Altered regulation of negative affect in patients with fibromyalgia : a diary study

in EUROPEAN JOURNAL OF PAIN (2021)

Background Fibromyalgia is characterized by widespread musculoskeletal pain and often accompanied by cognitive and emotional problems. Adaptation to fibromyalgia may therefore also rely on one's ability ... [more ▼]

Background Fibromyalgia is characterized by widespread musculoskeletal pain and often accompanied by cognitive and emotional problems. Adaptation to fibromyalgia may therefore also rely on one's ability to regulate emotional problems. In this study, we examined two indices of emotion regulation, that is, (a) affective instability, involving frequent large fluctuations in self-reported affect, and (b) resting heart rate variability (HRV). 45.4 years; 39 females) and 46 matched healthy controls (M-age = 44.9 years; 37 females). Heart rate was monitored under resting conditions to derive HRV. Subsequently, participants completed an electronic end-of-day diary for 14 consecutive days assessing daily levels of pain, disability, negative affect (NA) and positive affect (PA). Affective instability was operationalized as the mean square of successive differences in daily mood. Results Results indicate increased levels of NA instability and reduced levels of HRV in patients with fibromyalgia in comparison with healthy controls. Furthermore, HRV and NA instability were inversely related. Finally, in patients, higher NA instability was related to increased pain disability. Conclusions Current findings support the idea that patients with fibromyalgia are confronted with fluctuating emotions. These results may have important implications for treatment as they provide support for the use of emotion regulation skills training in patients with fibromyalgia to impact upon NA instability. Significance This study provides novel insight in the link between emotion regulation indices,that is, heart-rate variability and negative affective (NA) instability, in patients with fibromyalgia, and presents evidence for differences in both emotion regulation indices between patients with fibromyalgia and healthy people. Furthermore, results link increased NA instability with increased levels of daily disability in patients with fibromyalgia. Together, these findings offer support for a key role of emotion regulation in fibromyalgia outcomes, providing pathways for clinical practice. [less ▲]

Altered interoceptive awareness in high habitual symptom reporters and patients with somatoform disorders

in Frontiers in Psychology (2020), 11(1), 1859

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they ... [more ▼]

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they are limited to the interpretation of signals. We investigated whether individuals with MUS differ in interoceptive awareness as assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. Methods. Study 1: 486 individuals completed the Screening for Somatoform Disorders (SOMS-2). 32 individuals each of the upper and lower decile of the SOMS distribution (low symptom reporters/LSR, high symptom reporters/HSR) completed the MAIA. Study 2: MAIA scores of individuals diagnosed with somatoform disorder (SFD; n = 26) were compared to individuals with major depressive disorder (MDD; n = 25) and healthy controls (HC; n = 26). Results. HSR had lower scores than LSR on the MAIA scales Not-Distracting and Not-Worrying. The SFD and MDD groups showed lower scores than HC on the MAIA scales Not-Distracting, Self-Regulation, and Trusting. The MDD group scored lower than the other two groups on the scales Body Listening and Attention Regulation. There were no group differences on the scale Noticing. Conclusion. HSR, SFD and MDD patients do not differ from HC in the awareness of noticing of interoceptive signal processing, whereas cognitive facets of interoception, such as distraction or self-regulation are differentially affected. This highlights the necessity of including specifically targeted interventions, which improve interoceptive awareness, in the prevention and treatment of SFDs. [less ▲]

Kardiale Modulation der Schreckreaktion bei hoher gegenüber niedriger Symptombelastung: afferente Signalübermittlung auf der Hirn-Körper-Achse beein usst frühe Stimulus-Verarbeitung bei hoher Symptombelastung

in Hennig, J.; Stark, R. (Eds.) Abstractband Psychologie und Gehirn 2018 (2018)

Somatische Belastungsstörungen (SBS) sind oftmals durch andauernde medizinisch- unerklärte Symptome gekennzeichnet, deren Entstehung größtenteils ungeklärt ist. Diese Studie hatte zum Ziel, die empirisch ... [more ▼]

Somatische Belastungsstörungen (SBS) sind oftmals durch andauernde medizinisch- unerklärte Symptome gekennzeichnet, deren Entstehung größtenteils ungeklärt ist. Diese Studie hatte zum Ziel, die empirisch bislang unbeantwortete Frage zu klären, ob Symptomentstehung auf veränderte Signalübermittlung auf der Hirn-Körper-Achse zurückzuführen ist. Zunächst wurden 486 Personen aus der Allgemeinbevölkerung anhand des SOMS-2 in Personen mit hoher Symptombelastung (HSB; unterstes Perzentil) und niedriger Symptombelastung (NSB; oberstes Perzentil) unterteilt. Personen mit HSB stellen eine besondere Risikogruppe für SBS dar. 28 HSB- und 31 NSB-Personen durchliefen ein Paradigma der kardialen Modulation der Schreckreaktion (CMS), ein Verfahren, das kardio-afferente Signalübermittlung prä-attentiv abbilden kann. Ihnen wurden je zehn akustische Schreckreize (105 dB) in sechs Zeitpunkten nach der kardialen R-Zacke (0, 100, 200, 300, 400, 500 ms) präsentiert. Als Indikator für die Schreckreaktion wurden die N1- und P2-Amplitude der auditorisch-evozierten Potenziale über Cz gemessen, da der Effekt der Hirn-Körper-Signalübermittlung im Kortex abgebildet werden sollte. Es zeigten sich geringere N1-Amplituden auf die Schreckreize, die während der systolischen Phase (200, 300 ms) im Vergleich zur diastolischen Phase (0 ms) präsentiert wurden (p=.0002), was für das Vorliegen eines CMS-Effekts spricht. Die HSB-Gruppe zeigte höhere P2-Amplituden als die NSB-Gruppe. Es zeigte sich außerdem, dass der CMS-Effekt bezüglich der N1-Komponente in der HSB-Gruppe geringer ist (p=.035), jedoch bezüglich der P2-Komponente stärker ist als in der NSB-Gruppe (p=.031). Afferente Signalübermittlung auf der Hirn-Körper-Achse könnte bei Personen mit HSB bereits frühe, automatischeWahrnehmungsprozesse verändern, die durch späte, aufmerksamkeits-gesteuerte Prozesse kompensiert werden. Diese prä-attentive Beeinflussung der Stimulus-Verarbeitung könnte ein Mechanismus der Symptomentstehung bei Personen mit HSB und SBS sein. [less ▲]