Description
Fibromyalgia syndrome (FM) is a chronic musculoskeletal condition that is accompanied by widespread hypersensitivity to pain. Most people with FM have experienced at least one traumatic event prior to their diagnosis. Researchers have examined factors that affect pain among people with FM, such as trauma, depression, and coping; however; the interrelationships among these variables, and their relationship to pain, have not been examined. To better understand these relationships, a moderated-mediation model was used to examine trauma, depression, and coping mechanisms in their relationships to pain. The participants were 501 people who participated in a large intervention study, in which no intervention effects were found. The majority of participants were female (95.4%), White (86%), and ranged in age from 20 to 84 years. All participants were members of a health maintenance organization who had a physician’s diagnosis of FM that was confirmed using the American College of Rheumatology’s guidelines for diagnosing FM. The Traumatic Events Questionnaire was used to assess trauma; the Ways of Coping Questionnaire was used to assess coping style; the Center for Epidemiologic Studies Depression Scale was used to assess depression; and, the McGill Pain Questionnaire was used to assess pain. The PROCESS macro Model 7 was used to analyze the moderated mediation. The results indicated significant moderated-mediation = 0.02 (95% CI = -0.0381; -0.003). The indirect effect of depression on the relationship between trauma severity and pain was significant (p < 0.001), indicating that an increase in depression was associated with higher pain ratings. Relative emotion-focused coping moderated the effect of trauma severity on depression (p = 0.034). Individuals with high relative emotion-focused coping had higher depression scores than individuals with low relative emotion-focused coping when trauma severity was low. However, when trauma severity was high, depression scores among individuals with low and high relative emotion-focused coping were equivalent. The findings from this study provide support for the interrelationships between trauma severity, depression, relative emotion- focused coping, and pain. Interventions targeting depression and the reduction of emotion- focused coping may be effective in reducing pain for people with FM.
