Physiological reactivity and interoceptive awareness in pediatric anxiety disorders: A conceptual and empirical review
Objectives This review aims to summarize the data relative to objective and subjective measures of body responses in children and adolescents with anxiety. Methods We reviewed 24 studies measuring (1) cardiac responses and (2) interoceptive processes in children and adolescents with anxiety. Results Anxious children and adolescents generally do not differ from their non-anxious peers on their cardiac parameters and objective physiological reactivity to stressful events but some results suggest a reduced autonomic flexibility in pediatric anxiety related to chronic anxiety. Moreover, anxiety does not alter the interoceptive accuracy, but youths with anxiety misinterpret the intensity and the visibility of their symptoms. Conclusion Interoception are biased in pediatric anxiety and further studies are needed to provide information about the role of perceptive, attentional, and interpretative processes in these biases, as well as determine the respective influence of anxiety type and symptoms intensity.