The impact of traumatic childhood experiences on interoception: disregarding one’s own body

Abstract

Background Deficient interoception, the processing and perception of internal bodily signals, has been discussed as a mechanism underlying various mental disorders. First results indicate a mediating role of interoception in the interplay of traumatic childhood experiences and adult mental disorders. Traumatic childhood experiences may hinder the adequate processing, integration, and trust in bodily signals that are important in order to understand and regulate own needs and emotions, thereby increasing the vulnerability for mental disorders. However, an overarching study investigating alterations in different interoceptive measures and trauma-related disorders as well as their mediating role between early trauma and emotion dysregulation is still missing. Methods One hundred thirty-six individuals with varying levels of traumatic childhood experiences who either had a current diagnosis of major depression, posttraumatic stress disorder, or somatic symptom disorder, or no mental disorder, took part in a multidimensional assessment of interoceptive processes, including interoceptive accuracy, sensibility, and awareness. Kruskal–Wallis tests were used to compare groups regarding interoceptive processes and associations with traumatic childhood experiences and emotion dysregulation were analyzed with Spearman correlations. Furthermore, mediation analyses were computed to examine and compare interoceptive processes as potential mediators between traumatic childhood experiences and emotion dysregulation. Results Only body dissociation, a measure for interoceptive sensibility, was significantly reduced in individuals with a current mental disorder. Body dissociation was also the only interoceptive measure significantly associated with traumatic childhood experiences and emotion dysregulation and the only significant mediator in the relationship between traumatic childhood experiences and emotion dysregulation across groups. Conclusion Results suggest body dissociation, but not other interoceptive measures, as an important feature linking traumatic childhood experiences to current emotion dysregulation, an important transdiagnostic feature. As body dissociation refers to a habitual non-attendance or disregard of interoceptive signals, integrative therapeutic interventions could help affected individuals to overcome difficulties in emotion perception and regulation. Trial registration The general study design was preregistered; see the German Clinical Trials Register (DRKS-ID: DRKS00015182). This study’s analysis plan was not preregistered.

Out of touch? How trauma shapes the experience of social touch – neural and endocrine pathways

“…Decreased functional connectivity of the vestibular system with the PI in PTSD patients has been linked to weakened interoceptive awareness that subsequently may impede multisensory integration and facilitate a disengagement from their environment (Harricharan et al, 2017). This is in line with findings of body dissociation mediating the association between traumatic childhood experiences and emotional dysregulation (Schmitz et al, 2023).…”

“…In individuals with childhood maltreatment, decreased cardiac interoceptive accuracy after acute social stress or pharmacologically induced noradrenergic activation has been observed (Schaan et al, 2019;Schulz et al, 2022). However, another study was unable to find similar effects of childhood maltreatment on interoceptive measures besides body dissociation (Schmitz et al, 2023). When presented with negative emotional cues, female patients with PTSD showed increased reactivity in more posterior regions of the insula compared to controls that may mirror an interaction between an exaggerated generation of interoceptive anxiety cues and heightened anxiety symptoms (Bruce et al, 2013).…”

From early relational experiences to non-suicidal self-injury in anorexia and bulimia nervosa: a structural equation model unraveling the role of impairments in interoception

“…Similarly, early traumas appear to disrupt an individual's ability to sustain a connection with their internal states, yielding significant repercussions in later adulthood [ 40 ]. Consistently, neuroimaging studies have underscored the impact of exposure to TCEs in neural impairments in the interoceptive network, especially in the insula, medial prefrontal cortex and subcortical structures [ 72 , 73 ].…”

“…Indeed, the interoceptive configuration depends on the quality of synchronization in the attachment relationship established with the caregiver [ 39 ]. Similarly, recent findings have highlighted how TCEs can affect an individual's ability to stay connected with one’s own internal states [ 40 ]. In parallel, the extent to which an individual is able to detect and interpret body signals has been considered to influence the formation of emotional experiences and their regulation [ 41 , 42 ].…”

Insular dysfunction of interoception in major depressive disorder: from the perspective of neuroimaging

“…Secondly, research has emerged to explore the elements that have an effect on individual interoceptive ability. A recent study revealed that early life traumatic experiences may alter individual emotion regulation capacities by influencing their interoceptive functions (e.g., interoceptive sensibility) ( 125 ). Therefore, further research is necessary and beneficial for the study of MDD to explore the shaping and development of individual interoception throughout the lifespan and its influencing factors, as well as to delve deeper into the dynamic role of the brain insula in it.…”