title: Emotions and emotional approach and avoidance strategies in fibromyalgia.
abstract: OBJECTIVE
  Disturbances in emotional functioning may contribute to psychological and physical symptoms in patients with fibromyalgia. This study examined emotions and emotion-regulation strategies in women with fibromyalgia and in controls, and how these variables relate to symptoms of fibromyalgia.
  
  
  METHODS
  We compared 403 women with fibromyalgia to 196 control women using self-report questionnaires.
  
  
  RESULTS
  Negative emotions and the use of emotional-avoidance strategies were elevated, and positive emotions were reduced, in fibromyalgia patients; the alexithymia scale "difficulty identifying feelings" showed a large deviation from normal. Emotional-approach measures were not deviant. In the fibromyalgia sample, emotional-avoidance strategies were highly correlated with more mental distress and were modestly correlated with more pain and fatigue, while emotional-approach strategies were only minimally related to better functioning. We tested two interaction models. The intense experiencing of emotions was related to more pain only in patients who lack the ability to process or describe emotions. Although fibromyalgia patients showed deficits in the experiencing of positive affect, positive affect did not buffer the association between pain and negative affect.
  
  
  CONCLUSIONS
  This study demonstrates increased negative emotions and decreased positive emotions, as well as increased emotional-avoidance strategies, in women with fibromyalgia. Research should test whether interventions that reduce emotional avoidance lead to health improvements in women with fibromyalgia.
authors.affiliation: Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. h.vanmiddendorp@uu.nl
authors.forename: Henriët
authors.initials: H
authors.lastname: van Middendorp
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lumley
authors.forename: Johannes W G
authors.initials: JW
authors.lastname: Jacobs
authors.forename: Lorenz J P
authors.initials: LJ
authors.lastname: van Doornen
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
mesh_terms: D000339:Affect; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003710:Demography; D004924:Escape Reaction; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires