Abstract
Background. Current research in fibromyalgia (FM) seems to adhere to one of two separate paradigms – neurophysiological vs psychological, failing to provide an integrated account of the main findings related to both fields. This lack of integration hinders not only progress in our understanding of FM, but also the effectiveness of potential interventions.
Objectives. The main objectives of this study were to: a) review literature in order to identify and summarize main domains and features of FM; b) de-velop an integrative, multi-level model informed by the available evidence; and c) shed light upon the dynamic interplay between body and mind.
Methods. A model was developed based on an extensive review of the available literature and clinical insights from the interdisciplinary team. The model was repeatedly refined by observations and recommendations of ex-perts in the field.
Results. We propose that FM is fueled by the chronic hyperactivation of the threat/defense system (due to multiple factors, including early-traumatic experiences and dispositional features). This leads to multiple biases that bolster the perceived salience and dangerousness of everyday events and cross-amplifies alarm signals, such as pain. At the core of this self-sustain-ing process is hyperactivity in the salience neural network.
Conclusion. Although further research is needed to test and fine-tune the proposed model, it seems promising as a guide for future research and clini-cal management of FM. Studies investigating the efficacy of psychosocial interventions designed to diminish the dominance of the threat-system and promote soothing mechanisms seem warranted.
Objectives. The main objectives of this study were to: a) review literature in order to identify and summarize main domains and features of FM; b) de-velop an integrative, multi-level model informed by the available evidence; and c) shed light upon the dynamic interplay between body and mind.
Methods. A model was developed based on an extensive review of the available literature and clinical insights from the interdisciplinary team. The model was repeatedly refined by observations and recommendations of ex-perts in the field.
Results. We propose that FM is fueled by the chronic hyperactivation of the threat/defense system (due to multiple factors, including early-traumatic experiences and dispositional features). This leads to multiple biases that bolster the perceived salience and dangerousness of everyday events and cross-amplifies alarm signals, such as pain. At the core of this self-sustain-ing process is hyperactivity in the salience neural network.
Conclusion. Although further research is needed to test and fine-tune the proposed model, it seems promising as a guide for future research and clini-cal management of FM. Studies investigating the efficacy of psychosocial interventions designed to diminish the dominance of the threat-system and promote soothing mechanisms seem warranted.
| Original language | English |
|---|---|
| Pages (from-to) | s-130 |
| Journal | Clinical and Experimental Rheumatology |
| Volume | 37 |
| Issue number | Suppl.116 |
| Publication status | Published - 2019 |
| Event | The International Congress on Controversies in Fibromyalgia - Hilton Vienna, Vienna, Austria Duration: 4 Mar 2019 → 5 Mar 2019 https://www.fibromyalgia2019.com/ |