(PS7-33) Examination of Interoceptive Deficits in Individuals with Eating, Anxiety, and Comorbid Eating and Anxiety Psychopathology

Individuals with eating disorders exhibit a range of interoceptive deficits, including low trust in and hypervigilance of/worry about bodily sensations. Eating disorders and anxiety are highly comorbid and it is unclear to what extent these interoceptive deficits might be attributable to comorbid anxiety versus specific to eating pathology. The current study compared levels of interoceptive trust and hypervigilance/worry related to general (i.e., across bodily systems, e.g., cardiac, respiratory) and gastrointestinal-specific (GI) interoception among individuals with 1) elevated eating pathology only (Eating Pathology; n = 48), 2) elevated anxiety pathology only (Anxiety; n = 108), 3) comorbid eating and anxiety pathology (Comorbid; n = 61), and 4) no psychiatric elevations (i.e., no eating, anxiety, or depression; Healthy; n = 334). We anticipated that compared to the Healthy group, 1) the Eating Pathology group would exhibit worse GI-specific but not general trust and hypervigilance/worry, and 2) the Comorbid and Anxiety groups would exhibit comparable deficits in GI-specific and general interoceptive trust and hypervigilance/worry.

University students (n = 591; 53% women; < 45% Non-Hispanic White) reported general interoceptive trust and hypervigilance/anxiety (Multidimensional Assessment of Interoceptive Awareness – Body Trust subscale; Anxiety Sensitivity Index – Physical Concerns subscale) and GI-specific interoceptive trust and hypervigilance/worry (Intuitive Eating Scale – 2 Reliance on Hunger and Satiety Cues subscale; Visceral Sensitivity Index). Participants also reported their disordered eating (Eating Pathology Symptom Inventory) and anxiety (Generalized Anxiety Disorder – 7) symptoms. Four ANOVAs were run with Welch’s robust test and Games-Howell post hoc comparisons. The Benjamini-Hochberg procedure for false discovery rate was applied to control for multiple comparisons.

Significant group differences of medium to large effects (η² = .124-.237) were observed across all interoception variables (ps < .001). Partially consistent with hypotheses, compared to the Healthy group, the Eating Pathology group reported 1) elevated hypervigilance/worry about GI-specific, but not general body sensations and 2) elevated GI-specific and general body trust. As expected, the Comorbid and Anxiety groups reported similarly elevated hypervigilance/worry and lower trust for both general and GI-specific cues compared to the Healthy group. Generally, the Comorbid group reported worse general and GI-specific interoception than the Eating group. Findings suggest that both general and GI-specific interoceptive deficits may be worse in individuals with comorbid eating and anxiety concerns and highlight the need for idiographic treatment approaches for eating disorders based on comorbidities. GI-specific interoceptive exposures may be best for individuals who only present with eating pathology, but individuals with comorbid anxiety may benefit from interoceptive interventions that target different bodily systems (e.g., interventions to increase heart rate or induce sensations of hyperventilation). Findings should be replicated with both larger nonclinical and clinical samples.