The mediating role of anger and pain catastrophizing in the relationship between childhood trauma and fibromyalgia symptom severity in individuals diagnosed with fibromyalgia syndrome

This study aimed to investigate the sequential mediating roles of anger and pain catastrophizing in the relationship between childhood trauma and fibromyalgia impact levels among patients diagnosed with fibromyalgia. The limited number of studies that investigate these variables together highlights the potential contribution of this research to the literature. The sample comprised 132 adult fibromyalgia patients receiving treatment at various centers. Participants completed a demographic information form, the Revised Fibromyalgia Impact Questionnaire (FIQR), the Childhood Trauma Questionnaire (CTQ-33), Turkish Revised and Extended Version), the Trait Anger and Anger Expression Styles Scales, and the Pain Catastrophizing Scale (PCS-TR). Preliminary correlation analyses revealed no significant direct association between childhood trauma and fibromyalgia impact. However, mediation analyses considering indirect effects were conducted in line with the study objectives. Results demonstrated that childhood trauma exerted an indirect effect on fibromyalgia impact through pain catastrophizing. Specifically, physical abuse, a subtype of childhood trauma, influenced fibromyalgia impact indirectly via pain catastrophizing. Emotional neglect, another subtype, showed an indirect effect on fibromyalgia impact through the sequential mediation of trait anger and pain catastrophizing. These findings highlight pain catastrophizing as a critical factor influencing fibromyalgia impact levels. Consequently, addressing maladaptive pain-related cognitions should be prioritized in psychotherapeutic interventions for fibromyalgia patients. Furthermore, interventions targeting anger reduction may be particularly beneficial, especially for those with a history of emotional neglect.