Apego y Trauma en mujeres con Fibromialgia. Efectos en la sintomatología asociada

Abstract

Aim: The general aim of this doctoral thesis has been to carry out a detailed analysis of attachment and trauma, as psychosocial variables, relevant to the symptoms of patients with fibromyalgia (FM) (in comparison to another group of women who did not have a chronic pain diagnosis). Additionally, in relation to these symptoms, it has been of interest to also focus on cognitive and olfactory function of these patients and the possible associations between these. Methods: A cross-sectional study was carried out using a sample of 146 women with fibromyalgia and 122 with no chronic pain diagnosis. Trauma was assessed using a semistructured interview based on the Davidson Trauma scales and the the revised scale of impact of stressors; anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS ); attachment was assessed in its dimensions using the Adult Attachment Questionnaire (AAQ); attachment, categorically, was assessed using the Relationship Questionnaire ; cognitive functioning was assessed using the WAIS-III; alexythimia using the Toronto Alexythimia Questionnaire (TAS-20) and olfactory functioning using the Connecticut Olfactory Test (CCCRC). Results: Higher percentages of insecure attachment were found among the FM patients (19.8% showed avoidant attachment style and 10.3% were anxious-ambivalent). Insecure attachment is associated with higher scores in alexythimia in comparison to those with secure attachment styles among FM patients. The validation process of the AAQ in FM patients showed that it maintained the same factorial structure as in non-clinical population, therefore, proving to be a valid and reliable measure to be used from a dimensional perspective. FM patients showed a larger prevalence of traumatic events, although it is not possible to make associations in regards to timing of the traumatic event and the diagnosis of FM. Patients with FM showed worse functioning in perceptual organization and speed of processing, as well as a larger olfactory deficit, showing a positive association between olfactory and cognitive deficits. Conclusions: The results found show a need to include attachment styles as predictors of emotional experience of pain, from the perspective of the model of Diathesis-Stress, in patients with FM. Furthermore, an association was found between attachment and functional limitations. Patients who have suffered trauma associated to abuse present high levels of anxiety and/or depression. In relation to cognitive functioning, some components within the manipulative scale were found to be affected along with olfactory deficits in FM patients.