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

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.