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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author 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
author_facet 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
author_sort Lorenzo Moccia
collection DOAJ
description 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.
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spelling doaj-art-5f7c9defa7014e98811b3f3541bd4dbc2025-08-20T03:10:27ZengBMCJournal of Eating Disorders2050-29742025-06-0113111110.1186/s40337-025-01255-5Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variabilityLorenzo Moccia0Cassandra Serantoni1Marianna Ambrosecchia2Eliana Conte3Giuseppe Maulucci4Delfina Janiri5Georgios D. Kotzalidis6Vassilij Di Giorgio7Fabio Conti8Marco De Spirito9Vittorio Gallese10Gabriele Sani11Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro CuoreDepartment of Neuroscience, Section of Physics, Università Cattolica del Sacro CuoreDepartment of Medicine and Surgery, Unit of Neuroscience, University of ParmaDepartment of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro CuoreDepartment of Neuroscience, Section of Physics, Università Cattolica del Sacro CuoreDepartment of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro CuoreDepartment of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro CuoreIstituto Di Neuroscienze, Neomesia Kos GroupIstituto Di Neuroscienze, Neomesia Kos GroupDepartment of Neuroscience, Section of Physics, Università Cattolica del Sacro CuoreDepartment of Medicine and Surgery, Unit of Neuroscience, University of ParmaDepartment of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro CuoreAbstract 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.https://doi.org/10.1186/s40337-025-01255-5Eating disordersAnorexia NervosaRestrictive typeEarly adverse experiencesChildhood abuseInteroception
spellingShingle 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
Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variability
Journal of Eating Disorders
Eating disorders
Anorexia Nervosa
Restrictive type
Early adverse experiences
Childhood abuse
Interoception
title Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variability
title_full Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variability
title_fullStr Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variability
title_full_unstemmed Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variability
title_short Interoceptive impairments in early-stage anorexia nervosa: exploring the impact of childhood trauma and heart rate variability
title_sort interoceptive impairments in early stage anorexia nervosa exploring the impact of childhood trauma and heart rate variability
topic Eating disorders
Anorexia Nervosa
Restrictive type
Early adverse experiences
Childhood abuse
Interoception
url https://doi.org/10.1186/s40337-025-01255-5
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