What is the role of developmental variables in the etiology of fibromyalgia?

Updated: Nov 14, 2018
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Developmental variables include the psychosocial experiences during childhood (eg, school stress, role models, unhappy families, abuse) that shape the cognitive, affective, and behavioral aspects of pain in adults. Some studies show that two thirds of patients with chronic pain have first-degree relatives with chronic pain, one third have a family member with an affective illness, and one third have a family member with alcohol abuse.

Childhood physical, emotional, or sexual abuse appears to be a common antecedent of anxiety, somatization, and chronic pain in many adults. For example, in a community population–based screening survey, the association of childhood abuse with the presence of more than 5 tender points (a characteristic of fibromyalgia) in adults was very strong (odds ratio, 6.9). [75] Biologic vulnerability likely derives, in part, from persisting effects of early life stresses on the stress response system.


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