Generalized hypervigilance in fibromyalgia (FM): evidence of perceptual amplification

The hypervigilance model of pain perception states that chronic pain
patients have a heightened sensitivity to pain (e.g. low
threshold and tolerance) because of increased attention to
external stimulation and a preoccupation with pain sensations.
This study tested the hypothesis that individuals with
fibromyalgia, a chronic pain disorder of undetermined origin,
have a generalized hypervigilant pattern of responding that
extends beyond the pain domain. Twenty fibromyalgia
out-patients, 20 rheumatoid arthritis (RA) patients, and 20
normal controls served as subjects. The RA and normal control
subjects were age and sex matched to the fibromyalgia
patients. Subjects were tested for pain tolerance, pain
threshold, and noise tolerance and were asked to complete a
number of questionnaires that assessed hypervigilance. As
predicted, the responses of the fibromyalgia patients to both
the pain and auditory stimuli were consistent with the
generalized hypervigilance hypothesis. These patients had
significantly lower threshold and tolerance values than the
RA patients, who in turn, had lower values than the normal
control subjects. The results of the psychological
questionnaires revealed that the fibromyalgia and RA patients
preferred lower levels of external stimulation than the
control subjects. The outcome of this study supports the
generalized hypervigilance hypothesis, suggesting that
fibromyalgia patients have a perceptual style of
amplification. The implications of these findings for
understanding the role of biological, cognitive, and
perceptual factors in pain disorders are discussed.

McDermid AJ, Rollman GB, McCain GA

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