Daily affect regulation in patients with fibromyalgia

Abstract

Background: Fibromyalgia is characterized by widespread musculoskeletal pain accompanied by other physiological, cognitive and emotional challenges. It has been suggested that successful adaptation to fibromyalgia depends on emotion regulation capacity. Maladaptive emotion regulation can result in affective instability, which has been shown to moderate the association between daily pain and daily disability. Methods: In this study, we examined two indices of emotion regulation capacity: (1) affective instability, involving frequent large fluctuations in self-reported affect, and (2) resting heart rate variability (HRV), in a sample of 46 fibromyalgia patients (Mage = 45.4 years; 39 females) and 46 healthy controls (Mage = 44.9 years; 37 females). During a baseline phase, patients completed standard questionnaires while heart rate was monitored under resting conditions to derive HRV. Over the next 14 consecutive days participants completed an electronic end-of-day diary assessing daily levels of pain severity, disability, distractibility, negative (NA) and positive affect (PA). Affective instability was operationalized as the mean square of successive differences in daily mood (separately for NA and PA). Findings: Consistent with previous research, HRV and NA instability were inversely related. Furthermore, relative to controls, fibromyalgia patients displayed increased NA instability and showed stronger associations between mean daily NA and NA instability. Discussion: These findings suggest that HRV predicts dysfunctional regulation of NA, and that NA instability plays a role in the adaptation to fibromyalgia. These findings may have clinical implications relating to the treatment of fibromyalgia such as targeting NA instability in therapeutic settings.