Clinical Manifestations of Trauma Exposure in Fibromyalgia: The Role of Anxiety in the Association Between Posttraumatic Stress Symptoms and Fibromyalgia Status

Abstract

Research about how traumatic experiences relate to fibromyalgia (FM) is lacking. This research explored the presence of trauma in an FM Spanish sample and the relationships between 1) number of several trauma types and post-traumatic stress disorder (PTSD) symptoms, and 2) the severity of clinical manifestations in FM, testing for possible mediation models. The sample included 173 FM patients and 53 healthy controls aged 24-66 years. Traumatic events (physical trauma, physical and sexual abuse, psychological trauma), PTSD symptoms, pain intensity, sleep disturbance, anxiety, depression, coping style, and daily functioning were evaluated with self-reports. FM patients reported a higher percentage of trauma than the control group (t = 8.46, p = .004), a higher number of traumas, mainly emotional and physical, (t = 2.61, p < .010), and more PTSD symptoms (t = 2.28, p = .033), (Hedges’ g/Cohen’s d between 0.42 and 0.76). In most FM patients, the most troublesome trauma and PTSD symptoms occurred before FM diagnosis. More PTSD symptoms were associated with worse pain, sleep disturbances, anxiety, depression, coping style, and daily functioning (between r = .23, p < .05 and r = .33, p < .01). A multiple mediation analysis showed a significant indirect effect of anxiety in the relationship between PTSD symptoms and daily functioning, F (4, 81) = 7.04, p < .01. PTSD symptoms were associated with major clinical symptoms in a subset of FM patients. Future research should explore the effectiveness of a trauma-focused therapy for these patients compared to standard cognitive-behavioral therapy.