Catastrophizing, Acceptance, and Coping as Mediators Between Pain and Emotional Distress and Disability in Fibromyalgia

Abstract

Catastrophizing, acceptance, and coping have an important predictive value in chronic pain; however, it is not known which of these variables has the greatest contribution in fibromyalgia (FM). This study explored the mediating role of catastrophizing, acceptance, and coping in the relationship between pain and emotional distress/disability in a FM sample. Ninety-two FM patients and 51 healthy participants controls were evaluated on pain- and psychological-related variables. Catastrophizing, acceptance, behavioral coping, and emotional coping were significantly correlated with emotional distress and/or disability. Catastrophizing had a significant effect as a mediator on the relationship between pain and depression/anxiety. The current management of FM could improve by including cognitive techniques aimed at modifying the negative appraisal of pain.

Pain acceptance and its impact on function and symptoms in fibromyalgia

“…The positive effect of acceptance remains significant also when adjusting for potentially relevant factors. The crosssectional findings are consistent with results from previous studies [12,17,24,25,27,36,37] and adds to the evidence that pain acceptance plays a part in patients with fibromyalgia as well as in other patients with chronic pain. However, the longitudinal sub-study is the first of its kind in patients with fibromyalgia.…”

“…Trainor et al [26] found higher general psychological acceptance to be associated with better functioning in 339 individuals with fibromyalgia. In another study with 92 patients with fibromyalgia, Lami et al [27] found a lower prevalence of anxiety, depression and functional impairment in those with higher pain acceptance. It remains of interest to further examine the relations between pain acceptance and impact of illness in fibromyalgia, given the scarce amount of fibromyalgia-specific research on this topic.…”

Physical and psychological paths toward less severe fibromyalgia: A structural equation model

“…Among psychological factors, particularly meaningful are those related to maintaining patients' functioning, despite ongoing stress; namely, psychological resilience [5,6]. For example, high positive affect and low pain catastrophizing are associated J o u r n a l P r e -p r o o f 4 with low psychological distress, which in turn is related to low symptom severity [7,8].…”

Immune System Sex Differences May Bridge the Gap Between Sex and Gender in Fibromyalgia

“…As long as the pathophysiology of the FMS is not elucidated, the diagnosis (Wolfe et al, 2016;Arnold et al, 2019) and the treatment (Macfarlane et al, 2017) will remain inadequate. Many consider FMS to be psychosomatic (Lami et al, 2018) and there are still physicians who do not recognize the disorder. Although the name indicates a fibromuscular affection and the syndrome is classified as a rheumatic disorder, FMS is treated as a neurological problem, in accordance with the currently most accepted hypothesis: central sensitization (Staud et al, 2009).…”

“…The latter include infections (Smatti et al, 2019) and stress due to traumatic experiences (Sharif et al, 2018). Stress and certain personality characteristics associate positively with autoimmune diseases, FMS, and other chronic diseases in retrospective studies with selected controls (Martin et al, 1996;Lami et al, 2018). But whereas stress and personality are considered precipitating factors or consequences in autoimmune diseases (Mitsonis et al, 2009;Hassett and Clauw, 2010), they are interpreted as the cause in FMS (Lami et al, 2018) despite a lack of convincing evidence demonstrating a causal relation (Häuser and Henningsen, 2014).…”