Balancing stress and resilience: is the importance attached to each associated with the severity of physical symptoms in fibromyalgia: a cross-sectional study

Abstract

The current study examines whether the importance attached to stress as a threat and to resilience as a drive, and the interaction between the two are associated with the severity of physical symptoms in female fibromyalgia participants. An integrative model proposed by Pinto and colleagues (2020) suggests an imbalance between the “threat” and “drive” systems in fibromyalgia. Literature suggests a consistent negative association between stress and pain severity, and that resilience may alleviate the pain symptoms. It was predicted that 1) participants who consider stress a more important threat will report more severe physical symptoms, 2) participants who consider resilience as a drive of more importance will report less severe physical symptoms and 3) individuals with low importance of resilience and high importance of stress will experience markedly more severe physical symptoms. To investigate this, the results of a card sorting task were used, in which participants categorized and rated drives which motivate them and threats which can worsen physical symptoms. Dendrograms were computed and overarching categories decided upon by the research team. Participants were 68 women with fibromyalgia between 22 and 65 years old. A regression analysis showed that neither the importance of stress as a threat nor of resilience as a drive were significantly associated with physical symptoms (PHQ-15). The interaction between stress and resilience was not significantly associated with PHQ-15. Also a univariate analysis of variance showed PHQ-15 did not differ between groups of high and low perceived importance of stress and resilience. The forced sorting task may account for this lack of effect. Future research should include a quantitative measure of individual stress and resilience.