When emotions hurt: negative interpretations of bodily signals and interoceptive difficulties in fibromyalgia.

Overview

1. Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Pasteur 3 St, Warsaw, Poland
2. IIMPACT in Health, Adelaide University, Adelaide, South Australia Australia
3. Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia Australia
4. Brain Stimulation, Imaging and Cognition Research Group, College of Health, Adelaide University, Adelaide, SA Australia
5. Hopwood Centre for Neurobiology, South Australian Health and Medical Research Institute, Adelaide, SA Australia
6. Women’s and Children’s Hospital, Adelaide, SA Australia

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, performed to test whether different emotions and states are associated with statistically distinct bodily patterns, indicated comparable classification accuracy of body sensation maps in the fibromyalgia group and controls. However, 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 in people with fibromyalgia. This raises the possibility that interventions that target perceptual retraining, and re-interpretation of bodily sensations might decrease the impact of pain and promote engagement in everyday activities for people with fibromyalgia.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00426-026-02341-2.

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Version 2, 28 September 2026

• Publisher: — → Springer Science+Business Media

Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 4 authors, 12 MeSH terms, 1 funder, 61 references.

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This paper

Herman, A. M., Szczawińska, J., Berryman, C., & Stanton, T. R. (2026). When emotions hurt: negative interpretations of bodily signals and interoceptive difficulties in fibromyalgia. Psychological research, 90(4), 125. https://doi.org/10.1007/s00426-026-02341-2

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