Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: II. Sexual, physical, and emotional abuse and neglect.
OBJECTIVE
Two recent reports have found associations between fibromyalgia and sexual victimization, but had methodologic characteristics that limited their interpretation.


METHODS
We compared 36 patients with fibromyalgia and 33 patients with rheumatoid arthritis by using structured interviews for sexual, physical, and emotional victimization histories, as well as dimensional self-report measures of victimization severity.


RESULTS
Compared with the patients with rheumatoid arthritis, those with fibromyalgia had significantly higher lifetime prevalence rates of all forms of victimization, both adult and childhood, as well as combinations of adult and childhood trauma. Although childhood maltreatment was found to be a general risk factor for fibromyalgia, particular forms of maltreatment (eg, sexual abuse per se) did not have specific effects. Experiences of physical assault in adulthood, however, showed a strong and specific relationship with unexplained pain. Trauma severity was correlated significantly with measures of physical disability, psychiatric distress, illness adjustment, personality, and quality of sleep in patients with fibromyalgia but not in those with rheumatoid arthritis.


CONCLUSIONS
Fibromyalgia seems to be associated with increased risk of victimization, particularly adult physical abuse. Sexual, physical, and emotional trauma may be important factors in the development and maintenance of this disorder and its associated disability in many patients.
Walker
E A
EA
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA. edwalker@u.washington.edu
Keegan
D
D
Gardner
G
G
Sullivan
M
M
Bernstein
D
D
Katon
W J
WJ
D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology*; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D010552:Personality Assessment; D010553:Personality Development; D011569:Psychiatric Status Rating Scales; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology*; D012307:Risk Factors; D012803:Sick Role; D014754:Violence / Q000523:psychology*