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Pain and emotion as predictive factors of interoception in fibromyalgia

Authors Borg C, Chouchou F, Dayot-Gorlero J, Zimmerman P, Maudoux D, Laurent B, Michael GA

Received 19 September 2017

Accepted for publication 29 November 2017

Published 19 April 2018 Volume 2018:11 Pages 823—835

DOI https://doi.org/10.2147/JPR.S152012

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr E. Alfonso Romero-Sandoval

Céline Borg,1–3 Florian Chouchou,4 Jenny Dayot-Gorlero,3 Perrine Zimmerman,1 Delphine Maudoux,5 Bernard Laurent,1,4 George A Michael3

1Neurology/Neuropsychology CMRR Unit, Hospital Nord, Saint-Priest-en-Jarez, France; 2Department of Psychology, University of Lyon, Lyon, France; 3Université de Lyon, Université Lyon 2, Laboratory EMC (EA 3082), Bron, France; 4Central Integration of Pain (NeuroPain), Inserm U1028, UCB Lyon1, Saint-Etienne, France; 5EA SNA-EPIS, Department of Clinical and Exercise Physiology, CHU de Saint-Etienne, Saint-Etienne, France

Introduction: This study investigated interoception in fibromyalgia (FM), a disorder characterized by chronic pain accompanied by mood deregulation. Based on observations on the relationship between somatosensory processing and pain in FM and considering the affective symptoms of this disorder, we tested in FM three dimensions of interoception: interoceptive accuracy (IA), interoceptive awareness (IAW) and interoceptive sensibility (IS).
Materials and methods: Twenty-one female FM patients (Mage = 50.3) and 21 female matched controls (Mage = 46.3) completed a heartbeat tracking task as an assessment of IA, rated confidence in their responses as a measure of IAW and completed the Multidimensional Assessment of Interoceptive Awareness as a measure of IS. Furthermore, they completed self-report scales that, according to a principal component analysis, targeted anxiety, emotional consciousness and pain-related affect and reactions.
Results: Multiple regression analyses showed that increased pain-related affect and reactions decrease IA in FM. When the results of each group were examined separately, such effect was found only in FM patients. On its turn, IS was predicted by emotional consciousness and pain-related affect and reactions, but these effects did not differ between FM and controls. Finally, none of the variables we used predicted IAW.
Discussion: Pain-related affect and reactions in FM patients can reduce their interoceptive ability. Our results help to better understand the integration between bodily signals and emotional processing in chronic pain.

Keywords:
fibromyalgia, interoception, heartbeat perception, pain, emotion

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