Supplementary Material for: Interoceptive Sensibility, Alexithymia, and Emotion Regulation in Individuals Suffering from Fibromyalgia

<b><i>Introduction:</i></b> People suffering from fibromyalgia syndrome report various difficulties in emotional processing, possibly resulting from changes in bodily perception (interoception). In our study, we investigated the relationships between interoceptive sensibility (IS) and two disease-relevant emotional components (alexithymia and emotion regulation) in fibromyalgia sufferers compared to healthy individuals. <b><i>Methods:</i></b> Fifty-five fibromyalgia sufferers and 55 healthy individuals, matched with regard to age and gender, participated in our cross-sectional study. All participants completed the following self-report measures: the Multidimensional Assessment of Interoceptive Awareness, the Toronto Alexithymia Scale, and the Emotion Regulation Skills Questionnaire. Depression and anxiety scores served as confounding variables. <b><i>Results:</i></b> Fibromyalgia sufferers reported a stronger tendency to note as well as to avoid (unpleasant) body sensations. IS and psychopathology each explained about thirty percent of the variance in emotion regulation in fibromyalgia sufferers. Alexithymia was related to IS and emotion regulation in controls but not in fibromyalgia sufferers. <b><i>Conclusion:</i></b> Disturbances in interoception could be seen as the starting point of emotional difficulties in people with fibromyalgia. Following the fear-avoidance-model, experiential avoidance may restrict patients’ ability to adaptively regulate emotional states, possibly initiating a vicious cycle of psychological distress and pain.

<b><i>研究背景:</i></b> 纤维肌痛综合征患者常报告存在多种情绪加工困难，该症状可能源于躯体感知（内感受，interoception）的改变。本研究旨在探讨纤维肌痛综合征患者与健康对照者相比，其内感受敏感性（interoceptive sensibility，IS）与两种疾病相关情绪特征——述情障碍（alexithymia）及情绪调节（emotion regulation）之间的关联。
<b><i>研究方法:</i></b> 本横断面研究共纳入55名纤维肌痛综合征患者与55名年龄、性别匹配的健康对照者。所有参与者完成了以下自评量表：多维内感受觉知量表（Multidimensional Assessment of Interoceptive Awareness）、多伦多述情障碍量表（Toronto Alexithymia Scale）以及情绪调节技能问卷（Emotion Regulation Skills Questionnaire）。研究以抑郁与焦虑得分作为混杂变量。
<b><i>研究结果:</i></b> 纤维肌痛综合征患者对躯体感觉（尤其是不适感）表现出更强的注意与回避倾向。内感受敏感性与精神病理特征分别可解释纤维肌痛综合征患者情绪调节能力约30%的变异量。在健康对照者中，述情障碍与内感受敏感性及情绪调节能力存在关联，但在纤维肌痛综合征患者中未观察到此关联。
<b><i>研究结论:</i></b> 内感受功能障碍可被视为纤维肌痛综合征患者情绪问题的潜在始发因素。依据恐惧回避模型（fear-avoidance-model），经验性回避可能会限制患者适应性调节情绪状态的能力，进而可能引发心理痛苦与疼痛的恶性循环。