Yamin Jolin B, Meints Samantha M, Pester Bethany D, Crago Madelyn, Papianou Lauren, Lazaridou Asimina, Paschali Myrella, Napadow Vitaly, Edwards Robert R
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 850 Boylston Street, Chestnut Hill, Boston, MA, 02467, USA.
Harvard Medical School, Boston, MA, USA.
BMC Musculoskelet Disord. 2025 Feb 25;26(1):195. doi: 10.1186/s12891-025-08449-7.
Childhood abuse has been linked to poorer health outcomes in individuals with fibromyalgia (FM), and this relationship may be affected by cognitive processes such as pain catastrophizing and mindfulness.
This study investigated the impact of childhood abuse on pain-related symptoms and functioning in individuals with (FM) and examined how the critical psychosocial constructs of pain catastrophizing and mindfulness might moderate this relationship. We hypothesized that childhood abuse would be linked to greater physical symptoms and lower functioning, with pain catastrophizing and mindfulness influencing these associations.
The study sample consisted of 113 women with FM. Correlational analyses were conducted to examine the relationship between childhood abuse and health outcomes (pain severity, pain interference, fibromyalgia impact, and physical functioning). Moderation analyses were conducted to examine the impact of pain catastrophizing and mindfulness on the relationship between childhood abuse and health outcomes.
As expected, catastrophizing was generally associated with elevated pain-related symptomatology and reduced functioning, and higher levels of mindfulness were associated with reduced pain impact. However, contrary to our hypothesis, childhood abuse was not directly associated with pain severity, pain interference, fibromyalgia impact, or physical functioning. Pain catastrophizing and mindfulness were significant moderators of the relationship between childhood abuse and health outcomes. Specifically, childhood abuse was related to higher pain interference only at low levels of catastrophizing and was associated with greater fibromyalgia impact and reduced physical functioning only at high levels of mindfulness.
Our findings suggest that while childhood abuse did not directly impact pain-related outcomes in this sample of fibromyalgia patients, cognitive factors like pain catastrophizing and mindfulness play significant roles in moderating these effects. These results underscore the importance of assessing for cognitive and psychological factors in the management of fibromyalgia, especially for patients with a history of childhood abuse. Further research is needed to explore these relationships in more diverse samples and to develop personalized and targeted interventions for this patient population.
童年期受虐与纤维肌痛（FM）患者较差的健康结局相关，这种关系可能会受到诸如疼痛灾难化和正念等认知过程的影响。
本研究调查了童年期受虐对FM患者疼痛相关症状及功能的影响，并检验了疼痛灾难化和正念这两个关键心理社会因素如何调节这种关系。我们假设童年期受虐会与更多的身体症状及更低的功能水平相关，而疼痛灾难化和正念会影响这些关联。
研究样本包括113名FM女性患者。进行相关性分析以检验童年期受虐与健康结局（疼痛严重程度、疼痛干扰、纤维肌痛影响及身体功能）之间的关系。进行调节分析以检验疼痛灾难化和正念对童年期受虐与健康结局之间关系的影响。
正如预期的那样，灾难化通常与疼痛相关症状的增加及功能的降低有关，而更高水平的正念与疼痛影响的降低有关。然而，与我们的假设相反，童年期受虐与疼痛严重程度、疼痛干扰、纤维肌痛影响或身体功能并无直接关联。疼痛灾难化和正念是童年期受虐与健康结局之间关系的显著调节因素。具体而言，仅在低水平的灾难化情况下，童年期受虐才与更高的疼痛干扰相关，且仅在高水平的正念情况下，童年期受虐才与更大的纤维肌痛影响及更低的身体功能相关。
我们的研究结果表明，虽然在这个纤维肌痛患者样本中童年期受虐并未直接影响疼痛相关结局，但疼痛灾难化和正念等认知因素在调节这些影响方面发挥着重要作用。这些结果强调了在纤维肌痛管理中评估认知和心理因素的重要性，尤其是对于有童年期受虐史的患者。需要进一步研究以在更多样化的样本中探索这些关系，并为该患者群体开发个性化和有针对性的干预措施。
