Valenzuela-Moguillansky Camila, Reyes-Reyes Alejandro, Gaete María I
Centro de Estudios de Argumentación y Razonamiento, Facultad de Psicología, Universidad Diego PortalesSantiago, Chile; Instituto de Sistemas Complejos de ValparaísoValparaíso, Chile.
Escuela de Psicología, Universidad Santo Tomás Concepción, Chile.
Front Hum Neurosci. 2017 Mar 13;11:117. doi: 10.3389/fnhum.2017.00117. eCollection 2017.
Fibromyalgia is a widespread chronic pain disease characterized by generalized musculoskeletal pain and fatigue. It substantially affects patients' relationship with their bodies and quality of life, but few studies have investigated the relationship between pain and body awareness in fibromyalgia. We examined exteroceptive and interoceptive aspects of body awareness in 30 women with fibromyalgia and 29 control participants. Exteroceptive body awareness was assessed by a body-scaled action-anticipation task in which participants estimated whether they could pass through apertures of different widths. Interoceptive sensitivity (IS) was assessed by a heartbeat detection task where participants counted their heartbeats during different time intervals. Interoceptive awareness was assessed by the Multidimensional Assessment of Interoceptive Awareness (MAIA). The "passability ratio" (the aperture size for a 50% positive response rate, divided by shoulder width), assessed by the body-scaled action-anticipation task, was higher for fibromyalgia participants, indicating disrupted exteroceptive awareness. Overestimating body size correlated positively with pain and its impact on functionality, but not with pain intensity. There was no difference in IS between groups. Fibromyalgia patients exhibited a higher tendency to note bodily sensations and decreased body confidence. In addition, the passability ratio and IS score correlated negatively across the whole sample, suggesting an inverse relationship between exteroceptive and interoceptive body awareness. There was a lower tendency to actively listen to the body for insight, with higher passability ratios across the whole sample. Based on our results and building on the fear-avoidance model, we outline a proposal that highlights possible interactions between exteroceptive and interoceptive body awareness and pain. Movement based contemplative practices that target sensory-motor integration and foster non-judgmental reconnection with bodily sensations are suggested to improve body confidence, functionality, and quality of life.
纤维肌痛是一种广泛存在的慢性疼痛疾病，其特征为全身性肌肉骨骼疼痛和疲劳。它严重影响患者与自身身体的关系以及生活质量，但很少有研究调查纤维肌痛患者疼痛与身体感知之间的关系。我们对30名纤维肌痛女性患者和29名对照参与者的身体感知的外感受和内感受方面进行了检查。外感受身体感知通过一项身体比例动作预期任务进行评估，参与者需估计自己是否能够穿过不同宽度的孔洞。内感受敏感性（IS）通过一项心跳检测任务进行评估，参与者在不同时间间隔内计数自己的心跳。内感受意识通过内感受意识多维评估（MAIA）进行评估。通过身体比例动作预期任务评估的“可通过比例”（产生50%阳性反应率的孔洞大小除以肩宽）在纤维肌痛参与者中更高，表明外感受意识受到干扰。高估身体大小与疼痛及其对功能的影响呈正相关，但与疼痛强度无关。两组之间的IS没有差异。纤维肌痛患者表现出更高的注意身体感觉的倾向以及身体自信降低。此外，在整个样本中，可通过比例和IS得分呈负相关，表明外感受和内感受身体感知之间存在反比关系。在整个样本中，主动倾听身体以获取洞察的倾向较低，可通过比例较高。基于我们的研究结果并以恐惧回避模型为基础，我们概述了一项提议，该提议突出了外感受和内感受身体感知与疼痛之间可能的相互作用。建议采用以运动为基础的沉思练习，这些练习针对感觉运动整合并促进与身体感觉的无评判重新连接，以提高身体自信、功能和生活质量。
