Pain, Anger, and Rumination in Fibromyalgia: A Vicious Cycle?

Area of Science:

• Psychology
• Pain Medicine
• Rheumatology

Background:

• Fibromyalgia is a chronic pain condition where emotional and cognitive factors significantly influence pain perception.
• Negative metacognitions and anger rumination are known to exacerbate anger states, potentially increasing pain intensity.
• Understanding the interplay between pain, metacognition, anger rumination, and state anger is crucial for fibromyalgia management.

Purpose of the Study:

• To investigate the relationship between pain intensity, dysfunctional metacognitions, anger rumination, and state anger in fibromyalgia patients.
• To explore the mediating roles of metacognitions and anger rumination in the association between pain and state anger.

Main Methods:

• A cross-sectional study involving 446 participants diagnosed with fibromyalgia.
• Self-report measures assessed metacognitions, anger rumination, state anger, and pain intensity.
• Serial mediation analysis using Hayes' PROCESS macro (Model 6) was employed.

Main Results:

• Pain intensity positively affected negative beliefs about worry, the need to control thoughts, and cognitive self-consciousness.
• The direct effect of pain intensity on state anger remained significant, indicating partial mediation by the studied factors.
• A vicious cycle involving dysfunctional metacognitions, anger rumination, state anger, and pain intensity was suggested.

Conclusions:

• Dysfunctional metacognitions and anger rumination contribute to increased state anger and pain intensity in fibromyalgia.
• Pain intensity may influence metacognitive beliefs, creating a feedback loop.
• Fibromyalgia anger management interventions should incorporate strategies addressing dysfunctional metacognitions and anger rumination.