AccScience Publishing / JCBP / Online First / DOI: 10.36922/JCBP025340063
ORIGINAL RESEARCH ARTICLE

Sensory processing sensitivity, alexithymia, and eating disorder risk in adolescents in alternative care: A multi-informant network study

Vincenzo Maria Romeo1,2,3*
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1 Department of Culture and Society, University of Palermo, Palermo, Italy
2 School of Specialization in Psychoanalytic and Group-analytic Psychotherapy (SPPG), Reggio Calabria, Italy
3 Neurosinc, Catania, Italy
Received: 18 August 2025 | Revised: 29 September 2025 | Accepted: 11 October 2025 | Published online: 4 December 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Adolescents in alternative care show elevated eating disorder risk, yet mechanistic bridges between sensory reactivity and emotion-processing deficits remain underexplored. This study mapped the interplay among sensory processing sensitivity (SPS), alexithymia, and eating-related risk and tested moderation by trauma burden using a multi-informant design. Approximately 200 youths (12–18 years) were recruited from foster and residential services. Measures included self-report SPS (highly sensitive child facets), alexithymia (Toronto alexithymia scale-20: Difficulties identifying feelings [DIF], difficulties describing feelings [DDF], externally oriented thinking), eating-risk (eating attitudes test-26 subscales; binge eating scale), internalizing symptoms (patient health questionnaire for adolescents; screen for child anxiety related emotional disorders), and trauma (childhood trauma questionnaire–short form), along with covariates (age, sex, care type, body mass index z-score, pubertal status). Teachers/caregivers provided parallel SPS ratings. Primary analyses estimated a regularized partial-correlation network (Gaussian graphical model; EBICglasso) on domain-level nodes; accuracy and centrality stability were assessed through bootstrapping. Trauma moderation was evaluated through permutation-based network comparison tests; multi-informant integration was modeled by including teacher-SPS as a node and through informant-specific sensitivity analyses. SPS facets—especially Low Sensory Threshold and Ease of Excitation—bridged to alexithymia (DIF/DDF) and to eating-risk nodes, with stronger global connectivity observed under higher trauma exposure. Teacher-SPS converged with youth reports while adding unique variance. Limitations included the cross-sectional design, self-report bias, and setting selection. Findings delineate actionable psychosomatic targets—sensory-load management and affect labeling/interoceptive skills—for early, low-intensity interventions in foster/residential contexts.

Keywords
Sensory processing sensitivity
Alexithymia
Eating-disorder risk
Out-of-home care
Childhood trauma
Network analysis
Adolescents
Funding
None.
Conflict of interest
Vincenzo Maria Romeo is the Editorial Board Member of this journal but was not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. The author declared that he has no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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