Psychological Distress Can Be Intensely Felt in Fibromyalgia Patients, Especially Those with Paresthesia, Study Suggests

Psychological Distress Can Be Intensely Felt in Fibromyalgia Patients, Especially Those with Paresthesia, Study Suggests

Fibromyalgia patients, particularly those with paresthesia (unusual skin sensations), are likely to experience psychological distress more intensely than people without this disease, and have personality traits that favor harm avoidance while showing a tendency to being less adaptable to given situations, researchers report.

The study, “Paresthesia frequency in fibromyalgia and its effects on personality traits,” was published in International Journal of Rheumatic Diseases.

Paresthesia – tingling, tickling, pricking, numbness or burning sensations on a person’s skin with no apparent physical cause – can be common in patients with fibromyalgia.

But how common varies widely: prior studies report that paresthesia can be present in 26% to 84% of fibromyalgia cases.

Personality, defined largely as temperament and character, also varies considerably among any group of people, although certain traits tend to stand out within groups. Temperament refers to spontaneous emotional expressions and responses that are thought to be somewhat heritable, while character is also heritable but responsive to social adaptation and maturation.

Several studies have investigated personality traits among fibromyalgia patients, but not the relationship between paresthesia and such traits — both of which, has noted, are highly variable.

Researchers recruited 101 women with fibromyalgia, and grouped them according to whether they did or did not have paresthesia. A healthy control group was also recruited.

Participants were evaluated using a test called Temperament and Character Inventory. Here, temperament is divided into four categories: harm avoidance, novelty seeking, persistence, and reward dependence. Character is divided into three: cooperativeness, self-transcendence, and self-directedness.

Researchers discovered that both fibromyalgia groups, regardless of paresthesia, had significantly higher scores in harm avoidance (excessive worrying, pessimism) and self-transcendence than those in the control group, and lower scores in self-directedness (self-determination; ability to adapt behavior to achieve wanted goals) compared to controls.

But patients with paresthesia scored significantly higher in both harm avoidance and self-directedness than did those without paresthesia.

Prior studies have shown that patients with high harm avoidance scores have “anticipated pessimistic concerns with future events, fear of the unknown and shyness with strangers, which leads to reduced habituation in situations of potential danger, whereby they seek to stay clear of challenges or involvement in new conditions.”

Self-directedness is defined as the ability to adapt to different situations in pursuit of wanted goals or values; low scores here imply a lack of such adaptability.

Self-transcendence is associated with an embrace of such spiritual ideas as considering oneself a vital part of the universe, leading to a spiritual union with the universe.

High self-transcendence scores are associated with psychotic symptoms including borderline, narcissistic, schizotypal and paranoid personalities. By scoring higher here than healthy adults serving as controls, the fibromyalgia patients showed a greater tendency toward these negative emotions, the study reported.

These results suggest that “patients with fibromyalgia experience psychological distress more intensely, and they have more variable negative emotions related to high HA [harm avoidance] scores and low SD [self-directedness] scores than controls,” the researchers wrote.

There were no significant differences among fibromyalgia patients with paresthesia, fibromyalgia patients without paresthesia and healthy controls in any of the other temperament and character traits.

The authors conclude, “These results suggest that psychological distress associated with high harm avoidance and low self-directedness scores are more prominent in fibromyalgia patients, and especially of those who have paresthesia.”