Is Perfectionism Always Dysfunctional? Looking into Its Interaction with Activity Patterns in Women with Fibromyalgia

Abstract

The intrinsically adaptive or maladaptive nature of certain activity patterns in fibromyalgia (FM) has been put into question. The role of contextual factors related to their influence on functional limitation is required. Perfectionism complicates the ability to cope of these patients. The aim of the study has been to analyze the moderating role of perfectionism between activity patterns and functional limitation. The sample were 228 women with FM. Moderation analyses were conducted with the PROCESS Macro. Activity avoidance and excessive persistence were associated with poorer functionality, regardless of perfectionism. Pain avoidance and task persistence were more strongly associated with FM impact in women with high or moderate levels of perfectionism. In a clinical setting adapting the recommendations given to patients according to their level of perfectionism would be justified. Pain avoidance might be inadvisable at high levels of perfectionism, and task persistence is recommendable especially when perfectionism is high.

Activity Patterns and Functioning. A Contextual–Functional Approach to Pain Catastrophizing in Women with Fibromyalgia

“…Recent studies point out the role of pain and perfectionism as moderator variables in predicting the adaptive nature of certain activity patterns (i.e., pacing, excessive persistence, pain-contingent persistence, task-contingent persistence and pain avoidance) [23,24].…”

“…However, the contextual role, from the psychological flexibility model, of these variables in the relationship between activity patterns and functioning has not yet been sufficiently explored. Recent studies point out the role of pain and perfectionism as moderator variables in predicting the adaptive nature of certain activity patterns (i.e., pacing, excessive persistence, pain-contingent persistence, task-contingent persistence and pain avoidance) [ 23 , 24 ].…”

“…In addition to the aforementioned negative effect of activity avoidance, extensively documented in previous literature [ 10 , 16 , 17 , 18 , 19 ], our results point to the maladaptive role of excessive persistence and pacing. Regarding excessive persistence (i.e., overdoing), previous literature has shown its association with disability [ 10 ] and negative psychosocial and emotional outcomes [ 20 , 24 , 69 , 70 ]. Our results also point to the maladaptive role of pacing, although this data has not been sufficiently contrasted in the literature [ 18 , 19 , 21 , 69 , 71 ].…”

“…Along the same line, Esteve et al [ 20 ] incorporated the goal orientation of patterns as a differential characteristic that can define their adaptive or maladaptive character (i.e., three pacing patterns, each of which is associated with a single goal (conserving energy for valued activities, increasing activity levels, and reducing pain)). Finally, recent studies have pointed out the validity of the psychological flexibility model in the relationship between activity patterns and certain disease outcomes, highlighting the role of both contextual (i.e., pain intensity [ 23 ]) and personal variables associated with one’s values (i.e., perfectionism [ 24 ], goal preferences [ 25 ]).…”

What Does the Psychological Flexibility Model Contribute to the Relationship Between Depression and Disability in Chronic Pain? The Role of Cognitive Fusion and Pain Acceptance

“…These subprocesses have also been conceptualized more succinctly as the capacity for behavior that is “open, aware, and active” (Hayes et al, 2011). According with this, cognitive fusion and pain acceptance has been described as two variables are especially relevant in FM functioning (Ecija, Catala, López-Roig et al, 2021; Ecija, Catala, Sanroman et al, 2021; Lami et al, 2018). On the one hand, cognitive fusion is conceptualized as the tendency to get entangled with one’s internal experiences, instead of looking at them as transient internal events (Greco et al, 2008; Hayes et al, 2006).…”