Department of Psychology, University of North Texas.
Department of Psychology, San Diego State University.
Behav Med. 2024 Jul-Sep;50(3):211-223. doi: 10.1080/08964289.2023.2196389. Epub 2023 Apr 17.
Fibromyalgia syndrome (FM) is a chronic musculoskeletal condition that is accompanied by hypersensitivity to pain. Researchers have examined factors that affect pain ratings among people with FM, such as trauma, depressive symptoms, and coping; however, collectively, the interrelationships among this set of variables, and their relationships to pain, have not been examined. To better understand these relationships, a moderated-mediation model was used to examine how recalled trauma severity, depressive symptoms, relative emotion-focused coping relate to pain ratings. There were 501 participants who were primarily female, White, and ranged in age from 20 to 84 years. All participants had a physician's diagnosis of FM. The results indicated a significant moderated-mediation. Depressive symptoms significantly mediated the relationship between recalled trauma severity and pain ratings, such that greater trauma severity related to more depressive symptoms which in turn were associated with more pain. The mediation chain was moderated by relative emotion-focused coping (i.e., the proportion of emotion-focused coping compared to problem-focused coping), such that when relative emotion-focused coping was used at higher levels, the relationship between recalled trauma severity and depressive symptoms significantly weakened, reducing the indirect association between recalled trauma severity and pain ratings. The findings from the present study indicate that a treatment approach that includes a trauma-focused therapy such as exposure therapy or Emotional Awareness and Expression Therapy should be tested to determine whether these treatments can reduce the impact of past traumas, improve depressive symptoms, decrease pain ratings, and promote more adaptive coping among people with FM.
纤维肌痛综合征 (FM) 是一种慢性肌肉骨骼疾病，伴有对疼痛的敏感性增加。研究人员已经研究了影响 FM 患者疼痛评分的因素，例如创伤、抑郁症状和应对方式；然而，总体而言，这组变量之间的相互关系及其与疼痛的关系尚未得到研究。为了更好地理解这些关系，使用调节中介模型来检查回忆性创伤严重程度、抑郁症状和相对情绪聚焦应对方式如何与疼痛评分相关。有 501 名参与者，主要是女性，白种人，年龄在 20 岁至 84 岁之间。所有参与者都有 FM 医生的诊断。结果表明存在显著的调节中介作用。抑郁症状显著中介了回忆性创伤严重程度与疼痛评分之间的关系，即创伤严重程度越大，抑郁症状越严重，而抑郁症状又与疼痛程度相关。中介链由相对情绪聚焦应对方式（即情绪聚焦应对方式与问题聚焦应对方式的比例）调节，即当相对情绪聚焦应对方式使用水平较高时，回忆性创伤严重程度与抑郁症状之间的关系显著减弱，从而降低了回忆性创伤严重程度与疼痛评分之间的间接关联。本研究的结果表明，应测试一种包括创伤聚焦疗法（如暴露疗法或情绪意识和表达疗法）的治疗方法，以确定这些疗法是否可以减轻过去创伤的影响，改善抑郁症状，降低疼痛评分，并促进 FM 患者更适应的应对方式。
