Mesce Martina, Nimbi Filippo Maria, Sarzi-Puttini Piercarlo, Lai Carlo, Galli Federica
Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Rome, Italy.
Department of Rheumatology, IRCCS Galeazzi-Sant'Ambrogio Hospital, Milan, Italy.
Eur J Psychotraumatol. 2025 Dec;16(1):2461434. doi: 10.1080/20008066.2025.2461434. Epub 2025 Feb 13.
This study investigates the psychological underpinnings of chronic pain conditions, specifically fibromyalgia, chronic headache, vulvodynia, and mixed condition (consisting of fibromyalgia in comorbidity with chronic headache and/or vulvodynia), with a focus on nociplastic pain mechanisms. The aim of the study is to better understand the psychological functioning of women with different chronic pain conditions to identify and discuss similarities and differences. In particular, we aim to explore any significant differences in the domain of traumatic experiences, in global defensive functioning, and in the domain of alexithymia among the evaluated groups. Further, the 4 groups with chronic pain will be compared with a healthy control group. A sample of 1006 Italian women diagnosed with chronic pain participated in the study, categorized into four clinical groups and a healthy control group. Measures were assessed using self-report measures, in particular: Traumatic Experiences Checklist, Defense Mechanism Rating Scales, and Toronto Alexithymia Scale. There are significant differences among groups, with mixed conditions exhibiting the highest levels of traumatic experiences, particularly emotional neglect and physical threats. Fibromyalgia and mixed condition groups displayed greater reliance on neurotic defense mechanisms. Additionally, fibromyalgia and mixed condition participants exhibited higher levels of alexithymia, indicating difficulties in emotional processing. These findings underscore the complex interplay between psychological factors and nociplastic pain conditions, emphasizing the importance of personalized psychological interventions in managing nociplastic pain. The study highlights the need for multidisciplinary approaches to nociplastic pain treatment, considering the diverse psychological profiles of affected individuals.
本研究调查慢性疼痛状况的心理基础，特别是纤维肌痛、慢性头痛、外阴痛以及混合状况（由纤维肌痛合并慢性头痛和/或外阴痛组成），重点关注伤害感受性疼痛机制。该研究的目的是更好地了解患有不同慢性疼痛状况的女性的心理功能，以识别并讨论其异同。具体而言，我们旨在探讨在评估组中，创伤经历领域、整体防御功能以及述情障碍领域是否存在任何显著差异。此外，将患有慢性疼痛的4个组与一个健康对照组进行比较。1006名被诊断患有慢性疼痛的意大利女性参与了该研究，她们被分为四个临床组和一个健康对照组。使用自我报告测量工具进行评估，具体包括：创伤经历清单、防御机制评定量表和多伦多述情障碍量表。各组之间存在显著差异，混合状况组的创伤经历水平最高，尤其是情感忽视和身体威胁。纤维肌痛组和混合状况组表现出对神经症防御机制的更大依赖。此外，纤维肌痛组和混合状况组的参与者表现出更高水平的述情障碍，表明在情绪处理方面存在困难。这些发现强调了心理因素与伤害感受性疼痛状况之间的复杂相互作用，凸显了个性化心理干预在管理伤害感受性疼痛中的重要性。该研究强调了对伤害感受性疼痛治疗采用多学科方法的必要性，要考虑到受影响个体的不同心理特征。
