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The following is a summary of “Role of pain and interpretation bias in fear of disease progression in people with diabetes,” published in the July 2024 issue of Pain by Michalski et al.

Fear of progression (FoP) may underlie anxiety in chronic health conditions and is linked to how symptoms like pain are interpreted.

Researchers conducted a retrospective study examining FoP, pain, interpretation bias, emotional states, and treatment adherence in Type 1 or Type 2 diabetes.

They included an age and gender-matched control group of 198 participants with Type 1 or Type 2 diabetes. Variables measured included FoP, pain severity, health threat-related interpretation bias, emotional states, and treatment adherence. The hypotheses made were people with diabetes would be more likely to interpret ambiguous stimuli as health threat-related compared to patients without diabetes. Secondly, among people with diabetes, pain severity and interpretation bias would be associated with higher levels of FoP, and interpretation bias would moderate the relationship between pain severity and FoP in people with diabetes, with the positive association between pain and FoP becoming stronger in a patient with greater interpretation bias.

The result showed that people with diabetes were more likely to see unclear situations as health threats than HCs; the effect was substantial (d=0.84). Additionally, patients with both diabetes and chronic pain were even more prone to interpret ambiguous stimuli as health risks (d=0.49). For participants with diabetes, the severity of the pain and the tendency to observe ambiguity as threats were significantly linked to FoP. Interpretation bias did not moderate the relationship between pain and FoP, and the associations were independent of general psychopathology.

Investigators concluded that people with diabetes were more likely to perceive ambiguous information as health threats, with persistent pain and interpretation bias linked to FoP, highlighting the need for better anxiety management.

Source: jpain.org/article/S1526-5900(24)00587-X/abstract#%20