Drawing the lines of fibromyalgia: a mixed-methods approach to mapping body image, body schema, and emotions in patient subtypes.

Abstract

Fibromyalgia is characterized by widespread chronic pain and multiple additional symptoms which may result in significant disability. Recent studies have demonstrated disturbances in body image and body schema in people affected by this condition. Importantly, it affects a heterogenous population in which distinct profiles can be identified based on physiological and/or psychological characteristics. The objective of our study was to explore individual differences in experiencing one's own body in fibromyalgia. We applied a mixed methods design and included data from 28 women diagnosed with fibromyalgia. We measured symptom intensity (Fibromyalgia Impact Questionnaire, part 1), disturbances in body schema (adapted Fremantle Back Awareness Questionnaire) and body image (Body Esteem Scale, Multidimensional Assessment of Interoceptive Awareness). Additionally, participants drew their bodies and how they experienced them (Body Drawing task). Next, we asked five experts in chronic pain treatment to evaluate the drawings on a specially designed scale and indicate what kind of emotions these drawings expressed. We found evidence of disturbed body experiences and large individual differences in each of the measured variables which allowed for clustering participants into three groups, named 'Connected body', 'Conflicted body', and 'Disconnected body'. These preliminary results suggest patients with fibromyalgia may have both qualitatively and quantitatively distinct disrupted body experience.