The association between adverse childhood experiences, self-silencing behaviours and symptoms in women with fibromyalgia

Poor adult health has consistently been associated with Adverse Childhood Experiences (ACEs). The process is not fully understood but is likely to involve a complex interaction of biological and psychosocial factors. Early life stress can affect the developing brain resulting in long-term hyper-responses to stress and raised inflammatory biomarkers. Women with fibromyalgia syndrome (FMS) frequently report ACEs and also self-sacrificial behaviours whereby they repress their own needs and emotions to preserve personal relationships. This behavioural profile (termed self-silencing) may develop following ACEs but has not previously been considered in the context of FMS. This study examined whether self-silencing mediates the link between ACEs and FMS symptoms. Women with (N = 539) and without (N = 184) an FMS diagnosis completed measures of Silencing-the-Self, health symptoms and ACEs. Number of ACEs and symptom levels were significantly associated in both groups. One aspect of self-silencing, care and self-sacrifice (putting others needs before your own) mediated the association between ACEs and symptoms in the FMS group only. Externalised self-perception (judging oneself according to perceived external standards) was negatively associated with symptoms but presented no mediating effects. Results present preliminary new information to explain the association between ACEs and FMS. Recognition of the factors which underlie symptomology is important in understanding the condition and supporting patients.