Pain-associated emotions and reactions can reduce the ability of women with fibromyalgia to perceive what’s going on inside their body, according to researchers in France.
Their findings add to our knowledge of how patients with chronic pain integrate body signals and emotional processing.
The study, “Pain and emotion as predictive factors of interoception in fibromyalgia,” was published in the journal Journal of Pain Research.
Researchers investigated interoception, the capacity of people to sense the internal state of their body, in fibromyalgia patients, comparing it with healthy people (controls). Some researchers consider it a lesser-known sense, as in the body’s five senses.
Many studies have indicated that fibromyalgia patients display signs of hypervigilance, a high awareness of potentially negative stimuli.
More recent research proposes that fibromyalgia is associated with an abnormally heightened attention to signals from the body, and emotional aspects of pain modulated this effect.
These findings suggest that interoception may be amplified in fibromyalgia patients and be influenced by pain.
To assess this, researchers analyzed interoception in 21 women with fibromyalgia and 21 healthy women (controls). Interoception was evaluated at three levels: accuracy, awareness, and sensibility.
Accuracy was measured by asking participants to mentally count their heartbeats, which were compared with the actual counts measured by an electrocardiogram.
Awareness was assessed by asking the women to rate their confidence when performing the accuracy task, and sensibility was rated using the MAIA questionnaire.
Other surveys were used to evaluate mood and feelings, self-awareness, level of pain and pain perception, and auditory selective attention.
Compared to healthy women, patients with fibromyalgia did not show any significant differences in their ability to perceive the internal state of their body, except that most healthy women saw their body as safe and trustworthy.
As expected, higher numbers in measurement scales for pain levels, pain catastrophizing, and pain perception were seen in fibromyalgia patients.
Analyses of all the data showed that anxiety, emotional consciousness, and emotions and reactions associated with pain were the main aspects influencing interoception.
In fibromyalgia patients, the stronger the pain-associated emotions and reactions reported by the patients, the less accurate their perception of their internal body state.
Conversely, the higher the emotional consciousness of the patients, the more precise they were at sensing their body’s internal state.
No association between any of these aspects was seen in healthy women in the study.
Emotional consciousness also positively influenced the sensitivity of women in perceiving their body, both in fibromyalgia patients and healthy controls.
The results do not show differences in interoception capacity between fibromyalgia patients and healthy women. But they reveal that women’s perception of the internal state of the body, especially the accuracy of these perceptions, is affected by anxiety, pain, and emotions — all key factors associated with fibromyalgia patients.
“Pain-related affect and reactions in [fibromyalgia] patients can reduce their interoceptive ability,” the researchers concluded. “Our results help to better understand the integration between bodily signals and emotional processing in chronic pain.”
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