Abstract
BackgroundPrevious research on whether interoception is altered in anorexia nervosa (AN) using the heartbeat tracking task has yielded inconsistent results. However, no previous research has examined whether interoception is associated with alexithymia and autistic traits in AN, conditions which are more prevalent in this population and thought to be related to performance in this task. The aim of this study was to explore whether altered interoception in AN is associated with alexithymia and autistic traits.MethodsWe assessed interoceptive accuracy using the heartbeat tracking task in n = 37 people with AN, and n = 37 age and gender matched healthy controls (HC), and explored within the AN group if interoceptive accuracy was related to self-rated alexithymia or autistic traits. We also assessed self-reported interoceptive ability, and the relationship between subjective and actual performance.ResultsHeartbeat tracking task performance was not found to be altered in the AN group compared to the HC group. However, confidence ratings in task performance in the AN group were lower compared to the HC group. Unlike the HC group, confidence ratings in the AN group did not correlate with task performance. Within the AN group there was no relationship between interoceptive accuracy, alexithymia, and autistic traits, after controlling for the potential confounders of anxiety and depression. There was a relationship between confidence ratings and illness severity in the AN group.ConclusionThe results found no differences between heartbeat tracking task performance in people with AN compared to HC. There was no association between task performance, alexithymia and autistic traits in AN. Results do suggest that people with AN exhibit lowered confidence in their task performance, and that they may lack insight into this performance compared to HC. The findings are discussed in the context of potential significant limitations of the heartbeat tracking task, with recommendations for future research into interoception in AN.
Highlights
Anorexia nervosa (AN) is an eating disorder (ED) characterized by the restriction of energy intake resulting in low body weight, a resistance to weight gain, and altered body image [1]
As the aim of this study was to explore whether heartbeat tracking task performance could be related to alexithymia and autistic traits in AN, the current study has continued to use this method
Three participants with AN reported a prior diagnosis of autism
Summary
Anorexia nervosa (AN) is an eating disorder (ED) characterized by the restriction of energy intake resulting in low body weight, a resistance to weight gain, and altered body image [1]. Research on AN suggested that this food restriction, and associated symptoms such as altered body image and problems identifying emotions, may be driven by a difficulty detecting internal bodily sensations [2]. This concept of sensitivity to bodily stimuli has come to be understood under the wider term of interoception, or “the sense of the physiological condition of the entire body” [3]. No previous research has examined whether interoception is associated with alexithymia and autistic traits in AN, conditions which are more prevalent in this population and thought to be related to performance in this task. The aim of this study was to explore whether altered interoception in AN is associated with alexithymia and autistic traits
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