Predicting Adherence to Walking from Anxiety, Depression, Disease Impact, Catastrophizing, and Cognitive Fusion in Patients with Fibromyalgia: Does Pain Severity Matter?

Aim: This study analyzed whether the contribution of several factors associated with walking adherence in fibromyalgia (FM) patients varies across pain severity levels. Methods: Participants were 228 women with FM (mean age 57 years; SD = 8.49). Results: Bivariate analyses replicated the expected association between predictors (FM impact, anxiety, depression, catastrophizing, and cognitive fusion) and poorer adherence to walking. Multivariate analyses showed a negative contribution of FM impact, catastrophizing, and depression on walking adherence after controlling for pain levels (all p < 0 .01). A moderation effect of pain severity in the relationship between predictors and adherence to walking was only found for cognitive fusion ( B = −0.01, t = −2.02, p = 0.040). Specifically, cognitive fusion only contributed to poor walking adherence at moderate and severe pain levels, but not when pain was mild. The contribution of the remaining predictors was not moderated by pain levels, which means that they contributed to walking adherence irrespective of the pain severity of the patient. Pain severity did not contribute to walking adherence when controlling for the predictors. Conclusion: Clinical implications are discussed from the perspective of personalized interventions and preferable target interventions when attempting to increase adherence to walking in this population.