Unresolved trauma in fibromyalgia: A cross-sectional study

Waller, Elisabeth; Scheidt, Carl Eduard; Endorf, Katharina; Hartmann, Armin; Zimmermann, Peter

doi:10.1177/1359105315580460

Cited by 14 publications

(13 citation statements)

References 23 publications

(24 reference statements)

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“…We think that this may be due to our small sample size; in fact, this PTLE has only been reported by two studies and appears with a frequency of 18% in a sample of 600 people, and only one case is included in another sample of 34 patients . Additionally, the PTLEs found are attributed to psychosocial rather than medical factors, which is in line with the findings of most other studies . On the other hand, at the level of analysis of specific PTLEs, none of the published research reported percentages similar to those obtained in our study.…”

Section: Discussionsupporting

confidence: 83%

“…Several studies have utilized qualitative methodologies, such as in‐depth interviews and life histories, leading some researchers to propose a distinction between traumatic and non‐traumatic fibromyalgia . Other studies have used psychometric instruments to find PTLEs; a number found a higher prevalence of psychosocial events, while others found a higher prevalence of physical events (eg surgery, accidents, childbirth, and pregnancy) . However, few studies have organized PTLEs into more general categories.…”

Section: Introductionmentioning

confidence: 99%

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Causal attributions of potentially traumatic life events in fibromyalgia patients

et al. 2019

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Fibromyalgia is a disorder characterized by chronic generalized pain, including allodynia and hyperalgesia, and is usually accompanied by fatigue, sleep disturbances, stiffness in the joints, and mild cognitive impairment, along with other symptoms. Its diagnosis is clinical, and is based on the self-reporting of the severity of pain and the associated symptoms. 1,2 A key factor in the pathophysiology of fibromyalgia is central sensitization, which is a state of neuronal hyperexcitability.The origin of central sensitization can be complex and attributed to multiple causes, with predisposing factors and organic, environmental, and psychosocial triggers, including chronic stress, whether it be in the form of trauma, stressful life events, or even daily hassles that can occur over the course of a lifetime. 3 The term potentially traumatic life event (PTLE) 4 is used to refer to Abstract Aim: In common clinical practice, potentially traumatic life events and the possible attribution of such events to fibromyalgia often go undetected. Having demonstrated in a previous study that hypnosis facilitates the exploration of such events, we now aim to explore and classify the content of these events and to determine whether there is an association between the type of event, the state of consciousness in which the patient verbalized it, and possible causal attributions of the disorder.Method: Thirty-two women (age 52 ± 7 years) suffering from fibromyalgia and receiving care in a primary healthcare center participated in the same semi-structured interview twice: once in a wakeful state and once under hypnosis. They answered two questions: what other events in your life coincided with the onset of fibromyalgia? Are those events related to your fibromyalgia in any way? To counteract biases related to order or recall, the order of the two interviews was randomized with a 3month period in between. Results:The patients verbalized 23 different types of events, which we classified into eight categories, mostly psychosocial events. Although the relationship between the three variables was not statistically significant, two of the bivariate associations predicted (type of event and state of consciousness; and state of consciousness and causal attribution) were confirmed (χ 2 , P values of .01 and <.001 respectively). Conclusion:Potentially traumatic life events could remain undetected in primary healthcare consultations and hypnosis could prove a useful tool for their detection. K E Y W O R D Scausal attributions, fibromyalgia, hypnosis, life events, primary health care

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Causal attributions of potentially traumatic life events in fibromyalgia patients

et al. 2019

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“…These authors identified different clusters of FM, with a cluster of patients reporting most pain and disability having the highest scores on CA. Yet, other studies have also typically failed to find a relationship between CA and pain severity in FM (Aaron et al., ; Waller et al., ). It is possible that other measures, for example, disability, are more appropriate than pain intensity to demonstrate an impact of CAs on the clinical outcome of FMS‐patients.…”

Section: Discussionmentioning

confidence: 97%

Prevalence and impact of childhood adversities and post‐traumatic stress disorder in women with fibromyalgia and chronic widespread pain

Coppens

Wambeke

Morlion

et al. 2017

European Journal of Pain

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Objective: This study investigates the prevalence of different types of childhood adversities (CA) and posttraumatic stress disorder (PTSD) in female patients with Fibromyalgia or Chronic Widespread Pain (FM/ CWP) compared to patients with Functional Dyspepsia (FD) and achalasia. In FM/CWP, we also investigated the association between CA and PTSD on the one hand and pain severity on the other. Methods: Patient samples consisted of 154 female FM/CWP, 83 female FD and 53 female achalasia patients consecutively recruited from a tertiary care hospital. Well-validated self-report questionnaires were used to investigate CA and PTSD. Results: Forty-nine per cent of FM/CWP patients reported at least 1 type of CA, compared to 39.7% of FD patients and 23.4% of achalasia patients (p < 0.01). The prevalence of CA did not differ significantly between FM/CWP and FD, but both groups had a higher prevalence of CA compared to both achalasia and healthy controls (p < 0.01). FM/ CWP patients were six times more likely to report PTSD than both FD (p < 0.001) and achalasia (p < 0.001) patients. Conclusion: In FM/CWP, PTSD comorbidity, but not CA, was associated with self-reported pain severity and PTSD severity mediated the relationship between CA and pain severity. In summary, the prevalence of CA is higher in FM/CWP compared to achalasia, but similar to FD. However, PTSD is more prevalent in FM/CWP compared to FD and associated with higher pain intensity in FM/CWP. Significance: As expected and has been shown in other functional disorders, we found elevated levels of childhood adversity in FM/CWP patients. Results of this study however suggest that the impact of childhood adversity (i.e. whether such events have led to the development of PTSD symptoms), rather than the mere presence of such adversity, is of crucial importance in FM/CWP patients. Screening for PTSD symptoms should be an essential part of the assessment process in patients suffering from FM/CWP, and both prevention and intervention

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“…Alexithymia and FMS share several factors, including a close link with trauma and dissociation as a defense mechanism. In fact, several authors have confirmed the role of traumatic experiences on the onset and the presence of fibromyalgia as well as in individuals with alexithymia (7,8). Individuals with alexithymia seem to confer much more weight to the physical sensation of arousal instead of interpreting it, which remains suspended somehow.…”

Section: Introductionmentioning

confidence: 95%

Machine Learning Increases Diagnosticity in Psychometric Evaluation of Alexithymia in Fibromyalgia

et al. 2020

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Here, we report an investigation on the accuracy of the Toronto Alexithymia Scale, a measure to assess alexithymia, a multidimensional construct often associate to fibromyalgia. Two groups of participants, patients with fibromyalgia (n = 38), healthy controls (n = 38) were administered the Toronto Alexithymia Scale and background tests. Machine learning models achieved an overall accuracy higher than 80% in detecting both patients with fibromyalgia and healthy controls. The parameter which alone has demonstrated maximum efficiency in classifying the single subject within the two groups has been the item 3 of the alexithymia scale. The analysis of the most informative features, based on all scales administered, revealed that item 3 and 13 of the alexithymia questionnaire and the visual analog scale scores were the most informative attributes in correctly classifying participants (accuracy above 85%). An additional analyses using only the alexithymia scale subset of items and the visual analog scale scores has shown that the predictors which efficiently classified patients with fibromyalgia and controls were the item 3 and 7 (accuracy = 85.53%). Our findings suggest that machine learning models analysis based on the Toronto Alexithymia Scale subset of items scores accurately distinguish patients with fibromyalgia from healthy controls.

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Unresolved trauma in fibromyalgia: A cross-sectional study

Cited by 14 publications

References 23 publications

Causal attributions of potentially traumatic life events in fibromyalgia patients

Causal attributions of potentially traumatic life events in fibromyalgia patients

Prevalence and impact of childhood adversities and post‐traumatic stress disorder in women with fibromyalgia and chronic widespread pain

Machine Learning Increases Diagnosticity in Psychometric Evaluation of Alexithymia in Fibromyalgia

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