldao et al., 2015). When a strategy fits a given situation, it is adaptive, and can be considered to have good strategy-situation fit (Cheng et al., 2014; Haines et al., 2016; Troy et al., 2013). This strategy-situation fit requires both evaluating contextual demands and flexibly matching strategies to meet these demands (Goodman et al., 2021). For example, emotional intensity is one particular contextual demand that has been frequently examined in relation to ER strategy choice (Matthews et al., 2021). Studies have consistently demonstrated that healthy participants prefer to use strategies that involve engagement with and re-interpretation of emotional information (i.e., reappraisal) in response to situations with relatively low emotional intensity, whereas they choose to use strategies that involve disengagement of attention from emotional stimuli (i.e., distraction) in high-intensity negative emotional situations (Feldman & Freitas, 2021; Hay et al., 2015; Sheppes et al., 2011, 2014). Furthermore, this flexible regulatory pattern has been found to be more adaptive compared to rigid regulatory styles, which are characterized by indistinguishably adopting a single strategy (Birk & Bonanno, 2016; Levy-Gigi et al., 2016; Murphy & Young, 2020). One possible reason for these findings is that strategies such as reappraisal are engaged to serve long-term goals, leading to adaptive consequences in low-intensity situations (Sheppes & Meiran, 2007; 2008). However, in high intensity contexts, simply disengaging attention via distraction can be less effortful and thus more effective in more quickly blocking potent, strong emotions (Sheppes et al., 2014; Webb et al., 2012). In line with this assumption, neural evidence has shown that distraction reduces activity of the amygdala more than reappraisal (McRae et al., 2010), especially for high-intensity emotions (Shafir et al., 2015). Using distraction versus reappraisal for events of varying emotional intensities is also consistent with leading therapy models such as dialectical behavior therapy (Linehan, 1987; 2014). Based on research and theory suggesting the importance of matches between emotional intensity and choice of ER strategy (Sheppes, 2020), in the present study we investigated strategy-situation fit by comparing participants’ ER strategy choices (i.e., reappraisal vs. distraction), in the contexts of differing emotional intensity levels. Specifically, we considered that people with a high level of strategy-situation fit would distract themselves rather than reappraise in high-intensity emotional contexts but would use more reappraisal than distraction in situations with low emotional intensity. People with low strategy-situation fit would have difficulty matching strategies to meet situations differing in emotional intensity, instead indiscriminately choosing less adaptive regulation strategies (e.g., distraction).

Considering the close relationship between strategy-situation fit and mental health (e.g., Goodman et al., 2021; Haines et al., 2016), we believe it is necessary to examine whether higher interoceptive attention may facilitate more successful matching of ER strategies to contextual demands; this might eventually help reveal novel pathways for effective ER-related intervention for those with mental health problems. To this end, in the current study we utilized the experience-sampling method (ESM) to investigate how individuals employ ER strategies in response to negative events that occur in daily life, and how these ER-use patterns might relate to interoceptive attention. ESM uses structured diary techniques to measure individual experiences of mood, behavior and context as they occur in daily life (Dimotakis et al., 2013). ESM is designed to reduce recall bias and to collect valid intensive longitudinal data for measuring individual differences in intraindividual variability. Thus, it is highly suitable for exploring when and how people use ER strategies in real-life settings and is often viewed as an optimal way to accurately measure ER ability (Aldao et al., 2015; Haines et al., 2016).

In sum, the present study aimed to test two hypotheses: 1) higher interoceptive attention may increase habitual use of ER strategies through augmented emotional awareness; and 2) higher interoceptive attention may increase strategy-situation fit in real life settings. To test the first hypothesis of a potential mediating role of emotional awareness in the relation between interoceptive attention and habitual ER use, we measured trait-level interoceptive attention, ER strategy use and emotional awareness. The Noticing scale of the MAIA (Mehling et al., 2012) was applied to measure self-reported levels of interoceptive attention. The Regulation of Emotion Systems Survey (RESS) (De France & Hollenstein, 2017) was used to assess individual habitual use of ER strategies including reappraisal, suppression, rumination, distraction, engagement and arousal control. We expected that reappraisal, rumination and arousal control would be positively correlated with interoceptive attention because they relate to increased bodily and emotional awareness. Conversely, we expected the strategies of distraction, suppression, and engagement may not have this association with interoceptive attention because they likely involve external attentional control or inhibitory systems (McRae & Gross, 2020), thus diverting attention from internal signals (James, 1884; Pollatos et al., 2005). For the second hypothesis, we fitted the co-variance between the use of two ER strategies (reappraisal and distraction) and the reported intensity of life events in multilevel models to quantify strategy-situation fit. Cross-level moderation effects were estimated to examine how interoceptive attention might modulate the effects of emotional intensity on regulatory strategy use. We expected that only individuals with high levels of interoceptive attention would use more distraction when regulating highly negative life events, while they would use more reappraisal when facing low-intensity negative situations.

Despite ongoing research and dialogue concerning the important role of interoception in emotion regulation (Füstös et al., 2013; Kever et al., 2015; Lischke et al., 2020; Pollatos et al., 2015; Schuette et al., 2021), there is limited quantitative research exploring the potential mechanisms behind their association, as well as how the dynamics of interoception and ER manifest in daily life. The present study confirmed that interoceptive attention may facilitate habitual use of ER strategies at least in part through increased emotional awareness. Furthermore, using ESM, we found that higher interoceptive attention was associated with increased strategy-situation fit in daily life. Specifically, individuals with higher interoceptive attention adopted more distraction than reappraisal, only during negative events of high intensity, whereas individuals with lower interoceptive attention indistinguishably used more distraction than reappraisal when dealing with negative life events—regardless of an event's intensity—likely reflecting a rigid regulatory style. Keeping in line with prominent theories, these findings taken together support the notion that interoceptive signals help application of ER strategies and selection of appropriate strategies tailored to a given situation (Craig, 2002; Damasio, 1996; James, 1884).

Higher interoceptive attention was associated with increased habitual use of several specific ER strategies including arousal control, reappraisal, and rumination. It is plausible that increased interoceptive attention would facilitate arousal control; attention to bodily signals shapes cognitive emotion regulation strategies including reappraisal and rumination, which is in accordance with several influential theories including embodied cognition and the somatic marker hypothesis (Barsalou, 2008; Damasio, 1996). In other words, higher bodily awareness may increase habitual application of ER strategies, both for strategies that are relatively adaptive (e.g., arousal control and reappraisal) and less adaptive (e.g., rumination). Findings are also consistent with other recent work examining the relationship between self-report interoceptive attention and habitual ER use (Schuette et al., 2021; Zamariola et al., 2019b). In contrast to the aforementioned ER strategies, higher interoceptive attention was also linked to decreased habitual use of distraction, suggesting that more attention to bodily signals related to emotions might make it difficult (or, alternatively, less necessary) to distract from emotions. The distraction strategy involves external attentional control systems (Kanske et al., 2011; McRae et al., 2010) and thus diverts attention away from internal visceral signals related to emotions (James, 1884; Pollatos et al., 2005), which may account for the negative associations between distraction and interoceptive attention. Although previous studies found interoceptive accuracy was positively correlated with suppression (Kever et al., 2015; Lischke et al., 2020; Pollatos et al., 2015), we did not find a significant association between interoceptive attention and suppression. The divergence between the findings in present and previous studies may reflect differing effects of various interoception sub-dimensions on ER strategy use (Calì et al., 2015; Garfinkel et al., 2016). The potential multidimensional nature of these interoception-ER associations, still need to be further clarified, as do potential underlying mechanisms of these associations. For example, the relations between different interoception sub-dimensions and various ER strategies need to be examined more thoroughly.

Our mediation models revealed that emotional awareness, in part, mediates the associations between interoceptive attention and habitual use of reappraisal, rumination, and arousal control. As expected, interoceptive attention is related to increased awareness of emotional states, which may in turn initiate use of reappraisal, rumination, and arousal control. This is in line with previous studies showing that individuals with higher interoceptive attention are better at emotion recognition, which is related to ER (Brewer et al., 2016; Murphy et al., 2017; Murphy et al., 2018). Despite these promising mediation model results, we should note that mediational and correlational analyses in cross-sectional data cannot fully capture causal mechanisms and the directionality of effects among variables, but merely provide evidence consistent with proposed causal models. For instance, it could still be that increased use of certain ER strategies improve emotional awareness and interoceptive attention, or that these relations are bidirectional; likewise, habitual use of ER strategies such as distraction or suppression might actively inhibit interoceptive attention and emotional awareness. Thus, further research should be done to investigate the direction and precise mechanisms of causation, when it comes to interoception, emotional awareness, and ER strategy use.

Perhaps most interestingly, we found an interaction between interoceptive attention and negative event intensity, in predicting ER strategy use. Namely, individuals who reported higher interoceptive attention used more distraction than reappraisal when the contexts were more negative due to negative life events, whereas individuals with lower interoceptive attention indistinguishably used more distraction than reappraisal, regardless of the negative intensity of the contexts. Previous studies have revealed that a preference for distraction rather than reappraisal is an optimal way for regulating strong negative emotion, so the tendency to modulate ER strategies as a function of contextual demands like event intensity may reflect a high level of ER flexibility and adaptive functioning (Sheppes et al., 2011). Therefore, our results demonstrate that individual differences in interoceptive attention could be an important factor in influencing individuals’ abilities to flexibly deploy ER strategies that meet specific situational demands. This result could be explained in the framework of ER flexibility proposed by Bonanno and Burton (2013). They propose three sequential components of flexibility: context sensitivity, repertoire of regulatory strategies, and response to feedback. The feedback consists of internal feedback such as bodily and emotional signals, as well as social feedback (Bonanno & Burton, 2013). The present study sheds light on one important form of internal feedback facilitating adaptive ER, namely increased bodily awareness. This is also consistent with previous empirical studies showing that increased interoceptive signals are associated with improved sensitivity of ER strategy selection to emotional intensity (Ardi et al; 2021; Birk & Bonanno, 2016). Our study extends this relation between interceptive attention and flexible use of ER strategies into actual daily life. Future work should examine the potential role of interoceptive attention and of strategy-situation matching, in the ER deficits documented among those with psychopathology (Sheppes et al., 2014; Wilson & Gilbert, 2008).

With the emergence of body-oriented interventions, the benefits of interoceptive attention are beginning to be explored. Our findings—which underscore the importance of interoception in emotion regulation—imply that training interoceptive attention may provide a promising way to improve individuals’ use of flexible and adaptive ER, in turn, leading to improvements in well-being and resilience (Bonanno, 2005; Kashdan & Rottenberg, 2010; Opitz et al., 2012). However, it should be noted that being overly focused on bodily sensations may result in somatization and anxiety (Dunn et al., 2010; Palser et al., 2018; Pollatos et al., 2007; Tan et al., 2018; Wang et al., 2020). Indeed, interoceptive attention was not only associated with greater use of reappraisal and arousal control in our current study, but was also positively associated with rumination, a key marker of depression and anxiety. When developing the MAIA, Mehling (2016) distinguished between hypervigilant attention to bodily sensations and mindful attention, with the latter being beneficial for emotional health; this highlights the importance of quality rather than just quantity, when determining the adaptiveness of interoception. Future studies are needed to investigate whether anxious attention to physiological signals may hamper flexible regulation of emotion and how mindfulness training might influence choice of ER strategies, considering that mindfulness promotes focused attention rather than distraction (Ardi et al; 2021; Mehling et al., 2013; Villemure et al., 2014).

Despite its strengths, the present study had several potential limitations worth noting. The sample consisted of university students and thus findings may not be applied to the broader general population or specific clinical groups. Future studies are needed to examine whether interoceptive ability may help regulate emotions in other populations such as teenagers or patients with mental health problems. Additionally, we only used trait questionnaire measures of interoceptive attention and emotional awareness, but it may be worthwhile to measure state interoceptive attention and emotional awareness and then examine the relationship between them and ER flexibility, as these processes may all three differ across various situations and life contexts. Third, future studies would benefit by incorporating physiological measurements related to emotions to complement self-reported data, which can provide more insights into the biological underpinnings of individual differences in emotion regulation. Fourth, this study did not include assessments of well-being or mental health/illness, which could help provide further support for an adaptive, functional role of interoceptive attention; future studies could examine whether interoceptive attention predicts daily well-being and resilience, which might be mediated through an impact on strategy-situation fit. Fifth, in the EMS procedure used for our sample, we measured ER use by participants during each set interval rather than in specific response to reported negative events, more follow-up work is needed. Finally, the concept of the strategy-situation fit needs to be extended to take into account the compatibility of ER strategies and additional specific situational characteristics, such as social contexts and regulatory goals (Benson et al., 2019; Eldesouky & English, 2019). More specifically, there may be a great discrepancy in the fit between ER preferences and contextual characteristics shaped by different cultural contexts. For example, contrary to the findings regarding ER choice within American samples, Indian people have shown a relative preference for reappraisal in processing high-intensity negative stimuli, which some have proposed may be related to common Indian religious beliefs (Mehta et al., 2017). Therefore, it is necessary to further investigate how the adaptive values of various strategy-situation combinations may vary across specific cultural and social contexts.

In summary, we investigated whether interoceptive attention might facilitate habitual use of ER strategies and flexible use of strategies to match contextual demands. Combining trait-level assessments with questionnaires and state-level measures with ESM, our findings indicated that interoceptive feedback may facilitate application of specific ER strategies and guide how one matches specific strategies to differing situations. Training interoceptive attention may provide a useful way to improve emotion regulation and poses a promising avenue for future work.

We thank Wolf Mehling, MD for reviewing and providing feedback on an earlier version of the manuscript. We also wish to acknowledge the assistance of Zhouqu Cai in data analysis.

Yafei Tan received support from the National Natural Science Foundation of China (32000747), and self-determined research funds of Central China Normal University from the colleges' basic research and operation of Ministry of Education of China (CCNU20TD001). Jiang Qiu received support from the National Natural Science Foundation of China (32071070), Natural Science Foundation of Chongqing (cstc2019jcyj-msxmX0520, cstc2020jcyj-msxmX0299), 111 program (B21036), the Research Program Funds of the Collaborative Innovation Center of Assessment toward Basic Education Quality at Beijing Normal University, the planned project of Chongqing humanities and Social Sciences (2018PY80, 2019PY51), Fundamental Research Funds for the Central Universities (SWU119007), Chang Jiang Scholars Program, National Outstanding Young People Plan and Chongqing Talent Program.