Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variability

Abstract Background Anorexia nervosa, restricting subtype (AN-R), is a severe psychiatric disorder, with abnormal interoception, autonomic nervous system disturbances, and increased exposure to childhood traumatic experiences (CTEs), frequently observed as correlates. This is the first study explori...

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Main Authors: Lorenzo Moccia, Cassandra Serantoni, Marianna Ambrosecchia, Eliana Conte, Giuseppe Maulucci, Delfina Janiri, Georgios D. Kotzalidis, Vassilij Di Giorgio, Fabio Conti, Marco De Spirito, Vittorio Gallese, Gabriele Sani
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Journal of Eating Disorders
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Online Access:https://doi.org/10.1186/s40337-025-01255-5
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Summary:Abstract Background Anorexia nervosa, restricting subtype (AN-R), is a severe psychiatric disorder, with abnormal interoception, autonomic nervous system disturbances, and increased exposure to childhood traumatic experiences (CTEs), frequently observed as correlates. This is the first study exploring the impact of CTEs and heart rate variability (HRV; i.e., an index reflecting parasympathetic arousal) on interoceptive accuracy (IA; i.e., the ability to track changes in bodily signals) in AN. Methods Twenty-five patients with AN-R within a year of onset and 25 matched healthy controls were recruited. IA was assessed through the heart beat detection task. HRV was measured before and after the task. Participants also completed the Childhood Trauma Questionnaire. We performed a to detect significant differences between groups in HRV reactivity and IA, and a linear regression to test the effect of factors of interest on IA. Results Patients with AN-R displayed significantly increased HRV reactivity and decreased IA compared to HCs. They also reported significantly more CTEs. Furthermore, childhood emotional neglect significantly predicts IA impairments. Conclusions Although the pathway linking emotional neglect to abnormal interoception in AN-R remains to be clarified, an embodiment-informed framework may show promise in the treatment of individuals with eating disorders who experienced childhood maltreatment.
ISSN:2050-2974