• Ana LLedó Boyer, Sofía López-Roig, María-Ángeles Pastor-Mira, Mª Carmen Terol Cantero, and Maite Martín-Aragón.
• Department of Behavioral Sciences and Health, Miguel Hernández University, Alicante, Spain. Electronic address: ana.lledo@umh.es.
• Pain Manag Nurs. 2024 Oct 1; 25 (5): e336e345e336-e345.

BackgroundIdentification of fibromyalgia has been a challenge for healthcare professionals due to the lack of a clinical biomarker. A well-supported integrative hypothesis holds that this condition is a chronic pain problem partly caused by long-term dysregulation of stress response. Therefore, stress assessment from a biopsychosocial perspective may be a useful approach to recognizing fibromyalgia.PurposeA cross-sectional case-control study was conducted to explore stress markers from a multidimensional perspective, including heart rate variability (as a biomarker of stress) as well as psychological distress and social stress.MethodsForty-seven women with fibromyalgia were recruited from support groups and another 47 were recruited as matched pain-free controls. Comparison and discriminant function analyses were performed.ResultsThe data support the goodness of biopsychosocial stress markers in women with fibromyalgia, resulting in the identification of between 70% and 74.5% of fibromyalgia cases (sensitivity) and 85%-87% pain-free controls (specificity), with medium-high levels of fit (λ = 0.58 and λ = 0.59; p < .00). Women with fibromyalgia were characterized by high levels of psychological distress, social stress (disorder levels), and autonomic dysregulation. Although distress and social stress had a greater weight in discriminant functions, dysregulation in terms of low parasympathetic activity and high sympathetic activity at rest was also relevant.ConclusionsA biopsychosocial approach to stress with an objective biomarker such as heart rate variability may be a useful tool to identify and manage FM.Copyright © 2024. Published by Elsevier Inc.

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