Interoceptive Awareness, Perceived Stress, and Physical Performance in Sport Sciences Students

Examining the Relationships Between Interoceptive Awareness, Perceived Stress, and Physical Performance Indicators: The Moderator Role of Gender and Sport Type

This cross-sectional observational study examined the relationships between interoceptive awareness, perceived stress, state and trait anxiety, sleep quality, and physical performance indicators in university-level sport sciences students. A total of 85 undergraduate students (54 males, 31 females; mean age = 20.65 ± 2.43 years) from the Faculty of Sport Sciences at Inonu University participated. Participants completed self-report measures (MAIA-2, PSS-10, STAI, PSQI) and a physical performance battery including handgrip strength, countermovement jump, sit-and-reach flexibility, and Y-Balance test. The study also investigated the moderator role of gender and sport type (team vs. individual) in these relationships, and tested the parallel mediating roles of perceived stress, trait anxiety, and sleep quality using PROCESS Model 4 with 5,000 bootstrap resamples.

Study Overview

• Status: Completed
• Conditions: Anxiety; Sleep Quality; Athletic Performance; Interoception; Perceived Stress; Physical Performance
• Intervention / Treatment: Other: Psychological and Physical Performance Assessment Battery

Detailed Description

Background: Interoceptive awareness - the perception, interpretation, and regulation of internal bodily signals - has emerged as a psychological resource relevant to sport performance and mental health. However, empirical evidence linking interoceptive awareness to objective physical performance outcomes in athletic populations remains limited, particularly regarding potential psychological mediators such as perceived stress, anxiety, and sleep quality.

Objectives: The primary objective of this study was to examine the direct and mediated relationships between interoceptive awareness and physical performance indicators in university sport sciences students. The secondary objectives were to investigate (a) the parallel mediating roles of perceived stress, trait anxiety, and sleep quality; and (b) the differences in study variables based on gender and sport type (team vs. individual).

Methods: This cross-sectional observational study included 85 undergraduate students (54 males, 31 females) enrolled at the Faculty of Sport Sciences, Inonu University. Data collection was conducted between May 11 and May 17, 2026. Psychological measures included the Multidimensional Assessment of Interoceptive Awareness (MAIA-2), the Perceived Stress Scale (PSS-10), the State-Trait Anxiety Inventory (STAI), and the Pittsburgh Sleep Quality Index (PSQI). Physical performance was assessed via handgrip strength (digital dynamometer), countermovement jump (My Jump 2 mobile application), sit-and-reach flexibility, and Y-Balance test (composite score). Statistical analyses included Pearson correlation, independent samples t-tests, hierarchical multiple regression, and parallel multiple mediation analysis (Hayes PROCESS Model 4; 5,000 bootstrap resamples).

Expected Outcomes: The study aims to clarify whether interoceptive awareness contributes to physical performance directly or indirectly through psychological mediators, and to determine whether such relationships are moderated by demographic and sport-related factors.

• Study Type: Observational
• Enrollment (Actual): 85

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Malatya
    • Malatya, Malatya, Turkey (Türkiye), 44280
      • Inonu University, Faculty of Sport Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Undergraduate students enrolled at the Faculty of Sport Sciences, Inonu University, Malatya, Turkey. The sample comprised 85 participants (54 males, 31 females; mean age = 20.65 ± 2.43 years) with diverse sport backgrounds, including team-sport athletes (n = 44), individual-sport athletes (n = 32), and students not actively participating in a specific sport branch (n = 9). Participants were recruited via convenience sampling during the Spring 2026 semester.

Description

Inclusion Criteria:

• Enrollment as an undergraduate student at the Faculty of Sport Sciences, Inonu University
• Age 18 years or older
• Voluntary willingness to participate in the study
• Provision of written informed consent
• Absence of acute injury or illness on the day of measurement

Exclusion Criteria:

• Acute musculoskeletal injury or illness at the time of measurement
• Failure or refusal to provide written informed consent
• Incomplete data on primary study measures
• Any contraindication to physical performance testing

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Sport Sciences Students; Undergraduate students enrolled at the Faculty of Sport Sciences, Inonu University. Participants included both team-sport athletes (n = 44) and individual-sport athletes (n = 32), with an additional 9 participants who did not report an active sport branch. Mean age was 20.65 ± 2.43 years (54 males, 31 females).

Other: Psychological and Physical Performance Assessment Battery; Participants completed a battery of self-report psychological measures (MAIA-2, PSS-10, STAI State-Trait, PSQI) followed by a standardized physical performance testing session including handgrip strength (digital dynamometer), countermovement jump (My Jump 2 mobile application), sit-and-reach flexibility test, and Y-Balance test. All assessments were conducted in a single 45-minute session per participant.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Interoceptive Awareness - MAIA-2 Total Score	Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2) total score. The MAIA-2 is a 37-item self-report questionnaire assessing eight dimensions of interoceptive awareness (Noticing, Not-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Self-Regulation, Body Listening, Trusting). Higher scores indicate greater interoceptive awareness. Total score is calculated as the mean of all 37 items (range: 0-5).	Single measurement at baseline (cross-sectional)
Handgrip Strength	Maximal handgrip strength (kg) measured using a digital hand dynamometer (Baseline Model 12-0286). Participants performed three trials with the dominant hand in a standing position with the elbow in full extension. The highest of three trials was recorded, with 30-second rest between trials.	Single measurement at baseline (cross-sectional)
Sit-and-Reach Flexibility	Dynamic balance and neuromuscular control assessed using the Y-Balance Test. Participants reached in anterior, posteromedial, and posterolateral directions while standing on one leg. Composite scores (%) were calculated for both right and left legs, normalized to leg length.	Single measurement at baseline (cross-sectional)
Countermovement Jump Height	Vertical jump height (cm) assessed using the My Jump 2 mobile application, a validated iPhone-based tool for measuring jump performance. Participants performed three maximal countermovement jumps with hands on hips and knee flexion of approximately 90°. The highest value was recorded, with 60-second rest between trials.	Single measurement at baseline (cross-sectional)
Y-Balance Test Composite Score	Dynamic balance and neuromuscular control assessed using the Y-Balance Test. Participants reached in anterior, posteromedial, and posterolateral directions while standing on one leg. Composite scores (%) were calculated for both right and left legs, normalized to leg length.	Single measurement at baseline (cross-sectional)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
State Anxiety - STAI-S Total Score	State Anxiety subscale of the State-Trait Anxiety Inventory (STAI-S) total score. Consists of 20 items rated on a 4-point Likert scale, assessing current anxiety level. Higher scores indicate higher state anxiety (range: 20-80).	Single measurement at baseline (cross-sectional)
Trait Anxiety - STAI-T Total Score	Trait Anxiety subscale of the State-Trait Anxiety Inventory (STAI-T) total score. Consists of 20 items rated on a 4-point Likert scale, assessing general tendency toward anxiety. Higher scores indicate higher trait anxiety (range: 20-80).	Single measurement at baseline (cross-sectional)
Sleep Quality - PSQI Global Score	Pittsburgh Sleep Quality Index (PSQI) global score. Assesses sleep quality over the past month across seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Global score ranges from 0 to 21, with scores greater than 5 indicating poor sleep quality.	Single measurement at baseline; assesses sleep quality during the past month.
Perceived Stress - PSS-10 Total Score	Perceived Stress Scale, 10-item version (PSS-10) total score. Assesses the degree to which participants perceived life events as stressful during the past month. Items are rated on a 5-point Likert scale (0 = never to 4 = very often); items 4, 5, 7, and 8 are reverse-scored. Higher scores indicate higher perceived stress (range: 0-40).	Single measurement at baseline; assesses stress experienced during the past month.

Collaborators and Investigators

• Sponsor: Inonu University

Publications and helpful links

General Publications

• Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available.
• Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
• Mehling WE, Acree M, Stewart A, Silas J, Jones A. The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLoS One. 2018 Dec 4;13(12):e0208034. doi: 10.1371/journal.pone.0208034. eCollection 2018.
• Pluhar E, McCracken C, Griffith KL, Christino MA, Sugimoto D, Meehan WP 3rd. Team Sport Athletes May Be Less Likely To Suffer Anxiety or Depression than Individual Sport Athletes. J Sports Sci Med. 2019 Aug 1;18(3):490-496. eCollection 2019 Sep.
• Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, Feusner JD, Garfinkel SN, Lane RD, Mehling WE, Meuret AE, Nemeroff CB, Oppenheimer S, Petzschner FH, Pollatos O, Rhudy JL, Schramm LP, Simmons WK, Stein MB, Stephan KE, Van den Bergh O, Van Diest I, von Leupoldt A, Paulus MP; Interoception Summit 2016 participants. Interoception and Mental Health: A Roadmap. Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Jun;3(6):501-513. doi: 10.1016/j.bpsc.2017.12.004. Epub 2017 Dec 28.
• Balsalobre-Fernandez C, Glaister M, Lockey RA. The validity and reliability of an iPhone app for measuring vertical jump performance. J Sports Sci. 2015;33(15):1574-9. doi: 10.1080/02640414.2014.996184. Epub 2015 Jan 2.
• Farb N, Daubenmier J, Price CJ, Gard T, Kerr C, Dunn BD, Klein AC, Paulus MP, Mehling WE. Interoception, contemplative practice, and health. Front Psychol. 2015 Jun 9;6:763. doi: 10.3389/fpsyg.2015.00763. eCollection 2015.
• Forkmann T, Scherer A, Meessen J, Michal M, Schachinger H, Vogele C, Schulz A. Making sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy. Int J Psychophysiol. 2016 Nov;109:71-80. doi: 10.1016/j.ijpsycho.2016.09.019. Epub 2016 Oct 1.

Study record dates

Study Major Dates

• Study Start (Actual): May 11, 2026
• Primary Completion (Actual): May 17, 2026
• Study Completion (Actual): May 17, 2026

Study Registration Dates

• First Submitted: July 6, 2026
• First Submitted That Met QC Criteria: July 6, 2026
• First Posted (Actual): July 10, 2026

Study Record Updates

• Last Update Posted (Actual): July 10, 2026
• Last Update Submitted That Met QC Criteria: July 6, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Pittsburgh Sleep Quality Index; Interoceptive awareness; Gender differences; Handgrip strength; Perceived Stress Scale; Y-Balance test; Mediation analysis; State-Trait Anxiety; Team sports; Countermovement jump; MAIA-2; Sit-and-reach; Sport sciences students; Individual sports
• Additional Relevant MeSH Terms: Nervous System Diseases; Mental Disorders; Sleep Wake Disorders; Sleep Disorders, Intrinsic; Dyssomnias; Anxiety Disorders; Sleep Initiation and Maintenance Disorders
• Other Study ID Numbers: 2026/9991

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No