Experimental hypervigilance changes the intensity/unpleasantness ratio of pressure sensations: evidence for the generalized hypervigilance hypothesis

Patients with chronic pain conditions such as fibromyalgia often demonstrate hypervigilance—undue alertness for unpleasant or threatening bodily sensations—as well as enhancement of these sensations. The generalized hypervigilance hypothesis (GHH) of Rollman and colleagues asserts that hypervigilance leads to this perceptual amplification. However, cause-and-effect relationships are difficult to establish in studies using a quasi-experimental design. In the present study, we sought to address this issue by attempting to induce hypervigilance experimentally, in one of two groups to which young, healthy adults had been randomly assigned. Those in the experimental group wrote about the flu and practiced counting their own blinks, breaths, and heartbeats; those in the control group wrote about a neutral topic and counted innocuous lights and sounds. Next, both groups rated the intensity and unpleasantness of pressure sensations (ranging from mild to painful) caused by a series of applications of a weighted rod to the forearm. The intensity/unpleasantness ratio of these ratings was significantly greater in the experimental group, suggesting that induced hypervigilance had caused perceptual amplification that generalized to pressure sensations, which had not been part of the experimental manipulation. Psychometric measures of anxiety and catastrophizing were equivalent in the two groups, indicating that the experimental manipulation operated via attentional rather than emotional changes. The results support the GHH.