When Emotions Hurt: Reduced Differentiation Between Physiological and Emotional States in Fibromyalgia

When Emotions Hurt: Reduced Differentiation Between Physiological and Emotional States in Fibromyalgia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article When Emotions Hurt: Reduced Differentiation Between Physiological and Emotional States in Fibromyalgia Aleksandra M. Herman, Jullia Szczawińska, Carolyn Berryman, Tasha R. Stanton This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7790947/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract People with fibromyalgia often demonstrate hypersensitivity to benign bodily signals and misattribute non-noxious physical signals as pain, suggesting alterations in body-brain communication and interoception. However, little is known about whether altered body-brain communication may extend to misattribution of emotion as pain. Here, using a cross-sectional design, we aimed to investigate how individuals with fibromyalgia perceive, identify, and interpret emotions and other bodily sensations, including pain, compared to healthy controls. Across two independent studies, individuals with fibromyalgia and age- and gender-matched pain-free controls completed the emBODY task, which assesses the topography of bodily sensations experienced for different states (emotional states, neutral state, pain- and physiology-related states, fatigue). Additionally, participants completed assessments of alexithymia, bodily sensation interpretation, and interoception. In both studies, linear discriminant analysis, performedto test whether different emotions and states are associated with statistically distinct bodily patterns, indicated lower classification accuracy of body sensation maps in the fibromyalgia group than in controls. Moreover, compared with controls, the fibromyalgia group showed higher levels of alexithymia, higher awareness of bodily signals, and more negative interpretation of ambiguous bodily sensations in daily life, together with greater self-reported interoceptive difficulties. Our findings support an amplified perception of bodily signals coupled with interoceptive difficulties and poorer differentiation of both emotions and non-emotional states in people with fibromyalgia. This raises the possibility that interventions that targetperceptual retraining, emotional state differentiation, and re-interpretation of bodily sensations might decrease the impact of pain and promote engagement in everyday activities for people with fibromyalgia. fibromyalgia embodiment interoception emBODY tool body-mapping interpretation bias alexithymia Full Text Additional Declarations The authors declare no competing interests. Supplementary Files PAIDemBODYsupplement.pdf Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7790947","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":535727694,"identity":"cc975e43-35b4-4b32-9b0b-1935dc13889b","order_by":0,"name":"Aleksandra M. 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However, little is known about whether altered body-brain communication may extend to misattribution of emotion as pain. Here, using a cross-sectional design, we aimed to investigate how individuals with fibromyalgia perceive, identify, and interpret emotions and other bodily sensations, including pain, compared to healthy controls.\u003c/p\u003e\n\u003cp\u003eAcross two independent studies, individuals with fibromyalgia and age- and gender-matched pain-free controls completed the emBODY task, which assesses the topography of bodily sensations experienced for different states (emotional states, neutral state, pain- and physiology-related states, fatigue). Additionally, participants completed assessments of alexithymia, bodily sensation interpretation, and interoception.\u003c/p\u003e\n\u003cp\u003eIn both studies, linear discriminant analysis, performedto test whether different emotions and states are associated with statistically distinct bodily patterns, indicated lower classification accuracy of body sensation maps in the fibromyalgia group than in controls. Moreover, compared with controls, the fibromyalgia group showed higher levels of alexithymia, higher awareness of bodily signals, and more negative interpretation of ambiguous bodily sensations in daily life, together with greater self-reported interoceptive difficulties.\u003c/p\u003e\n\u003cp\u003eOur findings support an amplified perception of bodily signals coupled with interoceptive difficulties and poorer differentiation of both emotions and non-emotional states in people with fibromyalgia. This raises the possibility that interventions that targetperceptual retraining, emotional state differentiation, and re-interpretation of bodily sensations might decrease the impact of pain and promote engagement in everyday activities for people with fibromyalgia.\u003c/p\u003e","manuscriptTitle":"When Emotions Hurt: Reduced Differentiation Between Physiological and Emotional States in Fibromyalgia","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2026-02-19 21:49:18","doi":"10.21203/rs.3.rs-7790947/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-10-27 14:37:32","doi":"10.21203/rs.3.rs-7790947/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"13de9fe2-2369-4a46-976b-f09aeba0e0a3","owner":[],"postedDate":"February 19th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-05T07:38:25+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-19 21:49:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-7790947","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7790947","identity":"rs-7790947","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}