Perfectionism and Pain Intensity in Women with Fibromyalgia: Its Influence on Activity Avoidance from The Contextual Perspective

Abstract

Given the scarcity of studies regarding perfectionism from a contextual perspective, this study aims to analyze its role in the relationship between pain and activity avoidance and its differential effect among patients with different fibromyalgia severity. A cross-sectional study with 228 women with fibromyalgia classified into two disease severity groups (low/moderate vs. high) was carried out. Moderation analyses were conducted; perfectionism was used as moderator, pain (in high and low pain situations) as independent variable, and activity avoidance as the outcome. Among the high disease severity group, analyses showed direct contributions of perfectionism (p < 0.001) but not of pain (p > 0.05); moderation effects were found in high pain situations (p = 0.002) (for low levels of perfectionism, a positive association was found between pain intensity and avoidance). Among the low severity group, direct effects of perfectionism (p < 0.05) and pain intensity (p = 0.04) were found (although the latter only for high pain situations); moderation effects were found in high pain situations (p = 0.018) (for high levels of perfectionism a positive and significant association was found between pain intensity and avoidance). Perfectionism has been found to be a key variable in the differential relationship between pain intensity (in high pain situations) and activity avoidance in groups with high and low disease severity.

Exploring the Relationship between Perfectionism and Pain in Patients with Temporomandibular Disorders: A Cross-Sectional Study

“…Considering that perfectionism is associated with higher psychological distress [ 33 ], pain-related TMD patients may be more susceptible to negative consequences. Sheila et al reported that, in women with fibromyalgia, maladaptive perfectionism is associated with activity avoidance regardless of the degree of severity of the disease and the pain experienced in the situation, reducing the patients' ability to work and participate in social activities [ 34 ]. Therefore, perfectionism might be a target when cognitive behavioral therapy is undergone to manage pain in TMD patients.…”

Exploring the Preference for Fatigue-avoidance Goals as a Mediator Between Pain Catastrophizing, Functional Impairment, and Walking Behavior in Women With Fibromyalgia

“…This study aimed to establish mechanisms affecting activity in specific and common situations from the motivational perspective of goal conflict, taking into consideration fatigue as a disabling and forgotten symptom. 63,64 Furthermore, the study included different types of measurements, such as self-reports and objective measures, a common request in this field 35 since they increase the ecological validity of studies. In addition, another of the study's strengths is measuring walking using the 6MWT, as it is recommended by the Spanish Society of Rheumatology for Fibromyalgia.…”

“…These factors have received attention in previous research as mentioned, but connecting them was a pending issue. This study aimed to establish mechanisms affecting activity in specific and common situations from the motivational perspective of goal conflict, taking into consideration fatigue as a disabling and forgotten symptom 63,64. Furthermore, the study included different types of measurements, such as self-reports and objective measures, a common request in this field35 since they increase the ecological validity of studies.…”