Interoceptive patterns and alexithymia in adolescents with anorexia nervosa

Alexithymia is a central concept in understanding the psychological vulnerability to eating disorders. Associations between alexithymia and distinct components of interoception have previously been reported in healthy individuals and those with mental health problems. From a therapeutic perspective, it is important to determine whether such associations exist for adolescents with anorexia nervosa and which domains of interoception (i.e., accuracy [IAc], awareness [IAw], and sensibility [ISe]) are concerned.

A cross-sectional study was conducted on twenty 12-17-year-old hospitalized adolescent girls with restrictive anorexia nervosa (M=14years±1.59, mean BMI of 15.59). The heartbeat detection task (HBDT) assessed IAc and IAw. The Porges Body Perception Questionnaire (PBPQ) was used for ISe, the Children-Toronto Alexithymia Scale (CTAS) for alexithymia, alongside the Child Depressive Inventory (CDI) for depression, the ECAP for anxiety, and the Difficulties in Emotion Regulation Scale-Youth scale (DERS-Y) for emotional dysregulation.

The error rate at the HBDT was negatively correlated with the CTAS sub score "Externally-oriented thinking" but no other CTAS sub scores or other clinical dimensions. The association between IAw and the CTAS sub-score "Externally-oriented thinking" failed to remain significant after Bonferroni correction. The PBPQ total score was positively correlated with the CDI total score and the ECAP fear sub score.

Among adolescents hospitalized for anorexia nervosa, the more accurate the detection of heart rate, the more frequently operative thinking was reported, while a high level of ISe was associated with anxiety and depression-related symptoms. The mechanisms underlying the relation between the discrimination of body perception and emotional processing may vary across psychiatric disorders.