Objective: This proof-of-concept study explores the role of aberrant interoception as a possible mechanism underlying restrictive eating symptoms in avoidant/restrictive food intake disorder (ARFID) compared to anorexia nervosa (AN) and healthy comparisons (HC).
Method: We report preliminary normative adolescent interoceptive data in HCs (n = 100) compared to adolescents with ARFID (n = 30) and AN (N = 23). Adolescents (12-18) participated in a one-time virtual visit to assess heartrate guessing accuracy (interoceptive accuracy), correlation between confidence in heartrate guess and accuracy (interoceptive awareness), and self-reported interoception (interoceptive sensibility).
Results: HC adolescents had comparable interoceptive outcomes relative to published adult norms, consistent with existing literature. Data suggest that adolescents with ARFID have poor heartbeat guessing accuracy and experience challenges deciphering interoceptive signals, possibly contributing to symptoms. While adolescents with AN have greater heartbeat guessing accuracy, they cite difficulty trusting body cues, perhaps contributing to their lack of confidence in interoceptive cue detection.
Conclusions: Preliminary results reflect differences in interoception between the three groups.
Keywords: ARFID; Adolescent; Anorexia nervosa; Interoception.
In this study, we wanted to understand how individuals with restrictive eating disorders, like avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN), sense and respond to different signals in their body, such as heartbeat. This process is called interoception. Difficulty sensing body signals can lead to various mental health disorders, such as eating disorders. We asked adolescent participants without an eating disorder and adolescents with ARFID and AN to guess their heartbeat while wearing a finger pulse oximeter, to track interoceptive accuracy (or how accurate their heartbeat guesses were). We also measured their self-reported sense of interoception and overall metacognitive awareness of their ability to accurately interpret body signals. Our data replicate findings in existing healthy teenagers. For teens with eating disorders, those with ARFID had difficulty with interoceptive accuracy and listening to their bodies, but they had good awareness overall of their accuracy. Teens with AN had better accuracy but were more unsure about trusting their body and body signaling. Overall, our initial findings suggest that how individuals with eating disorders sense, interpret, and respond to body signals might help explain their eating habits. More research is needed in this area.
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