Maternal Interoception and Anxiety-Related Parenting: Implications for Family-Centered Prevention and Intervention

Background and Purpose: Parental anxiety robustly predicts childhood anxiety; however, beyond genetic heritability, mechanisms of intergenerational transmission remain unclear. One promising but underexplored mechanism is interoception—the perception and integration of internal bodily states—which plays a key role in emotion regulation and mental health. Impairments in interoception are associated with heightened emotional arousal and misinterpretation of benign bodily cues as threatening, processes that contribute to anxiety. Maternal interoceptive dysfunction may impact caregiving sensitivity (i.e., the ability to accurately perceive and respond to a child’s physiological and emotional needs), with negative implications for children’s developmental trajectories and mental health outcomes.

When a mother’s interoceptive functioning is impaired, she may struggle to detect, interpret, and manage her own internal bodily and affective states, compromising caregiving sensitivity and giving rise to anxiety-related parenting behaviors that model anxiety and reinforce threat-related interpretations (i.e., fear-enhancing parenting). However, existing research has largely focused on interoception at the individual level, with limited attention to its role in caregiving relationships that likely shape children’s anxiety risk. Guided by a biopsychosocial and person-in-environment perspective, this pilot study advances a theoretical framework in which maternal interoceptive dysfunction may disrupt caregiving sensitivity and contribute to anxiety-related parenting behaviors, thereby increasing children’s anxiety risk. To test this model, the present pilot study examined whether maternal interoception moderates the association between maternal anxiety and fear-enhancing parenting.

Methods: Participants included 39 mother-child dyads (children ages 4-8) from the Children of Philadelphia Emotion (COPE) Study, an ongoing intergenerational study of the Philadelphia Neurodevelopmental Cohort (PNC). Maternal interoception was measured by the Multidimensional Assessment of Interoceptive Awareness (MAIA), anxiety by the Generalized Anxiety Disorder Scale-7 (GAD-7), and fear-enhancing parenting by the Parental Enhancement of Anxious Cognitions scale (PEAC). Linear regression models tested whether maternal interoception moderated the association between maternal anxiety and fear-enhancing parenting, controlling for maternal age and socioeconomic status.

Results: Maternal anxiety significantly predicted fear-enhancing parenting, and this association was moderated by maternal interoception (b = -1.88, SE = 0.52, p < .001). Simple slopes indicated that maternal anxiety predicted greater fear-enhancing parenting at low interoceptive awareness (b = 3.50, SE = 0.80, p < .001), but not at high interoceptive awareness (b = -0.29, SE = 0.58, p = .63).

Conclusion and Implications: Findings suggest that maternal interoception buffers behavioral expression of anxiety in caregiving contexts, with implications for child anxiety risk. Greater maternal interoception may support mothers’ capacity to regulate physiological and emotional states, reducing the likelihood that anxiety manifests in fear-enhancing parenting behaviors. Given prior work identifying interoception as a modifiable biobehavioral process, these findings highlight a potential pathway for intervention, suggesting that targeting maternal interoception (e.g., through mindfulness- or body-based approaches) may shift caregiving behaviors and, in turn, reduce child anxiety risk. From a social work perspective, this work aligns with biopsychosocial and person-in-environment frameworks by illustrating how physiological processes are shaped by and expressed within relational contexts, informing integrated, family-centered approaches for high-risk mother-child dyads. Ongoing analyses will extend this work by linking parenting processes to child outcomes.