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Published on: January 5, 2024
The Emotional Allodynia Questionnaire: Preliminary Validation and Clinical Phenotyping in Fibromyalgia
Alberto Corriero1, Mariateresa Giglio1, Alfonso Pilolla1
1Department of Interdisciplinary Medicine - Pain and ICU Section, University of Bari Aldo Moro, Bari, Italy.
Background:
Despite IASP's recognition of pain as a sensory and emotional experience, current assessment tools largely overlook affective hypersensitivity to socially neutral stimuli, a phenomenon we term "emotional allodynia" that appears particularly recurrent in fibromyalgia.
Methods:
This preliminary psychometric validation study evaluated the Emotional Allodynia Questionnaire (AEQ), an 11-item 0-4 Likert scale designed to quantify maladaptive emotional responses to subtle relational stimuli (perceived unresponsiveness, loss of reciprocity) in 107 patients with fibromyalgia from a tertiary pain clinic (90.7% female, mean age 56.8 years, median VAS 8.0).
Results:
AEQ demonstrated excellent internal consistency (Cronbach's α = 0.917, 95% CI: 0.880-0.943). Exploratory factor analysis supported unidimensional structure (Kaiser-Meyer-Olkin, KMO = 0.90, loadings 0.55-0.86). Confirmatory factor analysis provided partial support (CFI = 0.924, RMSEA = 0.104). Convergent validity showed moderate-to-strong Spearman correlations with Central Sensitization Inventory (CSI) (ρ = 0.40), Pain Catastrophizing Scale (PCS) (ρ = 0.57), Difficulties in Emotion Regulation Scale (DERS) (ρ = 0.59), Beck Depression Inventory-II (BDI-II) (ρ = 0.52), State-Trait Anxiety Inventory (STAI-Y) (ρ = 0.51-0.56, all p <0.001). Principal Component Analysis revealed that AEQ loaded strongly on a shared affective-sensitization dimension (65.9% variance). Exploratory median-split AEQ-CSI phenotyping identified four distinct profiles - resilient, emotional allodynia, central sensitization, mixed - that differed across all measures (Kruskal-Wallis p <0.001).
Conclusion:
These preliminary findings suggest that the AEQ may represent a promising and theoretically coherent instrument for assessing a relational-affective dimension relevant to nociplastic pain, warranting replication in larger, independent samples.
