Nausea and disgust as aversive interoceptive signals in psychopathology.
Abstract
Background: Disruptions in reinforcement learning are reliably seen across psychiatric disorders. Yet the origins of reinforcement learning are in interoceptive signals: we learn to pursue primary interoceptive rewards, such as calories, or avoid primary interoceptive punishments, such as nausea. Interoceptive punishments may drive diverse aspects of psychopathology, from enhanced disgust processing in obsessive compulsive disorder to restricted eating behaviour in anorexia nervosa.
Aims: To determine the role of interoceptive punishments in psychopathology, we tested a) whether the experience of the interoceptive punishment of nausea covaried with psychiatric symptoms and b) whether learning about a close proxy of interoceptive punishment—disgust—predicted psychopathology.
Method: In a large representative sample (n=308), recruited online, participants completed a battery of questionnaires, on which we conducted a factor analysis, and a learning task, to which we fit computational reinforcement learning models. This enabled us to quantify both disgust-related and unrelated psychopathology as well as reinforcement learning measures from disgust-based, fear-based and points- based outcomes.
Results: Self-report measures of nausea were strongly and generally predictive of psychopathology, unexpectedly spanning nearly all symptoms and syndromes. A similar pattern emerged for self-reported disgust. This suggests that enhanced experience of interoceptive punishment is a general feature of psychiatric symptomatology. Additionally, a subset of questionnaires (contamination OCD, blood-injury phobia and spider phobia) related to computationally-derived measures of behaviour on a disgust-learning task, indicating a potential mechanism of interoceptive punishment learning.
Conclusions: These findings provide insight into a previously-unexplored symptom of mental health problems, nausea, and demonstrate a potential mechanism by which aversive interoceptive learning may contribute to psychopathology, revealing a new potential interoceptive treatment target.
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BibTeX
@misc{bagley2026nausea,
title = {{Nausea and disgust as aversive interoceptive signals in psychopathology.}},
author = {Emily Bagley and Camilla Nord},
howpublished = {PsyArXiv},
year = {2026},
month = sep,
doi = {10.31234/osf.io/vsgck_v1},
url = {https://osf.io/preprints/psyarxiv/vsgck_v1/},
note = {CC0},
}
RIS
TY - UNPB
TI - Nausea and disgust as aversive interoceptive signals in psychopathology.
AU - Emily Bagley
AU - Camilla Nord
PY - 2026
DA - 2026/09/28
PB - PsyArXiv
DO - 10.31234/osf.io/vsgck_v1
UR - https://osf.io/preprints/psyarxiv/vsgck_v1/
AB - Background: Disruptions in reinforcement learning are reliably seen across psychiatric disorders. Yet the origins of reinforcement learning are in interoceptive signals: we learn to pursue primary interoceptive rewards, such as calories, or avoid primary interoceptive punishments, such as nausea. Interoceptive punishments may drive diverse aspects of psychopathology, from enhanced disgust processing in obsessive compulsive disorder to restricted eating behaviour in anorexia nervosa. Aims: To determine the role of interoceptive punishments in psychopathology, we tested a) whether the experience of the interoceptive punishment of nausea covaried with psychiatric symptoms and b) whether learning about a close proxy of interoceptive punishment—disgust—predicted psychopathology. Method: In a large representative sample (n=308), recruited online, participants completed a battery of questionnaires, on which we conducted a factor analysis, and a learning task, to which we fit computational reinforcement learning models. This enabled us to quantify both disgust-related and unrelated psychopathology as well as reinforcement learning measures from disgust-based, fear-based and points- based outcomes. Results: Self-report measures of nausea were strongly and generally predictive of psychopathology, unexpectedly spanning nearly all symptoms and syndromes. A similar pattern emerged for self-reported disgust. This suggests that enhanced experience of interoceptive punishment is a general feature of psychiatric symptomatology. Additionally, a subset of questionnaires (contamination OCD, blood-injury phobia and spider phobia) related to computationally-derived measures of behaviour on a disgust-learning task, indicating a potential mechanism of interoceptive punishment learning. Conclusions: These findings provide insight into a previously-unexplored symptom of mental health problems, nausea, and demonstrate a potential mechanism by which aversive interoceptive learning may contribute to psychopathology, revealing a new potential interoceptive treatment target.
ER -