It's one of those stereotypes that many people with fibromyalgia (FMS) struggle against -- that childhood abuse is a cause or risk factor for our illness. A lot of research has been done showing high levels of abuse in the FMS population, but is it conclusive?
Two recent studies by the same German team caught my eye, and they both appear to refute many of the claims linking FMS and abuse.
Review of Studies: Looking through the available literature on FMS and abuse, researchers said that yes, these studies showed a correlation. However, they also said that bulk of these studies were low quality. And this is especially interesting: the lower the quality, the larger the overlap. This doesn't discount the correlation, but it certainly calls it into question and shows the need for high-quality research.
Role of Depression: Researchers looked at factors that might mediate an association between childhood abuse and FMS. The one thing they identified was depression -- fibromites who are depressed are more likely to have been abused as children. While it's safe to say abuse can lead to depression, we don't have evidence that either abuse or depression can actually cause FMS.
We still have a lot to learn on this issue. First, it's important to remember that a link to abuse doesn't mean that abuse is a causal factor, and it certain doesn't mean it's "the" cause. (See Cause vs. Risk Factor in FMS.) Certainly, not all of us with FMS have suffered abuse, and doctors who make this assumption do us a great disservice.
Is abuse really more common in FMS patients than in the rest of the population? If so, why? A common (and highly controversial) theory is that childhood abuse leads to physical changes in the stress system which then contribute to FMS. Others have questioned whether physical injuries or chronic pain from abuse are responsible for the link.
If abuse isn't more common in us, all this research tells us is that people who were abused as children are more likely to be depressed as chronically ill adults. No surprise there.
What I don't want to do is ignore or discount the fibromites who believe their abuse contributed to their illness. Whether abuse is or isn't more common in us, I do believe that it can be a contributing factor. Anything that causes prolonged physical and/or psychological stress appears to raise your risk of FMS. Dealing with the psychological ramifications of abuse is unlikely to directly relieve FMS symptoms, but it may help with relieving depression and developing better coping skills.
What do you take away from this research? Do you believe abuse is an important risk factor for FMS? Do you think the link has been overstated? Leave your comments below!
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