The relationship between pain catastrophizing and personal happiness in patients with fibromyalgia

Abstract

Background: Pain catastrophizing (PC) commonly accompanies experiences of chronic pain and is highly prevalent in patients with fibromyalgia. PC is associated with many functional constraints as well as psychological distress and therefore affects personal happiness. The aim of the study was to examine the involvement of several mediators in this relationship of PC and happiness in patients with fibromyalgia. We assessed mediating effects of alexithymia, pain anxiety, willingness to experience pain, and engagement in life activities (AE). Method: A total of 95 female patients with fibromyalgia (age: M=45.3; SD=9.5) completed an online-questionnaire about PC (PCS), pain anxiety (PASS), alexithymia (TAS), pain willingness (CPAQ), activity engagement (CPAQ), and personal happiness (LGS). The proposed multiple mediation model controlled for age and pain severity. Findings: PC significantly predicted all mediators (all ps<.02), but only AE mediated the relationship between PC and personal happiness (indirect effect: b=-0.37, 95%CI [0.53;1.05]). Discussion: Psychological distress in patients with fibromyalgia is not directly connected with PC, but can be explained via AE. The acceptance of pain when engaging in activities could restore feelings of control over life, prevent rumination, and therefore preserve a patient’s happiness. Fostering physical activity despite of pain might be an important link regarding the relationship between PC and well-being that could be promoted in cognitive-behaviour therapy. However, this cross-sectional study design does not provide information about variations in AE over time. Further research should therefore identify factors that contribute to the extent of willingness of activity engagement.