(PS8-A5) Interoceptive Sensibility Bridges Post-traumatic Stress Disorder and Eating Disorder Symptoms

Post-traumatic stress disorder (PTSD) and eating disorders (EDs) are highly comorbid, with an estimated 25% of individuals with EDs meeting diagnostic criteria for PTSD and 20% of individuals with PTSD meeting criteria for an ED (Ferrell et al., 2020). Yet, the mechanisms underlying this comorbidity are not well understood. Both PTSD and EDs are characterized by disturbances in interoceptive sensibility (i.e., one’s subjective experience of internal body sensations; Bruch, 1962; Forkmann et al., 2016; Wald & Taylor, 2008). Disturbances in interoceptive sensibility may be a risk factor for EDs among trauma survivors and/or may be a mechanism by which PTSD and ED symptomatology maintain each other. The current study used network analysis to examine whether facets of interoceptive sensibility (e.g., noticing sensations, worrying about sensations, trusting one’s body sensations) were bridge pathways between PTSD and ED symptoms. Study aims, hypotheses, and analyses were preregistered on the Open Science Framework. Undergraduate students (N = 995) completed an online survey including measures of PTSD symptoms, ED symptoms, and interoceptive sensibility. A glasso network was estimated with 17 PTSD symptoms, 13 ED symptoms, and 8 facets of interoceptive sensibility. Bridge strength centrality was calculated to identify the nodes that formed bridges between the communities of PTSD symptoms, ED symptoms, and facets of interoceptive sensibility. Results indicated that the network nodes with the highest bridge strength were the interoceptive sensibility facets body mistrust, worrying about sensations, and distracting from sensations. Bridge pathways showed potential connections between PTSD-related feelings of disconnection or numbness, body mistrust, and ED behaviors and cognitions, as well as potential connections between PTSD-related anxiety, concern about body sensations, and ED-related food and social fears. These findings provide insight into symptom-level connections between PTSD and EDs and how interoceptive sensibility may contribute to PTSD-ED comorbidity. Future research in clinical populations and using intensive longitudinal methods should clarify temporal relationships among experiences of interoceptive sensations, PTSD symptoms, and ED symptoms, to ultimately inform interventions aimed at disrupting pathways among PTSD and ED symptoms.