Interoceptive awareness in anorexia nervosa

Interoceptive awareness - the sense and awareness of the internal state of our bodies - has been of increasing interest in anorexia nervosa (AN) given the observation that people with AN do not respond appropriately to hunger cues. Despite the interest in the area, very little research has been undertaken to specifically assess interoceptive awareness in AN. The aim of this study was to explore levels of interoceptive awareness in individuals at different stages of AN, as well as first-degree relatives. Eighty participants were compared on self-reported interoceptive awareness using the Multidimensional Assessment of Interoceptive Awareness (MAIA), including participants with a current diagnosis of AN (c-AN), individuals who were weight-restored from AN (wr-AN), biological sisters of individuals with AN (AN-sis), and healthy controls (HC). Significant group differences were found for the noticing, not-distracting, self-regulation and trusting subscales of the MAIA; but not for the not-worrying, attention regulation, emotional awareness or body listening subscales. Specifically, wr-AN and AN-sis scored higher on the noticing subscale than HC; c-AN and wr-AN scored lower on the not-distracting subscale than HC; and the c-AN group showed lower scores on the self-regulation and trusting subscales than other groups. The results suggest that specific aspects of interoceptive awareness such as increased awareness of body sensations and reduced trusting of one's body, may relate to AN symptomatology such as ignoring hunger cues, and may represent trait factors that increase the risk of developing AN.