Catastrophizing and rumination mediate the link between functional disabilities and anxiety/depression in fibromyalgia. A double-mediation model.

Fibromyalgia can be considered to be a model of chronic pain resulting from dysregulation of pain processing. From a psychological point of view, it is possible to consider transdiagnostic processes that would participate in both the dysregulation of pain and associated emotions. OBJECTIVE: The aim of this study was to test the links that exist between the tendency to Repetitive Negative Thinking (RNT) and the anxious-depressive manifestations in fibromyalgia. More specifically, we wanted to test a double mediation model where RNT would mediate the link between pain and depression/anxiety via catastrophizing. METHOD: Eighty-two patients with fibromyalgia completed a series of questionnaires evaluating their level of depression, anxiety, disability related to pain, catastrophizing as well as various measures of Repetitive Thoughts. RESULTS: The results showed strong correlations between RNT levels, pain, and anxious-depressive manifestations in this population. Moreover, the links between pain and depression/anxiety were mediated by catastrophizing and RNT in serial. CONCLUSION: Results support the interest of studying RNT as a transdiagnostic process in fibromyalgia pain. Considering RNT in fibromyalgia allows a better understanding of tthe links that exist between pain and emotional disorders in this population and thus to better understand the psychopathological comorbidity of fibromyalgia.

The impact of rumination on fibromyalgia pain after physical activity: an experimental study.

Some fibromyalgia (FM) patients engage in rumination (i.e. a chain of repetitive, passive and relatively uncontrollable thoughts focused on negative content) to cope with the pain and discomfort of daily activities. The partial model of rumination in chronic pain suggests that rumination processes may play a causal role in maintaining pain. Rumination might also be one of the key factors interfering with the reestablishment of adapted physical activity. The objective of this study was to test how rumination vs. distraction induction influence FM patients' pain intensity, discomfort linked to pain, and affect after physical activity. Forty-seven participants with a diagnosis of FM were randomly assigned to undergo distraction induction vs. rumination induction after performing a physical activity in ecological setting. Their pain intensity, pain-related discomfort, and affect were measured at the baseline, after physical activity, and after rumination versus distraction induction. A series of mixed-design ANOVAs showed that rumination induction after physical activity impairs patients' recovery in terms of pain intensity and discomfort, but not affect, as compared to the distraction condition. In conclusion, participants with fibromyalgia who engage in rumination following a physical activity recover less from their pain experience as compared to distraction induction. These results are consistent with the partial model of rumination in chronic pain and support the idea that rumination may play a causal role in the development and maintenance of pain.