title: Stages of chronicity in fibromyalgia and pain catastrophising: a cross-sectional study.
abstract: BACKGROUND
  Fibromyalgia (FM) is a prevalent and disabling disorder characterised by widespread pain and other symptoms such as insomnia, fatigue and depression. Catastrophisation is considered to be a key clinical symptom in FM; however, few studies have investigated how contextual factors, such as catastrophisation, might contribute to the duration of the pain. The present research examined the relationship among pain, catastrophic thinking and FM impact, as a function of stage of chronicity.
  
  
  METHODS
  In this cross-sectional study, the sample of 328 patients diagnosed with FM was divided into 3 groups based on level of chronicity: Group A (6 months to 2 years, N = 46); Group B (2-4 years, N = 59); and Group C (more than 4 years, N = 223). The three subscales of the Pain Catastrophising Scale (PCS), rumination, magnification, and helplessness, were used as predictors of dysfunction. The Fibromyalgia Impact Questionnaire and the McGill Pain Questionnaire were also administered. A hierarchical regression analysis was performed on the entire sample and, subsequently, for each group to determine the effect of the continuous process variables (castastrophising and pain) on the stages of chronicity.
  
  
  RESULTS
  Total score and PCS subscales were strongly associated with pain and impact in all the stages of chronicity in FM patients (r = 0.27-0.73, p < 0.05). For Group A, a regression analysis revealed that rumination predicted FM impact beyond the variance accounted for by age and pain. Both magnification and helplessness predicted impact in Group B, and helplessness was a significant predictor of impact in Group C.
  
  
  CONCLUSIONS
  These findings provide preliminary evidence that stage of chronicity is an important moderator of psychological vulnerability for FM impact and should be taken into account by tailoring psychological interventions.
authors.affiliation: Department of Psychology, Centro Rodero, Clínica de Neurociencias, Santander, Spain.
authors.forename: Baltasar
authors.initials: B
authors.lastname: Rodero
authors.forename: Benigno
authors.initials: B
authors.lastname: Casanueva
authors.forename: Javier
authors.initials: J
authors.lastname: García-Campayo
authors.forename: Miquel
authors.initials: M
authors.lastname: Roca
authors.forename: Rosa
authors.initials: R
authors.lastname: Magallón
authors.forename: Yolanda López
authors.initials: YL
authors.lastname: del Hoyo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058443:Catastrophization / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult