Generalized hypervigilance in fibromyalgia: Normal interoceptive accuracy, but reduced self-regulatory capacity

- Patients with fibromyalgia do not show altered perception of interoceptive signals.
- Patients with fibromyalgia show decreased heart rate variability.
- Heart rate variability does not predict interoceptive accuracy.
- Hypervigilance may be context dependent or modality-specific.

ObjectiveThe factors underlying the aetiology of fibromyalgia (FM) are largely unknown. According to the generalized hypervigilance hypothesis (GHH), FM patients show excessive attention towards pain stimuli and other sensory events, thereby increasing pain perception and dysfunctional behaviour. We tested this notion by assessing interoceptive accuracy (IA) in FM patients and matched healthy controls. We also tested the hypothesis that FM is characterized by reduced self-regulatory capacity as indexed by heart rate variability (HRV).Methods47 FM patients (Mage = 45.5, 39 females) and 45 healthy controls (Mage = 44.9, 37 females) completed several self-report scales (Body Vigilance Scale, Depression Anxiety Stress Scales, Pain Catastrophizing Scale). To derive HRV, heart rate was monitored under resting conditions; for the assessment of IA participants performed a heartbeat tracking task in which they were asked to silently count their heartbeats.ResultsFM patients reported higher body vigilance than healthy controls, but there were no group differences in IA. FM patients had lower HRV compared with healthy controls. HRV did not predictor IA.ConclusionIn conclusion, our findings do not support the hypothesis of generalized hypervigilance in FM patients. Patients reported a heightened focus on bodily sensations, which was not reflected in IA. It may be that hypervigilance is not a general and stable characteristic but is rather context dependent and modality-specific.