Interoceptive accuracy, emotion recognition, and emotion regulation in preschool children

Little is known about the conscious experience of internal bodily sensations in preschool-aged children. Given that preschoolers are in the most rapid phase of brain development, and display profound emotional development, it was the aim of the present study to establish an adapted interoceptive accuracy paradigm and to investigate associations between sociodemographic (age, sex) and emotional variables with interoceptive accuracy. Forty-nine children (aged 4-6 years) completed the jumping jack paradigm (JJP), a heartbeat tracking paradigm, which includes a noninvasive physical perturbation via performing jumping jacks for 10 s. An interoceptive accuracy score was based on the comparison between self-reported and objectively recorded heart rate prior to and after completion of jumping jacks. Children also completed validated measures for emotion recognition and emotion regulation. Children's objectively recorded heart rate significantly increased after the JJP by 20 bpm on average. There was a positive relationship between reactivity on self-reported heart rate and objectively recorded heart rate increase. The derived scores for interoceptive accuracy increased with age, suggesting older children to report more self-reported heart rate change than objectively recorded, but were unrelated to children's sex or BMI. While emotion recognition and regulation significantly increased with age, the interoceptive accuracy score was unrelated to emotion recognition, but marginally associated to emotion regulation. Children with higher interoceptive accuracy score (i.e., self-reporting more heart rate change than objectively recorded) received lower emotion regulation score. The present study is the first to depict a novel behavioral paradigm to assess interoceptive accuracy in preschool-aged children.