title: Implicit affective evaluation of somatosensory sensations in patients with noncardiac chest pain.
abstract: OBJECTIVE
  Etiological models of noncardiac chest pain (NCCP) stress the importance of abnormal implicit affective evaluations of somatosensory sensations, but this has never been studied empirically. The aim was therefore to assess implicit affective evaluations of somatosensory stimuli in NCCP using an experimental design.
  
  
  METHODS
  A total of 34 patients with NCCP, 24 patients with cardiac chest pain, and 46 healthy controls, took part in the study. Participants completed a tactile modification of the Affect Misattribution Procedure (tAMP) and answered self-report measures on anxiety sensitivity, somatosensory amplification, and somatic symptom distress.
  
  
  RESULTS
  A 3 × 3-ANOVA revealed that most negative judgments were found in the aversive condition, but this effect was not specific to patients with NCCP. Anxiety sensitivity was positively associated with negative implicit evaluations of aversive tactile stimuli in the tAMP.
  
  
  CONCLUSIONS
  The task seemed to be too difficult for older participants. Also, future studies should apply clinically more relevant, e.g., heart related, stimuli that are more ecologically valid than the electrical stimulation of the finger used as a proxy for aversive somatosensory sensations here.
  
  
  CONCLUSIONS
  Against theoretical assumptions, patients with NCCP do not seem to show a stronger implicit negative interpretation bias concerning somatosensory sensations in comparison to patients either with cardiac chest pain, or without chest pain. Nevertheless, anxiety sensitivity seems to contribute significantly to implicit affective interpretations of somatic sensations. Further studies are required investigating the relevance of implicit interpretative processes for the course of NCCP and distressing somatic symptoms in general.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nürnberg, University Hospital of Erlangen, Schwabachanlage 6, D-91054 Erlangen, Germany. Electronic address: stefanie.schroeder@uk-erlangen.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schroeder
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Cologne, Pohligstraße 1, D-50969 Köln, Germany. Electronic address: agerlac0@uni-koeln.de.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Gerlach
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Wuppertal, Max-Horkheimer-Straße 20, D-42097 Wuppertal, Germany. Electronic address: martin@uni-wuppertal.de.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Martin
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D000368:Aged; D001007:Anxiety / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D002637:Chest Pain / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010465:Perception / Q000502:physiology*; D057566:Self Report; D012677:Sensation / Q000502:physiology*; D011795:Surveys and Questionnaires
keywords: Implicit affective interpretation; Noncardiac chest pain; Somatosensory sensations; Tactile affect misattribution procedure