Assessing childhood trauma, defense mechanisms, and alexithymia in single and comorbid syndromes among women with fibromyalgia and chronic pain

Background. The central role of psychological factors in fibromyalgia (FM) and in other chronic pain (CP) syndromes is recognized in the literature. However, these factors’ specific role in each chronic condition is still unclear. Objective. This study aims to compare the impact of selected psychological factors (such as childhood trauma, defense mechanisms, and alexithymia) between FM and four other groups such as chronic headache (CM), vulvodynia (VU), mixed diagnoses (MX; consisting of FM in comorbidity with CM and/or VU), and a control group. Methods. 1081 women (201 with FM, 220 with CM, 222 with VU, 327 MX, and 111 controls) completed a self-administered online protocol between June and November 2023. Results. Significant differences were found among the five groups in the variables examined: childhood trauma (R2=0.055; F=9.209; p=0.001), alexithymia (R2=0.085; F=13.243; p=0.001), and neurotic defenses (R2=0.064: F=10.835; p=0.001). The comparison shows that MX, compared with FM and the other conditions, is more characterized by a childhood history of trauma (particularly physical threats). On the other hand, FM differs from the other groups in that it scored significantly higher in both the inability to identify feelings and the use of neurotic defensive strategies. Conclusion. Psychological factors play a significant role in CP syndromes, particularly among women with FM alone and FM mixed diagnoses. To enable improvement in the quality of life of these women, all clinicians should consider the impact of psychological variables.