Early maltreatment and interoceptive awareness in youth: Associations among age, sex and child sexual abuse

Abstract

Background: Early maltreatment negatively impacts interoceptive awareness (IA), the attention to internal states and bodily sensations in daily life. Body trust, the belief that one can rely on internal bodily sensations as safe and accurate cues for needs, emotions, and states of arousal, is especially compromised. Although this has significant implications for for emotional regulation, self-awareness, and treatment limited research has examined IA in clinical samples of maltreated youth. Objective: The purpose of this study was to examine age and sex related differences in interoceptive awareness in a clinical sample of youth receiving treatment for complex trauma. A second aim was to examine the relationship between substantiated child sexual abuse (CSA) and body trust. Participants and setting: Data are from a clinical sample of 131 maltreated youth (ages 7–17) receiving therapeutic services for abuse and neglect. Mean age of 12 years, with 54 % female and 80 % in adoptive or guardian care. Methods: The study involved a secondary analysis of Multidimensional Assessment of Interoceptive Awareness-Youth (MAIA-Y) cross-sectional data. Two-way ANOVAs examined main and interaction effects for age and sex on five MAIA-Y scales. Linear regression analyzed the relationship between CSA and body trust. Results: Attention Regulation (p = .03, η2p = .04) was significantly higher in the older age group (11–17). Significant age by sex interactions emerged for Attention Regulation (p = .025, η2p = .04), Self-Regulation (p =.02, η2p = .04), and Trusting (p < .001, η2p = .11). Adolescent females (11–17) scored significantly lower than males and younger females on all three measures. CSA uniquely explained a proportion of low body trust scores (p = .005, R2 = .07). Conclusions: Adolescent females with early maltreatment demonstrate unique vulnerabilities in self-regulatory aspects of interoceptive awareness. These findings underscore the need for developmentally sensitive, gender specific interventions that prioritize restoration of body trust and self-regulatory aspects of interoceptive awareness in trauma treatment.