Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 4;13(1):101.
doi: 10.1186/s40337-025-01255-5.

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

Lorenzo Moccia #  1   2 , Cassandra Serantoni #  3   4 , Marianna Ambrosecchia  5 , Eliana Conte  6 , Giuseppe Maulucci  3   4 , Delfina Janiri  6   7 , Georgios D Kotzalidis  6 , Vassilij Di Giorgio  8 , Fabio Conti  8 , Marco De Spirito  3   4 , Vittorio Gallese #  5   9 , Gabriele Sani #  6   7
Affiliations

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

Lorenzo Moccia et al. J Eat Disord. .

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.

Keywords: Anorexia Nervosa; Childhood abuse; Early adverse experiences; Eating disorders; Interoception; Restrictive type.

Plain language summary

Anorexia nervosa (AN) is a serious mental health disorder. It affects how people sense their body signals, including heartbeats. AN can interfere with the autonomic nervous system. It often occurs in those who experienced trauma during childhood. This study explored how childhood trauma and heart rate variability (HRV) impact interoceptive accuracy (IA), which is the ability to feel bodily signals, in people with AN. Researchers studied 25 people newly diagnosed with AN and 25 healthy individuals. They looked at IA using a specific task. They measured HRV before and after the task. They also used a questionnaire to assess childhood trauma. People with AN had lower IA. They also had more reactive HRV. Plus, they reported more childhood trauma, especially emotional neglect. Emotional neglect was also a strong predictor of IA impairments. The study shows that treatments focusing on how the body handles emotions may help people with eating disorders, especially those who faced childhood trauma.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study received approval from the UCSC Institutional Review Board (PROTOCOL ID: 2014). All participants provided written informed consent to be enrolled in the study. Consent for publication: Not applicable Competing Interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021;34(6):515–24. 10.1097/YCO.0000000000000739. - PMC - PubMed
    1. Fichter MM, Quadflieg N. Mortality in eating disorders - results of a large prospective clinical longitudinal study. Int J Eat Disord. 2016;49(4):391–401. 10.1002/eat.22501. - PubMed
    1. Plana-Ripoll O, Pedersen CB, Agerbo E, et al. A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study. Lancet. 2019;394(10211):1827–35. 10.1016/S0140-6736(19)32316-5. - PubMed
    1. Steinhausen HC. The outcome of anorexia nervosa in the 20th century. Am J Psychiatry. 2002;159(8):1284–93. 10.1176/appi.ajp.159.8.1284. - PubMed
    1. Himmerich H, Treasure J. Anorexia nervosa: diagnostic, therapeutic, and risk biomarkers in clinical practice. Trends Mol Med. 2024;30(4):350–60. 10.1016/j.molmed.2024.01.002. - PubMed

LinkOut - more resources