The relationship of childhood trauma, dissociative experiences and depression with pain in female patients with fibromyalgia: a cross-sectional study

Abstract

The relationship of childhood trauma, dissociative experiences and depression with pain in female patients with fibromyalgia: a cross-sectional studyObjective: The aim of this study was to investigate childhood trauma (CT) and dissociative symptoms in patients with fibromyalgia and evaluate the relationship of these characteristics with pain intensity. Methods: Forty patients followed up with fibromyalgia diagnosis in the physical therapy and rehabilitation outpatient clinic; and as a control group, 38 healthy individuals who have similar age, gender, and educational status, were included in the study. A sociodemographic and clinical data form, Beck Depression Inventory (BDI), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ) and Visual Analogue Scale (VAS) were administered to participants. Results: Emotional abuse, physical neglect, physical abuse, CTQ total, SDQ and DES scores were found to be significantly higher in the fibromyalgia group than the control group. Only the difference for SDQ scores remained significant when a comparison made between groups by controlling depression levels. Somatoform dissociation scores were found to be a significant predictor of pain intensity in patients with fibromyalgia. Conclusion: Somatoform dissociative symptoms are found to be higher in patients with fibromyalgia than the control group. These symptoms may contribute to development and exacerbation of pain in fibromyalgia. Taking the dissociative symptoms into account have an important role in the treatment of patients with fibromyalgia who have a frequent history of CT, so the treatment of these patients should be carried out in cooperation with psychiatrists. Keywords: Childhood trauma, dissociation, fibromyalgia, somatoform dissociation ÖZET Kadın fibromiyalji hastalarında çocukluk çağı travmaları, disosiyatif yaşantılar ve depresyonun ağrı ile ilişkisi: Kesitsel bir çalışma Amaç: Bu çalışmanın amacı fibromiyalji (FM) hastalarında çocukluk çağı travmaları ile disosiyatif belirtileri araştırmak ve bu özelliklerin FM'deki ağrı şiddeti ile ilişkisini incelemektir. Yöntem: Fizik tedavi ve rehabilitasyon polikliniğinde fibromyalji tanısıyla takip edilmekte olan 40 hasta ile kontrol grubu olarak yaş, cinsiyet ve öğrenim durumu açısından benzer olan 38 sağlıklı kişi çalışmaya dahil edildi. Katılımcılara sosyodemografik ve klinik veri toplama formu, Beck Depresyon Ölçeği (BDÖ), Çocukluk Çağı Travmaları Ölçeği (ÇÇTÖ), Disosiyatif Yaşantılar Ölçeği (DYÖ), Somatoform Disosiyasyon Ölçeği (SDÖ) ve Görsel Analog Skala (GAS) uygulandı. Bulgular: FM grubunda duygusal istismar, fiziksel ihmal, fiziksel istismar, ÇÇTÖ toplam, SDÖ ve DYÖ puan ortalamaları kontrol grubuna göre anlamlı derecede yüksek bulundu. Gruplar arasında depresyon düzeyleri kontrol edilerek karşılaştırma yapıldığında ise sadece SDÖ puan farklılığının anlamlı olarak devam ettiği görüldü. Somatoform disosiyasyon puanlarının FM hastalarında ağrı şiddetinin anlamlı belirleyicisi olduğu saptan...

Childhood trauma and dissociation in female patients with fibromyalgia

“…With the exception of emotional neglect, the experiment group scored higher than the control group in the other four sub-dimensions of the CTQ. These results were consistent with the findings of previous studies with [11,12,26,27] and without a control group [9,14,17] which emphasized the presence of exposure to childhood trauma in FM patients. The incidence of emotional abuse was dramatically higher in the FM patients than in the control group, which was consistent with studies that have reported the essential forms of trauma related to fibromyalgia to be emotional [11,12,26,29].…”

“…These results were consistent with the findings of previous studies with [11,12,26,27] and without a control group [9,14,17] which emphasized the presence of exposure to childhood trauma in FM patients. The incidence of emotional abuse was dramatically higher in the FM patients than in the control group, which was consistent with studies that have reported the essential forms of trauma related to fibromyalgia to be emotional [11,12,26,29]. The findings were also consistent with the literature in respect of more physical trauma reported by FM patients than the control group [12,26].…”

“…The incidence of emotional abuse was dramatically higher in the FM patients than in the control group, which was consistent with studies that have reported the essential forms of trauma related to fibromyalgia to be emotional [11,12,26,29]. The findings were also consistent with the literature in respect of more physical trauma reported by FM patients than the control group [12,26].…”

Mindbody Methods and Massage Therapy for Fibromyalgia: A Systematic Review

“…While these trigger points may arise as a result of central nervous system sensitisation, alternatively, the trigger points could contribute to the development of fibromyalgia syndrome, as the presence of peripheral trigger points has been shown to contribute to central sensitisation (Shah & Heimur, 2012). Karas et al (2017) found that people with fibromyalgia had a higher rate of childhood trauma, were more likely to dissociate and/or report somatoform disorders. These authors suggested that fibromyalgia clients may benefit from emotional processing techniques.…”

“…While fibromyalgia is generally considered a condition of the nervous system, there is evidence that other systems are affected. Systemic inflammation and neuro-inflammation (Bäckryd, 2017;Littlejohn, 2015), myofascial trigger points (Shah & Heimur, 2012;Cakit et al, 2010), dissociation and somatoform disorders (Karas et al, 2017) are all associated with fibromyalgia. Shah and Heimur (2012) note that people with fibromyalgia are much more likely to have trigger points than the general population.…”