Do Interoceptive Sensations Provoke Fearful Responses in Adolescents with Chronic Headache or Chronic Abdominal Pain? A Preliminary Experimental Study

Abstract

Objective To determine whether fear can be triggered when experiencing interoceptive sensations locally proximal to the primary pain region. Methods Two groups of adolescents (11-18 years) with chronic headache (n=20) or chronic abdominal pain (CAP; n=20) completed three muscle tensing tasks to induce proximal versus distal sensations: (1) "frown" task (proximal for chronic headache; distal for CAP), (2) "tighten stomach" task (proximal for CAP; distal for chronic headache), and (3) safe comparison task (clench fist). Fear and avoidance were assessed via self-report. Results Adolescents with CAP reported greater fear and avoidance after the proximal compared with the distal task, while adolescents with chronic headache did not. Both groups reported similar levels of fear and avoidance in the frown and safe comparison task. Conclusions Results suggest that the perception of proximal interoceptive sensations appears to activate the fear system in adolescents with CAP. Future research is warranted.