Pos1450-Pare Traumatic Experiences and Defensive Mechanisms: Examining the Influence of Psychological Factors in Women With Fibromyalgia and Chronic Pain Syndromes in Comorbidity

Background: Fibromyalgia (FM) patients frequently experience multiple chronic pain (CP) comorbidities, including tension-type or migraine headache, irritable bowel syndrome, and low back pain. FM and all these conditions have been included among chronic nociplastic syndromes 1. The term "nociplastic pain" (NP) describes pain that results from altered function of pain-related sensory pathways in the central nervous system (CNS) and peripheral nervous system, resulting in hypersensitivity to pain. Central sensitization (CS) is one of the possible mechanisms underlying NP. CS is described as an "increased responsiveness of CNS nociceptive neurons to normal or subthreshold afferent inputs" 2. NP is characteristic of multiple clinical conditions that share common neurophysiological mechanisms and opens a new framework for understanding the co-occurrence of different chronic disorders and the role of related psychological factors. Among psychological factors, the literature highlights the role of: temperamental and personality traits, traumatic experiences, and defense mechanisms (DM; automatic processes that blunt the effects of external and internal reality and regulate emotional response). However, these variables are still understudied. Objectives: To investigate whether FM and FM with different CP conditions show differences regarding childhood traumatic experiences and DM. Methods: 528 women (n=201 FM; n=327 FM with comorbidities) participated and completed a self-administered online protocol consisting of the Traumatic Experience Checklist (TEC 3), Defense Mechanism Rating Scales (DMRS 4), and socio-anamnestic information. Data collection took place between April and December 2023. A MANCOVA general linear model was run to test for differences in TEC and DMRS scores covaried for age values, as age was significantly different between groups. Results: Data analysis shows significant differences in the TEC emotional abuse scale (F=3.976; df=2; p=.006) and the total score (F=2.938; df=2; p=.019) with FM with comorbidities group reporting higher scores. About DMRS the groups differ only in the scale of immature defenses (F=6.648; df=2; p=.039), with the FM group with comorbidities scoring higher. Conclusion: Greater childhood emotional abuse and immature DM seem to connote the group of FM with comorbidities. Thus, they would more frequently use DM as catastrophizing, devaluation, refusal of help, and acting out. It can be hypothesized that greater traumatic events exposure may have hindered the development of more mature DM. This could be a risk factor for both the development and management of difficult events, such as the onset of a complex and disabling disease like FM, especially when associated with other CP syndromes. Understanding the complex connection between CP and mental health therefore seems important. Clinicians should consider psychological variables as they may contribute to the onset and exacerbation of CP symptoms. Including these dimensions in the clinical assessment of patients with CP could allow for the creation of individualized interventions and improve quality of life. REFERENCES: 1 Fitzcharles MA, Cohen SP, Clauw DJ, Littlejohn G, Usui C, Häuser W. Nociplastic pain: towards an understanding of prevalent pain conditions. The Lancet. 2021 May 29;397(10289):2098–110. 2 Woolf CJ. Central sensitization: Implications for the diagnosis and treatment of pain. PAIN. 2011 Mar 1;152(3, Supplement):S2–15. 3 Nijenhuis ERS, Van der Hart O, Kruger K. The psychometric characteristics of the Traumatic Experiences Checklist (TEC): First findings among psychiatric outpatients. Clin Psychol Psychother. 2002;9(3):200–10. 4 Di Giuseppe M, Perry JC, Lucchesi M, Michelini M, Vitiello S, Piantanida A, et al. Preliminary Reliability and Validity of the DMRS-SR-30, a Novel Self-Report Measure Based on the Defense Mechanisms Rating Scales. Front Psychiatry. 2020 Jan 1;11:870. Acknowledgements: NIL. Disclosure of Interests: None declared.