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Sex Differences in Psychological Response to Pain in Patients With Fibromyalgia Syndrome

Racine, Mélanie PhD*,†,‡; Castarlenas, Elena MSc§,∥,¶; de la Vega, Rocío MSc§,∥,¶; Tomé-Pires, Catarina MSc§,∥,¶; Solé, Ester MSc§,∥,¶; Miró, Jordi PhD§,∥,¶; Jensen, Mark P. PhD#; Moulin, Dwight E. MD*,‡; Nielson, Warren R. PhD*,†

The Clinical Journal of Pain: May 2015 - Volume 31 - Issue 5 - p 425–432
doi: 10.1097/AJP.0000000000000132
Original Articles
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Objectives: To examine whether men and women with fibromyalgia syndrome (FMS) differ with respect to pain severity and functioning, pain-related beliefs, or pain-related coping. We hypothesized no significant sex differences in measures of pain and functioning, but that we would observe differences between men and women in how they view and how they cope with FMS-related pain.

Methods: A total of 747 women and 48 men with FMS who attended a multidisciplinary treatment program completed the study measures. Analyses of covariance were used to examine sex differences in the study measures, with a P-value of ≤0.01 and at least a moderate effect size (Cohen d≥0.5) required for a difference to be deemed statistically significant.

Results: Men and women did not differ on demographic measures except for their age, with the men in our sample being significantly younger than the women. Consistent with the study hypothesis, the results revealed no sex differences in the measures of pain and functioning. For pain-related beliefs, men were more likely to view pain as reflecting harm, and they were also more likely than women to use activity avoidance as a pain-coping strategy.

Discussion: The study findings suggest that women and men with FMS may think about and cope with pain somewhat differently, and may therefore benefit from different types of psychosocial pain intervention.

*Lawson Health Research Institute

Beryl & Richard Ivey Rheumatology Day Programs, St Joseph’s Health Care

Department of Clinical and Neurological Sciences, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada

§Unit for the Study and Treatment of Pain-ALGOS

Department of Psychology, Research Center for Behavior Assessment (CRAMC)

Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain

#Department of Rehabilitation Medicine, University of Washington, Seattle, WA

All authors reviewed and provided comments on drafts and subsequent revisions of this article, and approved the final version for submission and publication. M.R. participated in the design of the analyses, provided input in the data analysis plan, conducted the statistical analyses, and prepared the first draft of the manuscript; E.C., R.d.l.V., C.T.-P., E.S., J.M., M.P.J., and D.E.M. provided input into the data analysis plan and feedback on multiple drafts of the manuscript; W.R.N. participated in the decision to conduct this research, provided the data, input into the data analysis plan, and feedback on multiple drafts of the manuscript.

Supported by a bequest from the estate of Beryl Ivey to W.R.N. M.R. salary and travel support was funded by The Earl Russell Chair in Pain Medicine, Western University, London, ON, Canada. The work of J.M. and ALGOS is supported by grants from the Government of Catalonia (AGAUR; 2009 SGR 434), Universitat Rovira i Virgili (PFR program), RecerCaixa, and the Spanish Ministry of Innovation (MINECO; PSI2012-32471). The authors declare no conflict of interest.

Reprints: Warren R. Nielson, PhD, Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, Ontario, N6C 2R5 (e-mail: wnielson@uwo.ca).

Received February 14, 2014

Received in revised form July 9, 2014

Accepted June 12, 2014

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