Abstract
Differences in fibromyalgia impact on functioning exist and appear to be influenced by numerous factors, including symptomatology severity, as well as the cognitive profile of the individual. The contribution of these elements, however, tends to be explored in a fragmented manner. To address this issue, we tested a comprehensive structural equation model in which associations of cognitive fusion and pain catastrophizing with function limitations are investigated through fibromyalgia symptomatology (i.e., fatigue, pain severity, and depression) in 231 women with fibromyalgia. In the model, cognitive fusion and two catastrophizing components (magnification and helplessness) were associated with poorer functioning indirectly through fibromyalgia symptomatology. Only the rumination component of catastrophizing had a direct association with functional limitations. All fibromyalgia symptoms were linked to increased functional limitations. A parsimonious model with significant associations only obtained an excellent fit (S-B χ2 = 774.191, df = 543, p < 0.001; CFI = 0.943; RMSEA = 0.043; CAIC = −2724.04) and accounted for 50% of the variance of functional limitations. These results suggest that the relationship between psychological cognitive processes, fibromyalgia symptomatology, and functional limitations is complex and support the need for comprehensive models such as the present. The findings are discussed in the context of personalized psychological treatments (i.e., the need to address certain cognitive processes according to the problematic symptomatology or outcome).
Highlights
Functioning is significantly impaired in people with fibromyalgia (FM)
Pain severity is not the only factor associated with the impact of the syndrome and functional limitations are known to vary across patients reporting similar pain severity levels [4,5]
Fatigue and depression have been repeatedly associated with poorer functioning in people with FM [7,8], which explains why both were added as part of the newer diagnostic criteria published in 2010 by the American College of Rheumatology [9]
Summary
Functioning is significantly impaired in people with fibromyalgia (FM). It is widely accepted that a moderate-to-strong association exists between functional limitation and pain severity [1,2,3]. To the best of our knowledge a comprehensive model that includes both the fear-avoidance and the psychological flexibility model and the combination of symptoms and functioning in a structural equation model is missing This is important to investigate the complex associations between involved factors hypothesized in the literature. In the light of the previous literature [1,7,8,13,17], our goals is to test the hypothesized associations of pain catastrophizing, cognitive fusion, and FM symptom severity (pain, fatigue, and depression) in a theoretically-sound model that accounts for the contribution of these elements altogether in relation to functional limitation.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
