Subjective Neurophysiological Perception and Behavioral Avoidance in Women with Fibromyalgia: An Analysis of Pain and Affective Symptoms

Abstract

This study examined associations among pain intensity, psychological distress, neurophysiological perception, and avoidance behaviors in women with FMS. Participants included 120 women with FMS and 110 age-matched healthy controls who completed the Visual Analog Scale (VAS), Depression Anxiety Stress Scales (DASS-21), Cognitive Behavioral Avoidance Scale (CBAS), and Neurophysiological Perception Scale (NPS). Independent t -tests, Pearson correlations, and multivariate logistic regression were performed. Compared to controls, FMS participants had significantly higher VAS, DASS-21, and CBAS scores ( p < 0.001), and lower NPS scores. VAS correlated positively with DASS-21 and CBAS scores. In regression models, higher VAS (OR = 3.65) and behavioral avoidance (CBAS; OR = 1.38) were independently associated with FMS group membership, while depression showed an inverse association (OR = 0.42). These findings highlight pain severity, maladaptive avoidance, and reduced subjective neurophysiological perception as clinically relevant features and emphasize the need for multidimensional biopsychosocial assessment in early FMS.