Self-regulatory deficits in fibromyalgia and temporomandibular disorders
Abstract
Chronic pain conditions such as fibromyalgia (FM) and temporomandibular disorders (TMDs) are accompanied by complex interactions of cognitive, emotional, and physiological disturbances. Such conditions are complicated and draining to live with, and successful adaptation may depend on ability to self-regulate. Self-regulation involves capacity to exercise control and guide or alter reactions and behavior, abilities essential for human adjustment. Research indicates that self-regulatory strength is a limited source that can be depleted or fatigued, however, and the current study aimed to show that patients with FM and TMD are vulnerable to self-regulatory fatigue as a consequence of their condition. Patients (N=50) and pain-free matched controls (N=50) were exposed to an experimental self-regulation task followed by a persistence task. Patients displayed significantly less capacity to persist on the subsequent task compared with controls. In fact, patients exposed to low self-regulatory effort displayed similar low persistence to patients and controls exposed to high self-regulatory effort, indicating that patients with chronic pain conditions may be suffering from chronic self-regulatory fatigue. Baseline heart rate variability, blood glucose, and cortisol predicted persistence, more so for controls than for patients, and more so in the low vs. high self-regulation condition. Impact of chronic pain conditions on self-regulatory effort was mediated by pain, but not by any other factors. The current study suggests that patients with chronic pain conditions likely suffer from chronic self-regulatory fatigue, and underlines the importance of taking self-regulatory capacity into account when aiming to understand and treat these complex conditions.
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The many demands of living with chronic pain may affect the ability to self-regulate thoughts, emotions, and behavior.
“The many demands of living with chronic pain may also affect the ability to self-regulate (ie, regulate thoughts, emotions, and behavior) [3-5].”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [4]
People living with chronic pain conditions may, because of their condition, be susceptible to self-regulatory fatigue, perhaps even persistent self-regulatory fatigue.
“people living with chronic pain conditions may, because of their condition, be susceptible to self-regulatory fatigue, perhaps even persistent self-regulatory fatigue [4].”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [4]
The complexity, demands, and challenges of living with chronic pain may lead to a draining of capacity to self-regulate.
“The complexity, demands, and challenges of living with chronic pain may lead to a draining of capacity to self-regulate [4-6].”
From Digital Self-Management in Support of Patients Living With Chronic Pain: Feasibility Pilot Study (2020) · cites this paper as [6]
Research indicates that the complexity, demands, and challenges of living with chronic pain may lead to a draining of the capacity to self-regulate cognitive, emotional, and behavioral activities, sometimes particularly related to executive functioning.
“Research indicates that the complexity, demands, and challenges of living with chronic pain may lead to a draining of the capacity to self-regulate cognitive, emotional, and behavioral activities, sometimes particularly related to executing functioning [4-6].”
From Digital Self-Management in Support of Patients Living With Chronic Pain: Feasibility Pilot Study (2020) · cites this paper as [6]
Chronic pain conditions are often multifaceted and difficult to manage, involving physiological and psychological and social challenges for those affected.
“Chronic pain conditions are often multifaceted and difficult to manage, involving physiological and psychological and social challenges for those affected [1-4].”
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Background
- Authors
- Nes, L. S., Carlson, C. R., Crofford, L. J., de Leeuw, R., & Segerstrom, S. C.
- Affiliations
- Mayo Clinic (US)
- University of Kentucky (US)
- Corresponding author
- Nes, Lise Solberg
- Venue
- Pain
- Published
- 2010-10
- Volume
- 151
- Issue
- 1
- Pages
- 37-44
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2068273936
- Cited by
- 107
- References
- 32
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 1 · 2020: 6 · 2019: 7 · 2018: 9 · 2017: 4 · 2016: 16 · 2015: 10 · 2014: 8 · 2013: 11 · 2012: 4
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- UKnowledge (University of Kentucky) (submittedVersion)
- Funders
- University of Kentucky
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- self-regulation, self-regulatory fatigue, fibromyalgia, temporomandibular disorders, chronic pain, persistence, heart rate variability, cortisol, blood glucose, pain intensity
- MeSH terms
- Adult, Analysis of Variance, Blood Glucose, Electrocardiography, Female, Fibromyalgia, Heart Rate, Humans, Hydrocortisone, Individuality, Middle Aged, Problem Solving, Psychiatric Status Rating Scales, Psychological Tests, Saliva, Social Behavior Disorders, Social Control, Informal, Temporomandibular Joint Disorders, Linear Models, Case-Control Studies
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