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Exploring the Role of Perceived Stress in a Patient's Experience of Fibromyalgia

Toussaint LT, McAllister JS, Whipple OM, Aleman K, Hassett LA, Oh HT, Vincent A

The purpose of this exploratory study was to examine cross-sectional relationships between perceived stress and fibromyalgia impact. Also, we sought to examine the mediating effects of key fibromyalgia symptoms including pain, fatigue, unrefreshing sleep, dyscognition, depressed mood and autonomic symptoms on this relationship. Data from 705 patients meeting Fibromyalgia Research Survey Criteria who completed a battery of self-report measures was used. Bivariate correlations revealed that stress was associated with fibromyalgia impact (r=0.49). Stress was also associated with all symptoms assessed (rs=0.29-0.77) and fibromyalgia impact was also associated with these symptoms (rs=0.33-0.59). Mediation modeling revealed that the total effect of stress on fibromyalgia impact was statistically significant (B=0.35,p<0.001), however, the direct effect was not significant when controlling for all mediators (B=0.03,p<0.05) and the total indirect effect of all mediators (B=0.32,p<0.05) was statistically significant and fully explained the association between stress and fibromyalgia impact. Specifically, pain, fatigue, negative mood, and autonomic dysregulation had significant indirect effects on this relationship. Our results demonstrate that perceived stress is associated with the patient’s experience of exacerbated individual fibromyalgia symptoms. Also, the patient reported symptoms serve to explain the relationship between perceived stress and a patient’s report of overall impact of fibromyalgia on day-to-day living.