title: Rumination modulates stress and other psychological processes in fibromyalgia.
abstract: OBJECTIVE
  Fibromyalgia (FM) is characterized by widespread pain and high levels of sleep disturbance, fatigue, and altered cognition. Psychological stress can modulate these features. In this study, we examined the thinking style of rumination in women with FM to assess the effect of rumination on stress levels and other psychological variables in FM.
  
  
  METHODS
  Ninety-eight women with FM completed questionnaires to assess levels of rumination, stress, anxiety, depression, optimism, control, and coping. T-tests and bivariate (Pearson) analysis was performed to assess relationships between rumination and other psychological factors.
  
  
  RESULTS
  We found that those with higher levels of rumination had increased the use of negative coping techniques (p<0.001), higher anxiety (p<0.001), depression (p<0.001), and poor sleep levels (p<0.05). Higher rumination correlated with lower optimism (p<0.001) and control (Mastery) (p<0.001). High rumination correlated strongest with stress (p<0.001). Rumination predicted 26% of variance for perceived stress.
  
  
  CONCLUSIONS
  Rumination influenced several psychological processes deemed important in FM and was an important contributor to stress in FM. Specific interventions targeting rumination in FM may improve FM symptoms and outcomes.
authors.affiliation: Departments of Medicine and Rheumatology, Monash University and Monash Health, Melbourne, Australia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Malin
authors.affiliation: Departments of Medicine and Rheumatology, Monash University and Monash Health, Melbourne, Australia.
authors.forename: Geoffrey Owen
authors.initials: GO
authors.lastname: Littlejohn
keywords: Fibromyalgia; attitude; clinical features; pain; rumination; stress