Interoception and borderline personality disorder in female adolescents with restrictive eating disorders
- 1Department of Child Neuropsychiatry, Fondazione IRCCS San Gerardo Dei Tintori
- 2School of Medicine and Surgery, Università degli Studi di Milano – Bicocca
Abstract
Purpose Interoception has been reported to be impaired in patients with restrictive eating disorders (REDs), while its role in patients with borderline personality disorder (BPD) is more controversial. We set out to conduct a clinical study to explore the relationship between interoception, eating disorders, and BPD. Methods We recruited a sample of 75 female adolescents affected by REDs, of whom 21 received a diagnosis of comorbid BPD. In addition to collecting demographic and clinical data, we administered measures of interoceptive awareness (MAIA-2), the scale for eating symptomatology (EDI-3), and alexithymia (TAS-20) to all patients. Results Patients with REDs and comorbid BPD reported lower scores on the MAIA-2 Not-Distracting (p = 0.046) and Trusting (p = 0.023) subscales, reflecting decreased focus and reliance on bodily sensations of pain or discomfort compared to patients with REDs only. Lower scores on the MAIA-2 Trusting subscale were associated with higher scores on all EDI-3 subscales and on the total TAS-20 scale (p = 0.005), whereas lower scores on the MAIA-2 Not-Worrying subscale were associated with higher scores on the EDI-3 Interpersonal Problems composite subscale (p = 0.049), and higher scores on the MAIA-2 Noticing subscale were associated with higher scores on the EDI-3 Affective Problems composite subscale (p = 0.003). Conclusions Interoceptive dysfunction appears to be a key vulnerability factor for eating disorder psychopathology in female adolescents with REDs, with comorbid BPD potentially further exacerbating these impairments. Targeting interoceptive processes may represent a promising therapeutic approach to improve emotion regulation and clinical outcomes, particularly in patients with co-occurring BPD, and warrants further investigation in this clinical population. Level III Evidence obtained from cohort or case–control analytic studies.
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BibTeX
@article{riva2026interoception,
title = {{Interoception and borderline personality disorder in female adolescents with restrictive eating disorders}},
author = {Anna Riva and Carlo Panarella and Gabriele Arienti and Simona Di Guardo and Eleonora Brasola and Renata Nacinovich and Andrea E. Cavanna},
journal = {Eating and Weight Disorders},
year = {2026},
month = jul,
doi = {10.1007/s40519-026-01889-7},
url = {https://doi.org/10.1007/s40519-026-01889-7},
note = {CC BY},
}
RIS
TY - JOUR
TI - Interoception and borderline personality disorder in female adolescents with restrictive eating disorders
AU - Anna Riva
AU - Carlo Panarella
AU - Gabriele Arienti
AU - Simona Di Guardo
AU - Eleonora Brasola
AU - Renata Nacinovich
AU - Andrea E. Cavanna
PY - 2026
DA - 2026/07/01
JO - Eating and Weight Disorders
DO - 10.1007/s40519-026-01889-7
UR - https://doi.org/10.1007/s40519-026-01889-7
AB - Purpose Interoception has been reported to be impaired in patients with restrictive eating disorders (REDs), while its role in patients with borderline personality disorder (BPD) is more controversial. We set out to conduct a clinical study to explore the relationship between interoception, eating disorders, and BPD. Methods We recruited a sample of 75 female adolescents affected by REDs, of whom 21 received a diagnosis of comorbid BPD. In addition to collecting demographic and clinical data, we administered measures of interoceptive awareness (MAIA-2), the scale for eating symptomatology (EDI-3), and alexithymia (TAS-20) to all patients. Results Patients with REDs and comorbid BPD reported lower scores on the MAIA-2 Not-Distracting (p = 0.046) and Trusting (p = 0.023) subscales, reflecting decreased focus and reliance on bodily sensations of pain or discomfort compared to patients with REDs only. Lower scores on the MAIA-2 Trusting subscale were associated with higher scores on all EDI-3 subscales and on the total TAS-20 scale (p = 0.005), whereas lower scores on the MAIA-2 Not-Worrying subscale were associated with higher scores on the EDI-3 Interpersonal Problems composite subscale (p = 0.049), and higher scores on the MAIA-2 Noticing subscale were associated with higher scores on the EDI-3 Affective Problems composite subscale (p = 0.003). Conclusions Interoceptive dysfunction appears to be a key vulnerability factor for eating disorder psychopathology in female adolescents with REDs, with comorbid BPD potentially further exacerbating these impairments. Targeting interoceptive processes may represent a promising therapeutic approach to improve emotion regulation and clinical outcomes, particularly in patients with co-occurring BPD, and warrants further investigation in this clinical population. Level III Evidence obtained from cohort or case–control analytic studies.
SN - 1590-1262
ER -