CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China.
J Pain. 2024 Feb;25(2):557-569. doi: 10.1016/j.jpain.2023.09.012. Epub 2023 Sep 22.
People experience similarities between emotional feelings and bodily states on a daily basis, but both the magnitude and pervasiveness of this experiential similarity vary across individuals. Inspired by previous findings that chronic pain (CP) is characterized by strengthened pain-affect coupling and reduced interoceptive accuracy, we conducted 2 cross-sectional studies to examine whether patients with CP would exhibit less differentiated perception and mental representation of emotional feelings and bodily states. In study 1 (N = 500), patients with CP and healthy controls (HCs) completed a self-report questionnaire that asked explicitly about the perceived similarity between 5 basic emotion categories and a series of bodily states. In study 2 (N = 73), a specially designed false memory test was administered to examine whether patients with CP would have reduced differentiation of concepts of negative emotion and somatic distress. We found that patients with CP perceived greater and more pervasive similarities between emotional feelings and bodily states, as indicated by higher questionnaire scores and denser, less specialized bipartite emotion-body networks, both associated with lower subjective interoceptive accuracy. Furthermore, patients with CP formed false memories of negative emotion words (eg, grief) more readily than HCs after memorizing somatic distress words (eg, soreness), as if they represented negative emotion and somatic distress as a single, enmeshed semantic category. Our findings extend previous literature by demonstrating reduced discrimination between emotional and bodily experiences in CP that is not restricted to pain-related emotional and sensory experiences and may be related to a fundamentally less differentiated interoception. PERSPECTIVES: This study shows that patients with chronic pain have a profoundly less differentiated perception and implicit conceptualization of emotional feelings and bodily states, which appears to be associated with altered interoception. These findings may provide new perspectives on why they often experience a stronger pain-affect coupling.
人们在日常生活中会体验到情感和身体状态之间的相似之处，但这种体验相似性的程度和普遍性在个体之间有所不同。受先前发现的启发，即慢性疼痛（CP）的特征是疼痛影响耦合增强和内感受准确性降低，我们进行了两项横断面研究，以检查 CP 患者是否会表现出对情感和身体状态的感知和心理表征的差异较小。在研究 1（N=500）中，CP 患者和健康对照组（HCs）完成了一份自我报告问卷，该问卷明确询问了 5 种基本情绪类别和一系列身体状态之间的感知相似性。在研究 2（N=73）中，进行了专门设计的错误记忆测试，以检查 CP 患者是否会降低对负性情绪和躯体不适概念的区分。我们发现，CP 患者感知到情感和身体状态之间更大和更普遍的相似性，这表现为问卷得分更高，情感-身体二分网络更密集、更不专门，与主观内感受准确性降低有关。此外，CP 患者在记住躯体不适词（例如疼痛）后，比 HCs 更容易形成负性情绪词（例如悲伤）的错误记忆，就好像他们将负性情绪和躯体不适表示为一个单一的、交织的语义类别。我们的研究结果通过证明 CP 中情感和身体体验之间的区分度降低扩展了先前的文献，这种降低不仅限于与疼痛相关的情感和感官体验，并且可能与内感受的根本差异减小有关。观点：这项研究表明，CP 患者对情感和身体状态的感知和内隐概念化存在明显的差异较小，这似乎与内感受改变有关。这些发现可能为为什么他们经常经历更强的疼痛影响耦合提供了新的视角。
