Relationships Between Physical Symptoms, Emotional Distress, and Pain Appraisal in Fibromyalgia: The Moderator Effect of Alexithymia

Abstract

Alexithymia is a personality construct that is frequently identified in fibromyalgia (FM). Previous studies have explored the relationship between alexithymia and emotional distress in this disease. Yet, the additional link with factors of pain appraisal is unknown. This study examined the moderating effect of alexithymia in the relationship between emotional distress and pain appraisal in 97 FM women. A control group of 100 healthy women also participated in the study. All participants completed several self-reports about pain experience, sleep quality, impairment, emotional distress, pain appraisal, and alexithymia. FM women showed significantly more difficulty in identifying and describing feelings, but less externally oriented thinking than healthy women. In the clinical group, difficulty in identifying feelings and difficulty in describing feelings significantly correlated with lower sleep quality, higher anxiety and depression, and increased pain catastrophizing and fear of pain. Difficulty in describing feelings significantly correlated with higher pain experience and vigilance to pain. Externally oriented thinking was not correlated with any of the clinical variables. Difficulty in identifying feelings moderated the relationship between anxiety and pain catastrophizing, and difficulty in describing feelings moderated the relationship between anxiety and fear of pain. Implications of the findings for the optimization of care of FM patients are discussed.

Attachment styles, pain intensity and emotional variables in women with fibromyalgia

“…Regarding the other emotional variables, and in accordance with previous literature in regard to fibromyalgia, higher scores were found among the patients for anxiety, depression and alexithymia dimensions .…”

Pain experience in Fibromyalgia Syndrome: The role of alexithymia and psychological distress

“…However, the results are still controversial and in some cases non-significant associations (Cox et al, 1994;Friedberg and Quick, 2007;Millard and Kinsler, 1992) or mixed results have been yielded (Celikel and Saatcioglu, 2006;Lumley et al, 2005). This pattern of outcomes has also been shown in FM syndrome; no correlation or positive association was found between alexithymia and different pain measures (Huber et al, 2009;Malt et al, 2002;Martínez et al, 2015;Sayar et al, 2004).…”

The Relationship Between Parental Care and Pain in Children With Headache: A Narrative Review

“…A positive correlation between alexithymia and pain catastrophizing has also been observed for other pain disorders, such as fibromyalgia, 67 and in patients with chronic pain, 68 suggesting a common pathway among different chronic forms of pain, impairments of emotional expression, and cognitive distortions.…”