The potential buffering role of soothers on the association between threats and the severity of somatic symptoms in individuals with fibromyalgia
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Introduction: According to the integrative model of fibromyalgia by Pinto et al. (2020b) that is based on the affect regulation model of Paul Gilbert, fibromyalgia is a result of an imbalance between the ‘threat’ and ‘soothing’ system. Literature suggests that threats can aggravate pain severity and that soothers may alleviate pain severity. The aim of this study was to examine whether threats and soothers, and the interaction between the two were associated with the severity of physical symptoms in fibromyalgia patients. It was predicted that threats would be positively associated with the severity of physical symptoms, that soothers would be negatively associated with the severity of physical symptoms and the effect of threats on the severity of physical symptoms would be reduced with a higher level of soothers. Methods: In total, 427 patients participated in this study, 404 female and 23 male with a mean age of 49.3 years of which 380 patients were included in the analyses because of missing values. Factor analysis was used to obtain a structured overview of the soothers and threats that were measured with a newly developed questionnaire. Multiple regression analyses was used to measure the association between the severity of symptoms measured by Patient Health Questionnaire (PHQ-15) scores and the threats and soothers. Age was included as a covariate. A moderation analysis was conducted to examine whether the association between threats and somatic symptom severity was moderated by soothers. Results: A positive association between threats and the severity of physical symptoms was found. There was no association between soothers and the severity of physical symptoms. In addition, soothers did not moderate the relationship between threats and the severity of physical symptoms. Conclusion: The current study provides support for the relationship between threats and somatic symptom severity. However, there is no support for the association between soothers and the severity of somatic symptoms or a buffering role of soothers in the relationship between threats and somatic symptom severity. More work needs to be done researching this clinically relevant potential buffering role of soothers in the relationship between threats and somatic symptom severity in individuals with fibromyalgia.