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The Association Between Alexithymia, Interoception, and Pain in Pediatric Chronic Pain: A Systematic Review
Alisha Bruton1, Hayleigh Ast1, Jacqueline R O'Brien2
1Center for Mental Health Innovation, Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA.
Integrative Medicine Reports
|October 27, 2025
Summary
Children with chronic pain may experience increased alexithymia (difficulty identifying/describing emotions) and interoceptive impairment. Further research is needed to understand these factors for better pediatric pain management.
Area of Science:
- Psychology
- Pediatrics
- Pain Management
Background:
- Pediatric chronic pain significantly impacts emotional, psychological, and social functioning.
- Interoception (noticing internal body sensations) and alexithymia (difficulty identifying/communicating emotions) are potential contributing factors, observed in adults.
- These factors may influence the development, maintenance, and management of chronic pain in children.
Purpose of the Study:
- To investigate alterations in interoception and alexithymia in pediatric chronic pain populations.
- To synthesize existing evidence on the relationship between alexithymia, interoception, and chronic pain in children and adolescents.
Main Methods:
- A systematic literature search was conducted across multiple databases (CINAHL, PsycINFO, PubMed/MEDLINE, Scopus, Google Scholar).
- Included studies focused on participants aged 18 years or younger with chronic pain, assessing alexithymia or interoception.
- Study screening, data extraction, and risk of bias assessment followed PRISMA guidelines and the Newcastle-Ottawa Scale.
Main Results:
- Fourteen studies on alexithymia in pediatric chronic pain were identified; six of eight studies reported significantly higher alexithymia symptoms in the pain group.
- Alexithymia symptoms correlated with pain bother and interference, but not pain intensity.
- Two studies on interoception indicated an association between decreased self-reported interoception and higher chronic pain.
Conclusions:
- Findings suggest a potential increase in alexithymia symptoms among children and adolescents with chronic pain.
- Limitations include incomplete reporting and inconsistent measures, reducing evidence certainty.
- Further research is crucial to elucidate the roles of interoception and alexithymia in pediatric pain for improved mitigation and treatment strategies.
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