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Updated: Apr 12, 2026

Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
Heterogeneity in fibromyalgia based upon cognitive and physical performance and psychological symptomology
Brian T Follick1, Barbara J Cherry2, Dana N Rutledge3
1University of St. Thomas, Minneapolis, Minnesota.
Purpose:
This study sought to investigate the existence of subgroups within a fibromyalgia (FM) sample based on physical and cognitive performance measures, as well as self-report psychological measures. A multisystem disorder characterized by widespread musculoskeletal pain and co-morbid conditions, FM can lead to declines in cognitive functioning and difficulty with psychological health.
Data Sources:
Community participants (n = 57 women) recruited from support groups and university center databases provided documentation of having met the criteria for diagnosis of FM. Measures included validated performance and self-report instruments. Analysis was completed using hierarchical cluster analysis; a four cluster solution was chosen for its level of interpretability. The resulting model identified four distinct subgroups based upon patterns of performance and symptomology. Significant group differences were found on pain, fatigue, stiffness, and level of physical activity.
Conclusions:
Study results support the existence of subgroups among the FM population based on levels of cognitive and physical performance and psychological symptoms.
Implications For Practice:
Nurse practitioners aware of potential subgroups within FM should be better prepared to recommend treatment options for patients that target subgroup characteristics (e.g., high vs. low levels of psychological symptoms).
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