The role of caregiver mental health and interoception in dyadic interactions and interoceptive processing development

Interoception, the processing of internal bodily signals, is associated with mental health in adulthood. However, very little is known about the early development of interoceptive processing. In the UK, prevalence of childhood anxiety disorders has been increasing steadily, both pre- and post- the COVID-19 pandemic. Given the relationship between interoception and anxiety in adulthood, understanding the early development of interoceptive processing is both important and urgent. This thesis seeks to explore the factors influencing the early development of interoceptive processing and its relationship with anxiety risk. In recent years, several theories on the development of interoceptive processing have emerged. These theories consistently suggest that an infant’s early social experience, specifically interactions with their primary caregiver, facilitate the development of interoceptive processing. If so, caregivers’ skills in these early interactions could be influencing the development of interoceptive processing in their infants. For example, which of the caregivers’ specific behaviours are important? What factors influence caregivers’ ability in these behaviours? Do these early influences endure throughout childhood and are they associated with susceptibility to anxiety? Despite the importance of this topic, studies providing empirical evidence of interoceptive processing in infants remain sparse, with mixed findings. To add to what is known about the early development of interoceptive processing, I conducted five studies of caregivers and their infant or child, revealing several relationships between caregiver interoception, caregiver mental health and caregiver and infant behaviour. In addition, I demonstrated a strong association between caregiver and child interoception and an association between caregiver interoception and child threat sensitivity, a risk factor for anxiety. Together, these findings provide empirical support for theories on the development of interoceptive processing, adding to what little is known of its early development. In addition, these findings potentially shed some light on the underlying mechanisms behind familial relationships in anxiety disorders.