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Hypervigilance to Pain in Fibromyalgia: The Mediating Role of Pain Intensity and Catastrophic Thinking About Pain

Crombez, Geert PhD*; Eccleston, Chris PhD; Van den Broeck, Annelies MSc; Goubert, Liesbet MSc*; Van Houdenhove, Boudewijn MD§

Original Article
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Objective To investigate the mediating role of pain intensity, catastrophic thinking about pain, and negative affectivity in explaining enhanced attention for pain in patients with fibromyalgia.

Methods Sixty-four patients with fibromyalgia and 46 patients with chronic low back pain completed self-report instruments of vigilance to pain, negative affectivity, and catastrophic thinking about pain. These measures, along with diagnostic group and pain intensity, were entered into a partial correlational analysis to investigate which variables mediate the relationship between diagnostic group (fibromyalgia vs. chronic low back pain) and vigilance to pain.

Results Fibromyalgia patients reported significantly greater vigilance to pain than patients with chronic low back pain. They also reported higher pain intensity, more negative affectivity, and more catastrophic thinking about pain than patients with chronic low back pain. Vigilance to pain was correlated significantly with pain intensity, negative affectivity, and catastrophic thinking about pain. Further analyses revealed that pain intensity and catastrophic thinking about pain, but not negative affectivity, mediated the relationship between diagnostic group and vigilance to pain.

Conclusion Fibromyalgia patients report a heightened vigilance to pain. This vigilance is not a unique characteristic of fibromyalgia but is related to the intensity of pain and catastrophic thinking about pain.

Institution attribution: Ghent University, Catholic University of Louvain, University of Bath.

From the Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium; †Pain Management Unit, University of Bath, The Royal National Hospital for Rheumatic Diseases, United Kingdom; ‡Department of Psychology, University of Leuven, Belgium; §Pain Clinic, Leuven University Hospital, Belgium.

Received for publication August 7, 2001;

revised June 26, 2002; second revision November 1, 2002; accepted November 9, 2002.

Supported by a research grant (G.0107.98) of the Fund for Scientific Research, Flanders, and by a grant of the British-Flemish Academic Research Collaboration Programme (V 7.002.98N).

Reprints: Geert Crombez, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium (e-mail: geert.crombez@rug.ac.be).

© 2004 Lippincott Williams & Wilkins, Inc.