Hypervigilance for innocuous tactile stimuli in patients with fibromyalgia: an experimental approach

Background: Hypervigilance, i.e., excessive attention, is often invoked as a potential explanation for the observation that many individuals with fibromyalgia show a heightened sensitivity to stimulation in various sensory modalities, such as touch and hearing. Compelling evidence for this assumption is, however, lacking. The aim of the present study was to investigate the presence of somatosensory hypervigilance in patients with fibromyalgia. Methods: Fibromyalgia patients (n=41) and a matched control group (n=40) performed a tactile change detection task in which they had to detect whether there was a change between two consecutively presented patterns of tactile stimuli presented to various body locations. The task was performed under two conditions: in the unpredictable condition, tactile changes occurred equally often at all possible body locations; in the predictable condition, the majority of tactile changes occurred at one specific body location. Results: It was hypothesized that the fibromyalgia group would show better tactile change detection in the unpredictable condition and when changes ocurred at unexpected locations in the predictable condition. The results did not support this hypothesis. In neither condition was the fibromyalgia group better than the control group in detecting tactile changes. Conclusions: No evidence was found to support the claim that patients with fibromyalgia display somatosensory hypervigilance. This finding challenges the idea of hypervigilance as a static feature of fibromyalgia and urges for a more dynamic view in which hypervigilance emerges in situations when bodily threat is experienced

Investigating hyper-vigilance for social threat of lonely children

The hypothesis that lonely children show hypervigilance for social threat was examined in a series of three studies that employed different methods including advanced eye-tracking technology. Hypervigilance for social threat was operationalized as hostility to ambiguously motivated social exclusion in a variation of the hostile attribution paradigm (Study 1), scores on the Children’s Rejection-Sensitivity Questionnaire (Study 2), and visual attention to socially rejecting stimuli (Study 3). The participants were 185 children (11 years-7 months to 12 years-6 months), 248 children (9 years-4 months to 11 years-8 months) and 140 children (8 years-10 months to 12 years-10 months) in the three studies, respectively. Regression analyses showed that, with depressive symptoms covaried, there were quadratic relations between loneliness and these different measures of hypervigilance to social threat. As hypothesized, only children in the upper range of loneliness demonstrated elevated hostility to ambiguously motivated social exclusion, higher scores on the rejection sensitivity questionnaire, and disengagement difficulties when viewing socially rejecting stimuli. We found that very lonely children are hypersensitive to social threat

A comprehensive model of adjustment to pain in the co-occurrence of PTSD and chronic musculoskeletal pain: vulnerability and protective pathways

There are a significant comorbidity between PTSD and chronic pain. Thus, studies clarifying the vulnerability and protective variables and mechanisms associated with PTSD and chronic pain are needed. The aim of this study was to examine the association between trauma, resilience, PTSD symptoms, and the variables included in the fear-avoidance models (anxiety sensitivity, catastrophizing, fear-avoidance beliefs, fear of pain, pain hypervigilance) as well as pain acceptance and experiential avoidance in explaining adjustment to chronic pain (pain intensity, pain-related disability and emotional distress). Method: the sample consisted of 229 patients with chronic musculoskeletal back pain. Results: Structural Equation Modelling was used. Statistical tests indicated that the hypothesized model adequately fitted the data (RMSEA = .07; CFI = .99; NNFI = .98; TLI = .96). The χ2 test was significant (χ2 (8) = 19.25, χ2 /dl = 2.40, p = .014). The results provided support for the hypothesized model. All the standardized path coefficients were significant (p < .05). Conclusions: This study provides empirical support for the potential role of PTSD symptoms in fear-avoidance models of chronic pain, and may provide support for the diathesis-stress model of pain. It is the first comprehensive model of adjustment to pain to consider vulnerability and protective adaptation mechanisms in patients who have undergone a traumatic event. The study highlights the importance of a comprehensive framework of reference to understand the comorbidity of PTSD and chronic musculoskeletal pain, and the need to provide well-designed treatment programs for the simultaneous treatment of these conditions.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Gaze cuing of attention in snake phobic women: the influence of facial expression

Only a few studies investigated whether animal phobics exhibit attentional biases in contexts where no phobic stimuli are present. Among these, recent studies provided evidence for a bias toward facial expressions of fear and disgust in animal phobics. Such findings may be due to the fact that these expressions could signal the presence of a phobic object in the surroundings. To test this hypothesis and further investigate attentional biases for emotional faces in animal phobics, we conducted an experiment using a gaze-cuing paradigm in which participants\u2019 attention was driven by the task-irrelevant gaze of a centrally presented face. We employed dynamic negative facial expressions of disgust, fear and anger and found an enhanced gaze-cuing effect in snake phobics as compared to controls, irrespective of facial expression. These results provide evidence of a general hypervigilance in animal phobics in the absence of phobic stimuli, and indicate that research on specific phobias should not be limited to symptom provocation paradigms

Fear-avoidance model of chronic pain the next generation

Objective: The fear-avoidance (FA) model of chronic pain describes how individuals experiencing acute pain may become trapped into a vicious circle of chronic disability and suffering. We propose to extend the FA model by adopting a motivational perspective on chronic pain and disability. Methods: A narrative review. Results: There is ample evidence to support the validity of the FA model as originally formulated. There are, however, some key challenges that call for a next generation of the FA model. First, the FA model has its roots in psychopathology, and investigators will have to find a way to account for findings that do not easily fit within such framework. Second, the FA model needs to address the dynamics and complexities of disability and functional recovery. Third, the FA model should incorporate the idea that pain-related fear and avoidance occurs in a context of multiple and often competing personal goals. Discussion: To address these 3 key challenges, we argue that the next generation of the FA model needs to more explicitly adopt a motivational perspective, one that is built around the organizing powers of goals and self-regulatory processes. Using this framework, the FA model is recast as capturing the persistent but futile attempts to solve pain-related problems to protect and restore life goals

A case-matched study of neurophysiological correlates to attention /working memory in people with somatic hypervigilance

Accepted 14 June 2016Somatic hypervigilance describes a clinical presentation in which people report more, and more intense, bodily sensations than is usual. Most explanations of somatic hypervigilance implicate altered information processing, but strong empirical data are lacking. Attention and working memory are critical for information processing, and we aimed to evaluate brain activity during attention/working memory tasks in people with and without somatic hypervigilance. Method: Data from 173 people with somatic hypervigilance and 173 controls matched for age, gender, handedness, and years of education were analyzed. Event-related potential (ERP) data, extracted from the continuous electroencephalograph recordings obtained during performance of the Auditory Oddball task, and the Two In A Row (TIAR) task, for N1, P2, N2, and P3, were used in the analysis. Between-group differences for P3 amplitude and N2 amplitude and latency were assessed with two-tailed independent t tests. Between-group differences for N1 and P2 amplitude and latency were assessed using mixed, repeated measures analyses of variance (ANOVAs) with group and Group × Site factors. Linear regression analysis investigated the relationship between anxiety and depression and any outcomes of significance. Results: People with somatic hypervigilance showed smaller P3 amplitudes—Auditory Oddball task: t(285) = 2.32, 95% confidence interval, CI [3.48, 4.47], p = .026, d = 0.27; Two-In-A-Row (TIAR) task: t(334) = 2.23, 95% CI [2.20; 3.95], p = .021, d = 0.24—than case-matched controls. N2 amplitude was also smaller in people with somatic hypervigilance—TIAR task: t(318) = 2.58, 95% CI [0.33, 2.47], p = .010, d = 0.29—than in case-matched controls. Neither depression nor anxiety was significantly associated with any outcome. Conclusion: People with somatic hypervigilance demonstrated an event-related potential response to attention/working memory tasks that is consistent with altered information processing.Carolyn Berryman, Vikki Wise, Tasha R. Stanton, Alexander McFarlane and G. Lorimer Mosele

Observing another in pain facilitates vicarious experiences and modulates somatosensory experiences

Objective: This study investigated whether individuals reporting vicarious pain in daily life (e.g., the self-reported vicarious pain group) display vicarious experiences during an experimental paradigm, and also show an improved detection of somatosensory stimuli while observing another in pain. Furthermore, this study investigated the stability of these phenomena. Finally, this study explored the putative modulating role of dispositional empathy and hypervigilance for pain. Methods: Vicarious pain responders (i.e., reporting vicarious pain in daily life; N = 16) and controls (N = 19) were selected from a large sample, and viewed videos depicting pain-related (hands being pricked) and non-pain related scenes, whilst occasionally experiencing vibrotactile stimuli themselves on the left, right or both hands. Participants reported the location at which they felt a somatosensory stimulus. We calculated the number of vicarious errors (i.e., the number of trials in which an illusionary sensation was reported while observing pain-related scenes) and detection accuracy. Thirty-three participants (94.29%) took part in the same experiment 5 months later to investigate the temporal stability of the outcomes. Results: The vicarious pain group reported more vicarious errors compared with controls and this effect proved to be stable over time. Detection was facilitated while observing pain-related scenes compared with non-pain related scenes. Observers' characteristics, i.e., dispositional empathy and hypervigilance for pain, did not modulate the effects. Conclusion: Observing pain facilitates the detection of tactile stimuli, both in vicarious pain responders and controls. Interestingly, vicarious pain responders reported more vicarious errors during the experimental paradigm compared to controls and this effect remained stable over time

Diary reports of concerns in mothers of infant siblings of children with autism across the first year of life

We examined the home-based concerns reported by mothers of infant siblings of children with autism across the first year of life. At all three ages measured, mothers of high-risk infants were significantly more likely than mothers of low-risk infants to report language, social communication, and restricted and repetitive behavior concerns but were not more likely to report general, medically based concerns. At 6 and 9 months of age, maternal concerns were poorly related to infant or family variables. At 12 months of age, there were moderate correlations between maternal concerns and infant behavior, and concerns were associated with the proband's autism symptoms and mothers' concurrent depressive symptoms. These findings highlight the need to examine high-risk infants' development in the family context.R21 DC 08637 - NIDCD NIH HHS; R01-DC010290 - NIDCD NIH HHS; AS1323 - Autism Speaks; R21 DC008637 - NIDCD NIH HHS; R01 DC010290 - NIDCD NIH HH

The role of the right tempoparietal junction in the elicitation of vicarious experiences and detection accuracy while observing pain and touch

This study investigated the effects of observing pain and touch in others upon vicarious somatosensory experiences and the detection of subtle somatosensory stimuli. Furthermore, transcranial direct current stimulation (tDCS) was used to assess the role of the right temporoparietal junction (rTPJ), as this brain region has been suggested to be involved in perspective taking and self-other distinction. Undergraduates (N = 22) viewed videos depicting hands being touched, hands being pricked, and control scenes (same approaching movement as in the other video categories but without the painful/touching object), while experiencing vibrotactile stimuli themselves on the left, right, or both hands. Participants reported the location at which they felt a somatosensory stimulus. Vibrotactile stimuli and visual scenes were applied in a congruent or incongruent way. During three separate testing sessions, excitability of the rTPJ was modulated with tDCS (cathodal, anodal, or sham). We calculated the proportion of correct responses and false alarms (i.e., number of trials in which a vicarious somatosensory experience was reported congruent to the site of the visual information). Pain-related scenes facilitated the correct detection of tactile stimuli and augmented the number of vicarious somatosensory experiences compared with observing touch or control videos. Stimulation of the rTPJ had no reliable influence upon detection accuracy or the number of vicarious errors. This study indicates that the observation of pain-related scenes compared to the observation of touch or control videos increases the likelihood that a somatosensory stimulus is detected. Contrary to our expectations, the rTPJ did not modulate detection accuracy