Do Interoceptive Sensations Provoke Fearful Responses in Adolescents With Chronic Headache or Chronic Abdominal Pain? A Preliminary Experimental Study.
To determine whether fear can be triggered when experiencing interoceptive sensations locally proximal to the primary pain region.  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. 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.  Results suggest that the perception of proximal interoceptive sensations appears to activate the fear system in adolescents with CAP. Future research is warranted.
German Paediatric Pain Centre, Children's and Adolescents' Hospital.|Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health-School of Medicine, Witten/Herdecke University.
Florentina
F
Flack
Department of Biological and Clinical Psychology, University of Greifswald.
Christiane A
CA
Pané-Farré
German Paediatric Pain Centre, Children's and Adolescents' Hospital.|Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health-School of Medicine, Witten/Herdecke University.
Boris
B
Zernikow
Department of Clinical Child and Adolescent Psychology and Psychotherapy, University of Trier.
Luca
L
Schaan
German Paediatric Pain Centre, Children's and Adolescents' Hospital.|Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health-School of Medicine, Witten/Herdecke University.|Department of Clinical Child and Adolescent Psychology and Psychotherapy, University of Trier.
Tanja
T
Hechler
D015746:Abdominal Pain / Q000523:psychology*; D000293:Adolescent; D001362:Avoidance Learning; D002648:Child; D059350:Chronic Pain / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D020773:Headache Disorders / Q000523:psychology*; D006801:Humans; D065812:Interoception; D008297:Male; D057566:Self Report
children and adolescents; chronic pain; fear of pain; interoceptive sensations; symptom provocation