Pain and emotion as predictive factors of interoception in fibromyalgia

Figures & data

Table 1 General data (mean and SD) from the present study

Data	Controls	Fibromyalgia	Welch’s		Cohen’s d
			t-value	P-value
Demographics
Age, years	46.3 (9.9)	50.3 (8.7)	1.40	0.17	0.43
Years of education	14.2 (3.1)	12.6 (2.2)	1.91	0.07	0.59
Physiology
Body mass index, kg/m^2	26.0 (5.8)	27.7 (5.2)	0.96	0.34	0.59
Resting heart rate, bpm	79.3 (9.7)	81.7 (9.2)	0.81	0.42	0.25
Interoception
HBscore	0.39 (0.32)	0.47 (0.31)	0.89	0.37	0.28
Recording/response covariance	263 (293)	372 (287)	1.21	0.23	0.28
Confidence/accuracy covariance	0.04 (0.3)	−0.01 (0.1)	0.66	0.51	0.20
Sensibility (MAIA scale)
Noticing	13.05 (4.01)	14.83 (3.17)	−1.5	0.14	0.49
Not-Distracting	5.9 (3.38)	6.33 (3.36)	−0.3	0.70	0.13
Not-Worrying	9.74 (3.78)	8.39 (4.26)	1.01	0.32	0.34
Attention Regulation	18.68 (7.82)	17.44 (6.47)	0.52	0.60	0.17
Emotional Awareness	13.9 (4.41)	15.39 (3.45)	−1.1	0.26	0.38
Self-regulation	9.05 (4.77)	7.83 (3.79)	0.86	0.39	0.28
Body Listening	9.42 (6.16)	8.83 (4.2)	0.34	0.74	0.11
Trusting	10.21 (4.01)	6.72 (3.29)	2.90	0.006*	0.95
Total MAIA	89.9 (24.3)	85.7 (15.6)	0.61	0.54	0.20
Mood and affect
State Anxiety	43.0 (10.5)	46.4 (7.3)	1.20	0.24	0.37
Trait Anxiety	45.6 (9.0)	46.8 (5.3)	0.54	0.59	0.17
BDI	3.09 (2.7)	9.85 (5.5)	4.97	0.001*	1.54
AIM	76.9 (13.9)	81.2 (12.3)	1.06	0.29	0.33
Self-awareness
SSAS	27.4 (5.6)	33.1 (4.1)	3.77	0.001*	1.17
SCS	52.7 (11.2)	50.5 (12.5)	0.58	0.56	0.18
Pain and catastrophizing
VAS pain	0.94 (2.0)	4.26 (1.9)	5.43	0.001*	1.68
PCS	15.5 (8.5)	30.7 (9.6)	5.40	0.001*	1.67
QDSA	38.9 (20.2)	105.3 (40.8)	6.67	0.001*	2.06
Auditory attention
Accuracy	0.89 (0.08)	0.85 (0.09)	1.34	0.19	0.33
Stimulus/response covariance	628 (89)	656 (79)	1.07	0.29	0.42

Note:

* Significant difference between FM patients and controls; bicaudal probability.

Abbreviations: Hbscore, heartbeat perception score; MAIA, Multidimensional Assessment of Interoceptive Awareness; BDI, Beck Depression Inventory; AIM, Affect Intensity Measure; SSAS, Somatosensory Amplification Scale; SCS, Self-Consciousness Scale; VAS, Visual Analogue Scale; PCS, Pain Catastrophizing Scale; QDSA, Questionnaire Douleur Saint-Antoine; FM, fibromyalgia.

Table 2 Pearson correlation coefficients between measures of interoception considering the whole sample

Variable	Recording/response covariance	Confidence/accuracy covariance	MAIA scale
			Noticing	Not-Distracting	Not-Worrying	Attention Regulation	Emotional Awareness	Self-regulation	Body Listening	Trusting	Total MAIA
HBscore	0.755*	0.174	0.102	−0.198	0.318	−0.084	−0.026	0.014	−0.063	0.225	0.046
Recording/response covariance		0.089	0.187	−0.144	0.387*	−0.073	−0.093	0.025	−0.090	−0.002	0.025
Confidence/accuracy covariance			0.061	0.049	0.198	0.011	0.041	0.064	0.093	0.187	0.144
Noticing				−0.339*	−0.294	0.254	0.542*	0.302	0.317	−0.021	0.402*
Not-Distracting					−0.264	−0.341*	−0.045	−0.410*	−0.253	−0.265	−0.281
Not-Worrying						0.031	−0.400*	0.254	−0.020	0.321	0.145
Attention Regulation							0.505*	0.637*	0.738*	0.408*	0.847*
Emotional Awareness								0.457*	0.592*	0.170	0.664*
Self-regulation									0.748	0.418*	0.833*
Body Listening										0.453*	0.888*
Trusting											0.593*

Note:

* Significant correlation.

Abbreviations: Hbscore, heartbeat perception score; MAIA, Multidimensional Assessment of Interoceptive Awareness.

Table 3 Pearson correlation coefficients between measures of interoception and self-reported instruments assessing mood and affect, self-awareness, pain and catastrophizing. The whole sample is considered.

Variable	Mood and affect				Self-awareness		Pain and catastrophizing
	State Anxiety	Trait Anxiety	BDI	AIM	SSAS	SCS	VAS pain	PCS	QDSA
HBscore	0.073	0.153	−0.138	0.246	−0.136	−0.213	0.071	−0.139	0.078
Recording/response covariance	0.091	0.056	−0.115	0.108	−0.127	−0.265	−0.024	−0.170	0.063
Confidence/accuracy covariance	−0.029	−0.120	−0.092	0.012	−0.160	0.146	−0.335*	−0.074	−0.108
MAIA scale
Noticing	0.283	0.175	0.223	0.446*	0.273	0.334	0.116	0.273	0.399*
Not-Distracting	−0.039	−0.054	0.280	−0.069	−0.016	0.254	−0.120	0.102	0.147
Not-Worrying	−0.147	−0.033	−0.517*	−0.290	−0.355*	−0.518*	−0.238	−0.468*	−0.297
Attention Regulation	0.070	0.032	−0.104	0.216	0.230	0.214	0.017	−0.123	0.036
Emotional Awareness	0.072	0.019	0.240	0.440*	0.389*	0.494*	0.160	0.344*	0.291
Self-regulation	0.069	−0.055	−0.203	0.174	0.219	0.194	−0.078	−0.231	−0.044
Body Listening	0.152	0.002	0.061	0.227	0.390*	0.421*	0.055	−0.031	0.125
Trusting	−0.104	−0.022	−0.393*	0.077	−0.086	0.000	−0.154	−0.461*	−0.468*
Total MAIA	0.087	0.016	−0.110	0.283	0.262	0.319	−0.041	−0.150	0.037

Note:

* Significant correlation.

Abbreviations: BDI, Beck Depression Inventory; AIM, Affect Intensity Measure; SSAS, Somatosensory Amplification Scale; SCS, Self-Consciousness Scale; VAS, Visual Analogue Scale; PCS, Pain Catastrophizing Scale; QDSA, Questionnaire Douleur Saint-Antoine; MAIA, Multidimensional Assessment of Interoceptive Awareness.

Table 4 Factor loadings associated with a principal component analysis carried out on the self-reported measures. Three components were identified.

Questionnaire/scale	Anxiety	Emotional consciousness	Pain-related affect and reactions
State Anxiety	0.907
Trait Anxiety	0.942
SCS		0.954
AIM		0.463
BDI			0.763
SSAS			0.744
PCS-CF			0.820
QDSA			0.803
VAS pain			0.825
% Variance explained	19.5	11.7	40.7

Abbreviations: SCS, Self-Consciousness Scale; AIM, Affect Intensity Measure; BDI, Beck Depression Inventory; SSAS, Somatosensory Amplification Scale; PCS-CF, Pain Catastrophizing Scale - French Version; QDSA, Questionnaire Douleur Saint-Antoine; VAS, Visual Analogue Scale.

Table 5 β coefficients (+ 1 standard error of the mean) resulting from multiple regression analyses carried out on measures of interoceptive accuracy and interoceptive awareness.

Predictive variable	Interoceptive accuracy		Interoceptive awareness
	HBscore	Recording/response covariance	Confidence/accuracy covariance
Demographics
Group	0.759 (0.29)*	0.825 (0.27)*	0.273 (0.30)
Age	−0.163 (0.19)	−0.24 (0.17)	−0.004 (0.19)
Physiology
Body mass index	0.352 (0.19)	0.294 (0.18)	−0.037 (0.20)
Resting heart rate	−0.156 (0.25)	−0.187 (0.23)	−0.415 (0.25)
Factors underlying self-reported instruments
Anxiety	0.179 (0.18)	0.116 (0.16)	−0.136 (0.18)
Emotional consciousness	0.315 (0.20)	0.198 (0.18)	0.219 (0.20)
Pain-related affect and reactions	−0.627 (0.30)*	−0.674 (0.28)*	−0.443 (0.31)
Auditory attention
Accuracy	−0.051 (0.26)
Stimulus/response covariance		0.178 (0.24)	0.139 (0.27)

Note:

* Significant predictive relation.

Abbreviation: Hbscore, heartbeat perception score.

Table 6 β coefficients (+ 1 standard error of the mean) resulting from multiple regression analyses carried out on the MAIA scale as a measure of interoceptive sensibility

Predictive variable	Interoceptive sensibility (MAIA scale)
	Noticing	Not-Distracting	Not-Worrying	Attention Regulation	Emotional Awareness	Self-regulation	Body Listening	Trusting	Total MAIA
Demographics
Group	0.429 (0.30)	0.104 (0.35)	0.425 (0.27)	0.127 (0.31)	0.308 (0.27)	0.053 (0.33)	−0.069 (0.31)	−0.174 (0.32)	0.242 (0.30)
Age	−0.030 (0.19)	−0.162 (0.23)	−0.072 (0.17)	−0.252 (0.20)	−0.167 (0.17)	0.147 (0.21)	−0.230 (0.20)	−0.018 (0.21)	−0.198 (0.19)
Physiology
Body mass index	0.208 (0.20)	−0.103 (0.24)	0.259 (0.19)	0.240 (0.21)	0.108 (0.18)	0.240 (0.22)	0.161 (0.21)	0.187 (0.21)	0.305 (0.20)
Resting heart rate	0.055 (0.19)	−0.225 (0.22)	0.075 (0.17)	0.170 (0.20)	0.147 (0.17)	0.231 (0.21)	0.069 (0.20)	0.090 (0.20)	0.160 (0.19)
Factors underlying self-reported instruments
Anxiety	0.093 (0.16)	−0.084 (0.19)	0.089 (0.15)	0.062 (0.17)	−0.116 (0.15)	−0.045 (0.18)	0.043 (0.17)	0.009 (0.18)	0.023 (0.16)
Emotional consciousness	0.623 (0.21)*	0.064 (0.25)	−0.156 (0.19)	0.446 (0.22)	0.701 (0.19)*	0.461 (0.23)	0.441 (0.22)	0.253 (0.22)	0.645 (0.21)*
Pain-related affect and reactions	−0.182 (0.30)	0.034 (0.35)	−0.641 (0.27)*	−0.114 (0.31)	−0.048 (0.27)	−0.253 (0.33)	0.152 (0.31)	−0.272 (0.32)	−0.270 (0.29)

Note:

* Significant predictive relation.

Abbreviation: MAIA, Multidimensional Assessment of Interoceptive Awareness.