Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 23;11(10):1923-1930.
doi: 10.1093/tbm/ibab049.

Interoceptive attention regulation in Ehlers-Danlos syndromes: associations between pain and psychiatric symptom severity

Madison Niermeyer  1 , Douglas Ball  2 , Michael Green  1   3 , Bradley Jensen  4 , Laura Pace  5 , Robert Shingleton  1 , Bradley Fawver  1 , Stephen K Trapp  6
Affiliations

Interoceptive attention regulation in Ehlers-Danlos syndromes: associations between pain and psychiatric symptom severity

Madison Niermeyer et al. Transl Behav Med. .

Abstract

High rates of comorbid chronic pain, anxiety, and mood disorders among individuals with the Ehlers-Danlos syndromes (EDS+) are becoming increasingly recognized, though this complex symptomology remains poorly understood and undertreated. The current project examined whether interoceptive attention regulation is protective against depressive and anxiety symptoms in individuals with suspected EDS+. Data were collected from individuals participating in a transdisciplinary diagnostic visit within an EDS+ specialty consultation clinic. Participants were included in the current analyses (n = 49) if they had complete data on the following measures: the PHQ-8, the GAD-7, the Pain Severity subscale from the West Haven-Yale Multidimensional Pain Inventory, and the Attention Regulation subscale from the Multidimensional Assessment of Interoceptive Awareness. Consistent with expectations, the sample showed high levels of clinically significant anxiety and depressive symptoms. Pain severity ratings were significantly correlated with depressive but not anxiety severity. Moreover, higher levels of perceived interoceptive attention regulation abilities were significantly associated with less severe anxiety and depressive symptoms; however, attention regulation did not moderate the associations of pain with anxiety and depressive symptom severity.

Conclusions: The current project replicated recent findings that pain, anxiety, and depression are common in individuals with EDS+. The ability to focus and control somatic attention appears to be protective and a potential target for interventions in EDS+.

Keywords: Anxiety; Chronic illness; Depression; Ehlers–Danlos syndromes; Interoceptive awareness; Pain.

PubMed Disclaimer

Figures

Fig 1 |
Fig 1 |
Significant associations between the Attention Regulation subscale scores from the Multidimensional Assessment of Interoceptive Awareness and depressive and anxiety symptom severity. Better self-reported ability to direct attention to (or away from) bodily states is associated with less anxiety and depressive symptoms.
See this image and copyright information in PMC

References

    1. Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers–Danlos Syndromes. Am J Med Genet C: Semin Med Genet. 2017;175:8–26. - PubMed
    1. Fogel S. Surgical failures: is it the surgeon or the patient? The all too often missed diagnosis of Ehlers-Danlos syndrome. Am Surg. 2013;79(6):608–613. - PubMed
    1. Steinmann B, Royce PM, Superti-Furga, A. The Ehlers-Danlos syndrome. In: Steinmann B, Royce PM, eds. Connective Tissue and Its Heritable Disorders. 2nd ed. Wiley-Liss; 2002;2:431–523.
    1. Levy HP. Hypermobile Ehlers-Danlos Syndrome. In Adam MP, Ardinger HH, Pagon RA, eds. GeneReviews®. Seattle, WA: University of Washington. Available at https://www.ncbi.nlm.nih.gov/books/NBK1279/. - PubMed
    1. Bloom L, Byers P, Francomano C, Tinkle B, Malfait F. The international consortium on the Ehlers–Danlos syndromes. Am J Med Genet C: Semin Med Genet. 2017;175(1):5–7. - PubMed

Publication types