Pain in the brain: Psychological correlates of chronic pain and fibromyalgia

Fibromyalgia is a chronic disorder causing widespread pain, fatigue, and cognitive issues, linked to central nervous system dysfunction. This cross-sectional study compared the psychological profiles of women with fibromyalgia (N = 76) and women with non-fibromyalgic chronic pain (N = 73). Using cluster analysis, scale score comparisons using MANCOVA, and correlation difference tests, we examined whether these conditions present distinct psychological profiles in terms of touch avoidance, anxiety, depression, psychotic symptoms, self-criticism, pain acceptance, pain impact, and positive emotions. Cluster analysis successfully differentiated between FM and non-FM CP patients with 76% accuracy with and an adjusted Rand index of.26, suggesting distinct psychological profiles while acknowledging substantial overlap. FM patients reported significantly higher levels of anxiety, depression, and psychotic symptoms, along with greater self-criticism and reduced activity engagement (p < .001 for all significant comparisons expect psychotic symptoms, p = .07, and opposite sex touch avoidance, p = .014). Both groups showed elevated touch avoidance, with no significant differences between them. Correlation analysis revealed that self-criticism played a more central role in FM patients' psychological distress, showing stronger associations with depression, anxiety, and positive emotions compared to non-FM CP patients (Jennrich test for differences between the two correlation matrices: Χ2 = 436.72, p < .001). These findings suggest that while FM and non-FM CP share common psychological features, FM patients experience more severe psychological distress, with self-criticism potentially playing a crucial maintaining role. Results suggest that psychological interventions for FM patients should prioritize reducing self-criticism and enhancing self-reassurance, while healthcare providers should be mindful of the significant psychological burden these patients carry.