Psychosocial Factors and Central Sensitivity Syndromes
Leah M. Adams,
Dennis C. Turk.
Central sensitivity syndromes (CSSs) represent a heterogeneous group of disorders (e.g., fibromyalgia
[FM], irritable bowel syndrome [IBS], chronic headache, temporomandibular disorders
[TMDs], pelvic pain syndromes) that share many common symptoms, with persistent pain being the
most prominent feature.
Although the etiology and pathophysiology of CSSs are currently incompletely understood, central
sensitization has emerged as one of the significant mechanisms. Given that there are currently no
known cures for CSSs, people living with these disorders must learn to cope with and manage their
symptoms throughout their lives. Medical interventions alone have not proven to be sufficient for
helping people with CSSs manage their symptoms. A biopsychosocial perspective that considers the ways that biological,
psychological, and social factors work independently and jointly to affect a person’s experience is the most effective conceptualization
and guide for effective treatment. In this article, we discuss several psychological and social features that
may influence the experience of a person with CSS and their symptom management, regardless of their specific diagnosis.
We highlight the longitudinal aspect of adjustment to illness, the distinction between psychosocial factors as causes of
symptoms versus modifiers and perpetuators of symptoms, dispel the notion that all patients with the same diagnosis are a
homogeneous group (the “patient-uniformity myth”), and acknowledge the importance of environmental and situational
context on symptom management for individuals with any CSS.
Keywords: Central sensitivity syndromes (CSS), chronic pain, biopsychosocial, cognitive-behavior therapy, fear avoidance,
post-traumatic stress disorder, psychological factors, social factors.
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