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THU0587 Empirically Derived Classification of Fibromyalgia Patients: Subgroup Differences in the Processing and Regulation of Emotions
  1. I. López-Chicheri1,
  2. H. van Middendorp2,3,
  3. R. Geenen3,4
  1. 1Department of Psychology, Catholic University San Antonio, Murcia, Spain
  2. 2Department of Medical Psychology, Radboud University Nijmegen Medical Center, Nijmegen
  3. 3Department of Clinical and Health Psychology, Utrecht University
  4. 4Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, Netherlands


Background Patients with fibromyalgia vary widely in their physical and psychological functioning, and in how they perceive their disease. It has been reported that only one-third of patient benefits from treatment [1]. Multidimensional classification might help to tailor psychological treatment to the characteristics of patients [2].

Objectives 1) To replicate and describe the Multidimensional Pain Inventory (MPI) classification [3] in women with fibromyalgia and to examine whether the three MPI-classified subgroups differ in emotions, emotion processing styles, and emotion regulation strategies. 2) To study the association of emotion processing styles and emotion regulation strategies with fibromyalgia impact and positive and negative affect in MPI-classified subgroups.

Methods Participants were 291 women with fibromyalgia. Cluster procedures, analyses of covariance, and moderator and simple slope regression analyses were conducted.

Results Dysfunctional patients (DYS, 35% of the sample) presented the worst heath status and the highest levels of negative emotions, followed by the interpersonally distressed (ID, 26%) and the adaptive copers (AC, 38%) (all p<.01). The subgroups significantly differed on all of the emotion processing styles and emotion regulation strategies (all p<.05), except for cognitive reappraisal. DYS showed the highest levels of affect intensity, alexithymia, and emotional suppression, followed by ID and AC, while emotion expression was highest in AC. Higher alexithymia and affect intensity were related to more negative affect and to less positive affect in DYS and AC. DYS patients with higher cognitive reappraisal and ID patients with higher emotion expression showed less negative affect, whereas emotion expression was related to high positive affect in DYS and AC. Only in the ID-group, emotion suppression was related to more negative and less positive affect.

Conclusions This study confirms the importance of subdividing patients into subgroups and it highlights the possible differential impact of emotion processing styles and emotion regulation strategies on affect in each subgroup. Clinicians should take this into account when tailoring interventions to patients with fibromyalgia.


  1. Turk DC. Fibromyalgia: A patient-oriented perspective. In: Dworkin RH, Breitbart WS, eds. Psychosocial and psychiatric aspects of pain: A handbook for health care providers. Seattle, WA: IASP Press 2004:309–338.

  2. Turk DC. The potential of treatment matching for subgroups of patients with chronic pain: Lumping versus splitting. Clin J Pain 2005;21:44–55.

  3. Turk DC, Rudy TE. Toward an empirically derived taxonomy of chronic pain patients: Integration of psychological assessment data. J Consult Clin Psychol 1988;56:233–238.

Disclosure of Interest None Declared

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