Is thought management a resource for functioning in women with fibromyalgia irrespective of pain levels

OBJECTIVE This study aimed to examine the relationship between cognitive factors (cognitive fusion and catastrophizing) and functional limitation experienced by fibromyalgia patients across different levels of pain severity (i.e. moderation). METHODS The sample comprised 226 women with fibromyalgia. Their mean age was 56.91 years (SD = 8.94; range = 30 to 78 years). RESULTS Pain severity, cognitive fusion, and all components of catastrophizing (i.e., rumination, magnification, and helplessness) contributed to greater fibromyalgia impact on functioning in the multivariate analyses (all p <.001). A moderation effect was also found in the relationship between cognitive fusion and fibromyalgia impact on functioning (B = -0.12, t = -2.42, p = .016, [-0.22, -0.02]) and between magnification and fibromyalgia impact (B = -0.37, t = -2.21, p = .028, [-0.70, -0.04]). This moderation was not observed for rumination and helplessness. CONCLUSIONS The results suggest that some maladaptive forms of thought management (i.e., cognitive fusion and magnification) should be preferably challenged at milder levels of pain severity when attempting to improve functioning in people with fibromyalgia. According to our findings, cognitive fusion and magnification might have less room to impact functioning at higher levels of pain severity, therefore, rumination and helplessness, which had comparable associations with functioning irrespective of pain levels, would be preferable targets in psychological interventions with fibromyalgia patients experiencing more severe pain levels.