Modifiable Psychological Factors Affecting Functioning in Fibromyalgia

Abstract

Objective: To examine the role of several interrelated, potentially modifiable psychological factors (i.e., mindfulness and catastrophizing) in influencing patient-reported functioning. Methods: In this cross-sectional study, 107 patients with fibromyalgia completed self-report assessments of pain severity, functioning and impact of symptoms, mindfulness, and pain catastrophizing. Linear regression and bootstrapping mediation analyses were performed to assess the relationships between these factors. Results: Pain intensity was significantly and positively associated with pain catastrophizing and impact of fibromyalgia on functioning. Linear regression analyses indicated that pain intensity, catastrophizing, and mindfulness affect functioning in fibromyalgia. Follow-up mediation analysis revealed a significant indirect effect of pain catastrophizing on the relationship between pain intensity and fibromyalgia functioning. Conclusion: Individuals with fibromyalgia who have higher levels of pain and catastrophizing, and lower levels of mindfulness, are more likely to experience impaired functioning. Our findings suggest that pain catastrophizing appears to be an especially important variable contributing to reduced functioning in women with fibromyalgia. Therefore, catastrophizing-reducing treatments (e.g., cognitive behavioral therapy) are likely to have direct, beneficial impacts on functioning.

The Role of Pain Catastrophizing and Pain Acceptance in Performance-Based and Self-Reported Physical Functioning in Individuals with Fibromyalgia and Obesity

“…Research has repeatedly shown that pain catastrophizing and pain acceptance are important predictors of self-reported physical functioning in samples with acute [ 104 , 105 ] and chronic pain [ 105 , 106 ], including FM [ 41 , 107 , 108 , 109 , 110 ]. Our findings are consistent with the previous evidence.…”

“…Pain catastrophizing has been observed in individuals with FM [ 40 ] and has been robustly associated with physical impairment in FM and other pain conditions [ 41 , 42 , 43 , 44 ]. However, the role of pain catastrophizing in individuals with chronic pain conditions and comorbid obesity remains less clear.…”

“…To date, research into physical functioning in individuals with chronic pain and FM has mostly relied on self-report measures [ 25 , 41 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. Performance-based measures, which focus on actual rather than perceived functional ability, have generally been neglected.…”

“…In summary, the goal of the present study is to investigate the contribution of pain catastrophizing (vulnerability factor) and pain acceptance (resilience factor) to the physical functioning of individuals with FM and comorbid obesity. We hypothesized that pain catastrophizing [ 41 , 42 , 43 , 52 , 56 ] would be associated with reduced physical functioning, while pain acceptance would be associated with better physical functioning [ 47 , 60 , 62 , 76 ]. We also hypothesized that the contribution of psychological variables will be greater for perceived versus performance-based functioning [ 74 ].…”

Psychological Consequences of Coronavirus 2019 Pandemic in Fibromyalgia Patients: A Systematic Review Study

“…Pain is the most common complaint in these patients; most patients present with vague, diffuse pain and nonspecific muscle pain. Accompanying symptoms such as morning dryness, fatigue and headache are also common (12). The risk is higher in women than men and increases with age, such that it reaches its maximum at the age of 55 -79 (13).…”