State anxiety is independently associated with Visual Analog Scale pain rating in women with fibromyalgia

Abstract

The relationship between psychosocial factors and pain may not be the same across social-cultural contexts. The aim of this study was to examine associations among psychosocial factors and pain perception in women with fibromyalgia (FM) from Colombia. Ninety-six women with FM were recruited from an ambulatory clinic in Neiva, Colombia. They had an average age of 54 and 87.5% were from the lowest socioeconomic strata (SES) in the country. Visual Analog Scale (VAS) pain rating was administered, with the State-Trait Anxiety Inventory (STAI) to measure transient anxiety; Symptom Checklist 90 Revised (SCL-90R) to measure psychopathology; and the Brief COPE to measure coping with stress. Spearman correlations indicated that increased VAS pain scores were positively associated with years of diagnosis (rho = 0.21, P = 0.040), STAI-S (rho = 0.21, P = 0.043), SCL-90R global severity index (rho = 0.21, P = 0.037), SCL-90R positive symptom distress index (rho = 0.26, P = 0.012), SCL-90R somatization (rho = 0.28, P = 0.006), and SCL-90R depression (rho = 0.26, P = 0.009). Higher VAS scores were associated with more active coping (rho = 0.23, P = 0.024), positive reframing (rho = 0.21, P = 0.040), self-distraction (rho = 0.21, P = 0.040), acceptance (rho = 0.25, P = 0.014), and religiosity (rho = 0.27, P = 0.008). The multi-variable linear regression model showed that STAI-S was the only independent factor associated with VAS rating (Beta = 0.31, P = 0.012). Transient emotions are more highly associated with pain perception in women with FM than more stable psychosocial factors. It is possible that those women with more state anxiety experienced more pain, or that the experience of more pain caused more anxiety. Further research is warranted, especially with under-studied populations like those with low SES.