Early Maladaptive Schemas as a Risk Factor for Fibromyalgia: A Case-Control Study

Objective: There is evidence supporting the relationship between early stress and childhood trauma and the development of fibromyalgia (FM). Early maladaptive schemas (EMSs) are considered a consequence of early stress. Previous research has shown their role in maintaining stress responses and their relevance in other populations with pain. The main aim of this study has been to analyze the presence of EMSs in patients with FM compared to healthy adult women. In addition, the relationship between the strength of EMSs and pain intensity was tested. Method: The total sample consisted of 167 women: 83 patients with FM and 84 healthy controls. Results: Chi-square analyses showed that the percentage of participants with clinically significant scores is higher for patients with FM in 11 of the 18 EMSs evaluated. Moreover, discriminant analyses revealed that these EMS are useful to discriminate between FM and healthy controls, classifying 74.2% of original cases. In relation to the second aim, the mean pain intensity correlated with the strength of several EMSs: approval seeking, unrelenting standards, insufficient self-control, and mistrust/abuse. Conclusions: The current study highlights that a high rate of patients with FM have clinically significant EMSs compared to healthy matched controls, as has been found in other populations with pain. Besides, this study provides initial evidence that EMSs are positively associated with the pain experienced by patients with FM, suggesting the existence of a possible association between early stress and pain. Therefore, taking EMSs into account could be of great relevance to clinicians. Clinical Impact Statement Emotional-cognitive variables and early stress have a central role in fibromyalgia (FM). One of the consequences of childhood stress is the development of a strong system of maladaptive beliefs called early maladaptive schemas (EMSs). EMSs seem to be relevant in the development of several pain problems. This is the first study analyzing EMSs in patients with FM. The results showed that participants with FM have more clinically altered EMSs than healthy people, and these EMSs are associated to pain intensity. Taking EMSs into account could be of relevance to clinicians and Young's Schema Therapy could be useful in their management.