Doctoral Research
Exploring Adverse Childhood Experiences’ Impact on Interoception Across the Lifespan:
An Anonymous Self-Report Survey Study.
Sarah Haywood, OTD Student, Methodist University, B.S. Kinesiology Katherine Jones, EdD, OTD/L, CTL-LANA, CWT
Danielle Felak, OTR/L
Background
Adverse Childhood Experiences (ACEs) are highly prevalent and are associated with long-term neurobiological and psychosocial developmental challenges, as well as functional disruptions that impact individuals across the lifespan. Correlational emerging evidence between trauma exposure and interoceptive awareness indicates that early adversity modulates interoceptive processing, a foundational construct for emotional regulation, self-awareness, and occupational functioning. Study objectives evaluated the relationship between cumulative ACE exposure and adulthood interoceptive awareness across domains of the Brief Multidimensional Assessment of Interoceptive Awareness–2 (Brief MAIA-2). Hypothesizing, increased ACE exposure would negatively impact interoceptive awareness.
Methods
A quantitative, cross-sectional, anonymous survey design was employed. Adults (N = 143) aged ≥18 years were recruited utilizing purposive convenience sampling, through community-based social media platforms. Participants completed the 10-item ACE Questionnaire and the 24-item Brief MAIA-2 via a HIPAA compliant platform. Spearman’s rho correlation analyses and regression analyses were conducted to examine associations between cumulative ACE scores and multidimensional interoceptive awareness domains.
Results
Results indicated that higher cumulative ACE exposure is associated with lower interoceptive awareness within specific interoceptive domains. Statistically, significant correlations were identified within the domains of trusting, not-worrying, not-distracting, and attention regulation; related to trusting bodily sensations, managing emotional reactivity, sustaining attention to internal signals, and regulating internal focus. Demonstrating that greater exposure to childhood adversity is associated with domain-specific disruptions in interoceptive awareness, rather than a uniform global deficit as no significant relationship was identified across all domains.
Discussion
Findings suggest that interoception serves as a key mechanism linking childhood adversity to adult functioning, with disruptions occurring in the regulation, interpretation, and trust of internal bodily signals. These results support the integration of trauma-informed, interoception-focused assessment and intervention within occupational therapy practice.
Limitations include the cross-sectional design and reliance on self-report data. Future research should incorporate longitudinal and intervention-based approaches to further examine the relationship between ACE exposure and multidimensional interoceptive awareness.
My current research examines the relationship between adverse childhood experiences (ACEs) and interoceptive awareness in adulthood, exploring how early life adversity may influence individuals’ ability to perceive, interpret, and regulate internal bodily signals. ACEs including experiences such as abuse, neglect, household instability, and exposure to violence, have been widely associated with long-term impacts on neurological development, stress-response systems, and overall health outcomes. These early experiences can disrupt interoceptive processing, which plays a foundational role in emotional regulation, self-awareness, and engagement in meaningful occupations. this study investigates the association between cumulative ACE exposure and multidimensional interoceptive awareness in adults aged 18 years and older.
This research contributes to emerging occupational therapy literature examining how early life adversity influences interoceptive awareness and participation across the lifespan, as interoception is closely linked to emotional regulation, mental health, and occupational participation. Findings from this study suggest that cumulative exposure to adverse childhood experiences may be associated with decreased interoceptive awareness in adulthood, particularly within domains related to attention regulation, self-regulation, and trust in bodily sensations. Understanding this relationship provides valuable insight for occupational therapy practitioners, supporting the integration of trauma-informed, interoception-focused assessment and intervention approaches to improve emotional regulation, health outcomes, and meaningful occupational participation for individuals with histories of childhood adversity. Supporting the importance of trauma-informed, interoception-focused assessment and intervention approaches and highlights the role occupational therapists can play in addressing the long-term effects of childhood adversity across the lifespan.
