Sensory processing across eating disorders: A systematic review and meta-analysis of self-report inventories

ObjectiveThis review investigated the extant literature regarding the relationship between eating disorder diagnoses and sensory processing as measured by validated and reliable self-report inventories. Increasing evidence highlights the role of sensory processing in cognitive functions. Sensory processing is implicated in mental-ill health, including eating disorders (ED) and body image disturbances. However, the pathophysiological underpinnings of sensory processing, encompassing exteroception and interoception, in relation to ED remain underexplored.MethodWe included studies involving participants aged 15 years or older with an eating disorder diagnosis confirmed by semi-structured or structured interviews. We further limited inclusion to articles using validated and reliable self-report instruments to measure sensory processing. Our meta-analysis focused on studies using the interoceptive awareness subscale from the second version of the Eating Disorder Inventory. We used the Critical Appraisal checklist for quasi-experimental studies to assess the quality of included articles.ResultsThere were 19 studies that met our inclusion criteria. Most studies showed moderate-to-high quality. Anorexia nervosa (AN) and bulimia nervosa (BN) were associated with heightened exteroception. Moreover, people with AN reported a heightened sense of taste compared to those with BN. Our meta-analysis comprising 10 studies, 19 samples, and 6382 participants revealed that AN (binge-purge subtype) and BN were associated with increased interoceptive difficulties compared to AN (restrictive subtype) or binge-eating disorder.DiscussionOverall, this review emphasizes the need for a deeper investigation into sensory processing, spanning both exteroception and interoception, in relation to ED. This may prove important for individualizing person-centered care.Public significanceHow people process internal, for example, hunger, and external, for example, taste and sensations is known to influence cognition and mental-ill health, including ED and body image disturbances. However, the ways in which sensory processing may contribute to ED are incompletely understood. We found that individuals with AN or BN experienced heightened exteroception, while people with an eating disorder characterized by purging reported increased interoceptive difficulties. These patterns could inform the development of more personalized treatments. ObjetivoEsta revision investigo la literatura existente sobre la relacion entre los diagnosticos de trastornos de conducta alimentaria y el procesamiento sensorial, medido mediante inventarios de autoreporte validados y fiables. Cada vez hay mas evidencia que destaca el papel del procesamiento sensorial en las funciones cognitivas. El procesamiento sensorial esta implicado en la salud mental, incluidos los trastornos de conducta alimentaria y las alteraciones de la imagen corporal. Sin embargo, los fundamentos fisiopatologicos del procesamiento sensorial, que abarcan la exterocepcion y la interocepcion, en relacion con los trastornos alimentarios permanecen poco explorados.MetodoIncluimos estudios con participantes de 15 anos o mas con un diagnostico de trastorno de conducta alimentaria confirmado por entrevistas semiestructuradas o estructuradas. Ademas, limitamos la inclusion a articulos que utilizaran instrumentos de autoreporte validados y fiables para medir el procesamiento sensorial. Nuestro metaanalisis se centro en estudios que utilizaron la subescala de conciencia interoceptiva de la segunda version del Inventario de Trastornos de Conducta Alimentaria. Utilizamos la lista de verificacion de Evaluacion Critica para estudios cuasiexperimentales para evaluar la calidad de los articulos incluidos.ResultadosHubo 19 estudios que cumplieron con nuestros criterios de inclusion. La mayoria de los estudios mostraron una calidad moderada a alta. La anorexia nerviosa y la bulimia nerviosa se asociaron con una exterocepcion elevada. Ademas, las personas que padecian anorexia nerviosa reportaron de un sentido del gusto mas agudizado en comparacion con aquellas que padecian bulimia nerviosa. Nuestro metaanalisis, que comprendio 10 estudios, 19 muestras y 6382 participantes, revelo que la anorexia nerviosa (subtipo atracones-purga) y la bulimia nerviosa se asociaron con dificultades interoceptivas aumentadas en comparacion con la anorexia nerviosa (subtipo restrictivo) o el trastorno por atracon.DiscusionEn general, esta revision enfatiza la necesidad de una investigacion mas profunda sobre el procesamiento sensorial, abarcando tanto la exterocepcion como la interocepcion, en relacion con los trastornos de conducta alimentaria. Esto puede ser importante para personalizar la atencion centrada en la persona.