Causal attributions and alexithymia in female patients with fibromyalgia or chronic low back pain

Nord J Psychiatry. 2011 Apr;65(2):138-44. doi: 10.3109/08039488.2010.522596. Epub 2010 Sep 27.


Aims: Our general objective was to assess the psychological symptoms and the types of causal attributions linked to the symptoms among women chronic pain.

Methods: 70 fibromyalgia (FM) patients, 56 chronic low back pain (CLBP) patients and 72 healthy controls were assessed within a general hospital setting, using the Toronto Alexithymia Scale, Brief Symptom Inventory and Symptom Interpretation Questionnaire. Three-way analysis of variance and chi-square tests were used for inter-group comparisons, followed by multivariate correlation, covariate analysis and linear regression.

Results: Alexithymia, somatization, depression, anxiety and hostility scores were significantly higher in FM patients relative to CLBP patients and healthy controls (P < 0.05). Alexithymia was linked to psychological attributions in FM patients and to somatic attributions in CLBP patients. Psychological attributions, the number of symptoms and difficulty in describing emotions were related to increased anxiety in FM patients. Depression, anxiety and somatization were significantly increased in subjects with high alexithymia scores in the FM group. There was no difference between groups regarding causal attributions.

Conclusions: Causal attributions do not seem to have distinctive features between functional somatic syndromes like FM and CLBP, though differences might exist between groups as to the effects of coexisting psychological distress symptoms like anxiety and depression.

MeSH terms

  • Adult
  • Affective Symptoms / psychology*
  • Affective Symptoms / rehabilitation
  • Anxiety / psychology
  • Anxiety / rehabilitation
  • Attitude to Health*
  • Cross-Sectional Studies
  • Depression / psychology
  • Depression / rehabilitation
  • Female
  • Fibromyalgia / psychology*
  • Fibromyalgia / rehabilitation
  • Hospitals, General
  • Hostility
  • Humans
  • Low Back Pain / psychology*
  • Low Back Pain / rehabilitation
  • Middle Aged
  • Personality Inventory / statistics & numerical data
  • Physical Therapy Department, Hospital
  • Psychometrics
  • Somatoform Disorders / psychology*
  • Somatoform Disorders / rehabilitation
  • Turkey