Role of childhood trauma in interoception and alexithymia in schizophrenia

Childhood trauma (CT) is a notable risk factor for schizophrenia. Separately, CT has been associated with alexithymia, referring to difficulties in identifying and describing one's own feelings, as well as disturbed interoception, referring to difficulties sensing and responding to signals that originate from within the body. Both self-perception impairments have been observed in schizophrenia; however, the role of CT in these observations in schizophrenia is unclear. To address this gap, interoception was assessed using the Multidimensional Assessment of Interoceptive Awareness (MAIA), alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20), and CT was measured using the Childhood Trauma Questionnaire (CTQ) in a sample of 73 patients with schizophrenia or schizoaffective disorder (SSD) and 50 healthy controls. Patients had higher TAS-20 total score compared to controls (F = 36.0, p < 0.001) but groups were not different on any of the MAIA subscales. Across the full sample, CTQ total score was correlated with MAIA "trusting" subscale (ρ = -0.26, p = 0.005), and with TAS total score (ρ = 0.22, p = 0.016). Moreover, the MAIA "trusting" relationship remained significant within the SSD group. CT is associated with decreased feelings of trust in bodily sensations in schizophrenia, similar to findings in other major psychiatric disorders.