Traumatic experiences and interoceptive awareness: Comparing medically unexplained pain and fatigue to panic disorder and emotional exhaustion

Abstract

Background. The present study explores differences between patient groups –that share physical complaints as common characteristic –in the recognition of distress in the body and how this relates to personality characteristics and early childhood adversity. Methods. 26 patients with fibromyalgia/chronic fatigue syndrome (MUS), 31 patients with panic disorder (PD), and 36 patients with emotional exhaustion (EE) completed a self-observation tool every hour for 7 days assessing how much psychological stress and physical complaints they experienced. Furthermore, all patients completed questionnaires assessing traumatic experiences, interoceptive awareness and trait anxiety. Results. The within-subject correlation between psychological distress and physical complaints was higher in the PD group than in both other groups. Trait anxiety and anxiety sensitivity, which was higher in the PD group, were positively correlated with being able to see the link between emotional distress and physical complaints. Furthermore, the number of traumatic experiences was higher in the MUS group than in other groups, and was in turn significantly negatively correlated with recognizing distress in the body.

Conclusions. Differences between patient groups arise in trait anxiety and anxiety sensitivity as well as traumatic experiences. Patients experiencing medically unexplained pain and/or fatigue are less anxious and often have experienced more early childhood adversity, which in turn relates to a worse recognition of distress in the body than in patients with emotional exhaustion and panic patients. These findings may have implications for clinical practice, as it suggests differences in underlying mechanisms in different patient groups, who in turn may benefit from different, tailored treatment strategies.