{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:46:38Z","timestamp":1792687598729,"version":"4.5.0"},"reference-count":83,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Fibromyalgia is a chronic disorder causing widespread pain, fatigue, and cognitive issues, linked to central nervous system dysfunction. This cross-sectional study compared the psychological profiles of women with fibromyalgia (N\u2009=\u200976) and women with non-fibromyalgic chronic pain (N\u2009=\u200973). Using cluster analysis, scale score comparisons using MANCOVA, and correlation difference tests, we examined whether these conditions present distinct psychological profiles in terms of touch avoidance, anxiety, depression, psychotic symptoms, self-criticism, pain acceptance, pain impact, and positive emotions. Cluster analysis successfully differentiated between FM and non-FM CP patients with 76% accuracy with and an adjusted Rand index of.26, suggesting distinct psychological profiles while acknowledging substantial overlap. FM patients reported significantly higher levels of anxiety, depression, and psychotic symptoms, along with greater self-criticism and reduced activity engagement <jats:italic>(p<\/jats:italic>\u2009&lt;\u2009.001 for all significant comparisons expect psychotic symptoms, <jats:italic>p<\/jats:italic>\u2009=\u2009.07, and opposite sex touch avoidance, <jats:italic>p<\/jats:italic>\u2009=\u2009.014). Both groups showed elevated touch avoidance, with no significant differences between them. Correlation analysis revealed that self-criticism played a more central role in FM patients\u2019 psychological distress, showing stronger associations with depression, anxiety, and positive emotions compared to non-FM CP patients (Jennrich test for differences between the two correlation matrices: <jats:italic>\u03a7<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup>\u2009=\u2009436.72, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). These findings suggest that while FM and non-FM CP share common psychological features, FM patients experience more severe psychological distress, with self-criticism potentially playing a crucial maintaining role. Results suggest that psychological interventions for FM patients should prioritize reducing self-criticism and enhancing self-reassurance, while healthcare providers should be mindful of the significant psychological burden these patients carry.<\/jats:p>","DOI":"10.1371\/journal.pone.0324457","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T17:56:01Z","timestamp":1749664561000},"page":"e0324457","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pain in the brain: Psychological correlates of chronic pain and fibromyalgia"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7991-8812","authenticated-orcid":true,"given":"Marcello","family":"Passarelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Rizzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Casetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7517-3039","authenticated-orcid":true,"given":"Vittorio","family":"Guerrieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Rocco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2301-2066","authenticated-orcid":true,"given":"Raffaella","family":"Perrella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"issue":"4","key":"pone.0324457.ref001","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ejpain.2005.06.009","article-title":"Survey 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socioeconomic inequalities in pain across 19 European countries","volume":"23","author":"A Todd","year":"2019","journal-title":"Eur J Pain"},{"issue":"6","key":"pone.0324457.ref006","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1097\/j.pain.0000000000000160","article-title":"A classification of chronic pain for ICD-11","volume":"156","author":"R Treede","year":"2015","journal-title":"Pain"},{"issue":"8","key":"pone.0324457.ref007","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1002\/art.27497","article-title":"Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity","volume":"62","author":"V Napadow","year":"2010","journal-title":"Arthritis Rheum"},{"issue":"11","key":"pone.0324457.ref008","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1038\/s41584-020-00506-w","article-title":"Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment","volume":"16","author":"P Sarzi-Puttini","year":"2020","journal-title":"Nat Rev Rheumatol"},{"key":"pone.0324457.ref009","first-page":"67","article-title":"Evaluating gender differences in Egyptian fibromyalgia patients using the 1990, 2011, and 2016 ACR criteria","author":"A Moshrif","year":"2022","journal-title":"Open Access Rheumatol Res Rev"},{"issue":"6","key":"pone.0324457.ref010","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s11926-009-0063-8","article-title":"Chronic widespread pain and fibromyalgia: two sides of the same coin?","volume":"11","author":"R Staud","year":"2009","journal-title":"Curr Rheumatol Rep"},{"issue":"9169","key":"pone.0324457.ref011","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1016\/S0140-6736(99)03313-9","article-title":"Acute pain","volume":"353","author":"DB Carr","year":"1999","journal-title":"Lancet"},{"issue":"8","key":"pone.0324457.ref012","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1002\/ejp.850","article-title":"Resilience moderates the association between chronic pain and depressive symptoms in the elderly","volume":"20","author":"H Bauer","year":"2016","journal-title":"Eur J Pain"},{"key":"pone.0324457.ref013","doi-asserted-by":"crossref","first-page":"709","DOI":"10.2147\/CIA.S113576","article-title":"Depression and chronic pain in the elderly: links and management challenges","volume":"12","author":"P Zis","year":"2017","journal-title":"Clin Interv Aging"},{"issue":"4","key":"pone.0324457.ref014","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1097\/AJP.0b013e31829ea1e3","article-title":"Prevalence and correlates of chronic pain in a random population study of adults in Chongqing, China","volume":"30","author":"T Jackson","year":"2014","journal-title":"Clin J Pain"},{"issue":"20","key":"pone.0324457.ref015","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1001\/archinte.163.20.2433","article-title":"Depression and pain comorbidity: a literature review","volume":"163","author":"MJ Bair","year":"2003","journal-title":"Arch Intern Med"},{"issue":"5","key":"pone.0324457.ref016","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1017\/S0033291705006859","article-title":"Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links","volume":"36","author":"NKY Tang","year":"2006","journal-title":"Psychol Med"},{"issue":"1","key":"pone.0324457.ref017","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/jep.13190","article-title":"Operationalization of the new Pain and Disability Drivers Management model: A modified Delphi survey of multidisciplinary pain management experts","volume":"26","author":"Y Tousignant-Laflamme","year":"2020","journal-title":"J Eval Clin Pract"},{"issue":"6","key":"pone.0324457.ref018","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s40273-021-01029-2","article-title":"Economic Burden of Treatment-Resistant Depression among Adults with Chronic Non-Cancer Pain Conditions and Major Depressive Disorder in the US","volume":"39","author":"D Shah","year":"2021","journal-title":"Pharmacoeconomics"},{"issue":"4","key":"pone.0324457.ref019","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1080\/01973533.2014.917975","article-title":"When pain does not heal: The common antecedents and consequences of chronic social and physical pain","volume":"36","author":"P Riva","year":"2014","journal-title":"Basic Appl Soc Psychol"},{"issue":"2","key":"pone.0324457.ref020","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1037\/0033-2909.131.2.202","article-title":"Why does social exclusion hurt? The relationship between social and physical pain","volume":"131","author":"G Macdonald","year":"2005","journal-title":"Psychol Bull"},{"issue":"6","key":"pone.0324457.ref021","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1038\/nrn3231","article-title":"The pain of social disconnection: examining the shared neural underpinnings of physical and social pain","volume":"13","author":"NI Eisenberger","year":"2012","journal-title":"Nat Rev Neurosci"},{"key":"pone.0324457.ref022","doi-asserted-by":"crossref","first-page":"1372229","DOI":"10.3389\/fpsyg.2024.1372229","article-title":"Psychometric properties and item response theory analysis of the Persian version of the social pain questionnaire","volume":"15","author":"M Sepehrinia","year":"2024","journal-title":"Front Psychol"},{"issue":"1","key":"pone.0324457.ref023","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1177\/20494637221133630","article-title":"Compassion focused therapy for pain management: \u201c3 systems approach\u201d to understanding why striving and self-criticism are key psychological barriers to regulating activity and improving self-care for people living with persistent pain","volume":"17","author":"Z Malpus","year":"2023","journal-title":"Br J Pain"},{"issue":"6","key":"pone.0324457.ref024","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1002\/ejsp.837","article-title":"The consequences of pain: The social and physical pain overlap on psychological responses","volume":"41","author":"P Riva","year":"2011","journal-title":"Eur J Soc Psychol"},{"issue":"10","key":"pone.0324457.ref025","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1002\/da.20600","article-title":"Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art","volume":"26","author":"GJG Asmundson","year":"2009","journal-title":"Depress Anxiety"},{"issue":"1","key":"pone.0324457.ref026","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.semarthrit.2020.10.006","article-title":"The Prevalence of Psychiatric and Chronic Pain Comorbidities in Fibromyalgia: an ACTTION systematic review","volume":"51","author":"BA Kleykamp","year":"2021","journal-title":"Semin Arthritis Rheum"},{"key":"pone.0324457.ref027","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.janxdis.2018.04.005","article-title":"A population-based examination of the co-occurrence and functional correlates of chronic pain and generalized anxiety disorder","volume":"56","author":"B Csupak","year":"2018","journal-title":"J Anxiety Disord"},{"key":"pone.0324457.ref028","unstructured":"P\u00e9rez-Pareja J, Ses\u00e9 A, Gonz\u00e1lez-Ordi H, Palmer A. Fibromyalgia and chronic pain: are there discriminating patterns by using the Minnesota multiphasic personality inventory-2 (MMPI-2)? 2010;10."},{"key":"pone.0324457.ref029","article-title":"Association of the practice of physical activity and of health status on the quality of life of women with fibromyalgia","volume":"30","author":"Dv Oliveira","year":"2019","journal-title":"J Phys Educ"},{"key":"pone.0324457.ref030","article-title":"Psychological Distress in Women with Fibromyalgia: The Roles of Body Appreciation, Self-Compassion, and Self-Criticism","author":"S Levy","year":"2024","journal-title":"Int J Behav Med"},{"issue":"2","key":"pone.0324457.ref031","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1002\/pchj.617","article-title":"Fibromyalgia and nonfibromyalgia chronic pain: Differences in psychological characteristics and treatment outcomes","volume":"12","author":"K Salaberria","year":"2023","journal-title":"Psych J"},{"issue":"3","key":"pone.0324457.ref032","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1007\/s12671-019-01302-8","article-title":"Attachment-based compassion therapy for ameliorating fibromyalgia: mediating role of mindfulness and self-compassion","volume":"11","author":"J Montero-Marin","year":"2020","journal-title":"Mindfulness"},{"issue":"13","key":"pone.0324457.ref033","doi-asserted-by":"crossref","first-page":"8152","DOI":"10.3390\/ijerph19138152","article-title":"Attachment-based compassion therapy for reducing anxiety and depression in fibromyalgia","volume":"19","author":"A Santos","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"pone.0324457.ref034","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3390\/brainsci10050306","article-title":"Anhedonia to Gentle Touch in Fibromyalgia: Normal Sensory Processing but Abnormal Evaluation","volume":"10","author":"R Boehme","year":"2020","journal-title":"Brain Sci"},{"key":"pone.0324457.ref035","doi-asserted-by":"crossref","first-page":"956510","DOI":"10.3389\/fnint.2022.956510","article-title":"The analgesic power of pleasant touch in individuals with chronic pain: Recent findings and new insights","volume":"16","author":"M Fusaro","year":"2022","journal-title":"Front Integr Neurosci"},{"key":"pone.0324457.ref036","doi-asserted-by":"crossref","DOI":"10.3389\/fpain.2023.1197374","article-title":"Flipping the hidden curriculum to transform pain education and culture","volume":"4","author":"AS Mardian","year":"2023","journal-title":"Front Pain Res"},{"issue":"1","key":"pone.0324457.ref037","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1526-4637.2008.00527.x","article-title":"Provider judgments of patients in pain: seeking symptom certainty","volume":"10","author":"RC Tait","year":"2009","journal-title":"Pain Med"},{"issue":"1","key":"pone.0324457.ref038","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.pec.2008.06.005","article-title":"Patient perspectives on the impact of fibromyalgia","volume":"73","author":"LM Arnold","year":"2008","journal-title":"Patient Educ Couns"},{"issue":"4","key":"pone.0324457.ref039","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.3390\/jcm9041219","article-title":"Diagnostic criteria for fibromyalgia: critical review and future perspectives","volume":"9","author":"C Galvez-S\u00e1nchez","year":"2020","journal-title":"J Clin Med"},{"issue":"2","key":"pone.0324457.ref040","doi-asserted-by":"crossref","first-page":"2176745","DOI":"10.1080\/24740527.2023.2176745","article-title":"\u201cYou have to believe the patient\u201d: What do people with fibromyalgia find helpful (and hindering) when accessing health care?","volume":"7","author":"RK Nishikawara","year":"2023","journal-title":"Can J Pain"},{"issue":"10","key":"pone.0324457.ref041","article-title":"Diagnostic Challenges and Management of Fibromyalgia","volume":"13","author":"AG Qureshi","year":"2021","journal-title":"Cureus"},{"issue":"3","key":"pone.0324457.ref042","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 revisions to the 2010\/2011 fibromyalgia diagnostic criteria","volume":"46","author":"F Wolfe","year":"2016","journal-title":"Semin Arthritis Rheum"},{"key":"pone.0324457.ref043","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"Mice: multivariate imputation by chained equations in R","volume":"45","author":"S Buuren","year":"2011","journal-title":"J Stat Softw"},{"issue":"4","key":"pone.0324457.ref044","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.genhosppsych.2007.04.004","article-title":"Generalized anxiety disorder, somatic pain and health care costs","volume":"29","author":"M Olfson","year":"2007","journal-title":"Gen Hosp Psychiatry"},{"key":"pone.0324457.ref045","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.3389\/fpsyg.2020.01673","article-title":"Italian Validation of the Touch Avoidance Measure and the Touch Avoidance Questionnaire","volume":"11","author":"L Casetta","year":"2020","journal-title":"Front Psychol"},{"key":"pone.0324457.ref046","volume-title":"Manual for the state-trait anxiety inventory (Form Y1 \u2013 Y2)","author":"C Spielberger","year":"1983"},{"key":"pone.0324457.ref047","first-page":"11","article-title":"Verifica della validit\u00e0 dello STAI forma Y di Spielberger. [Verification of the validity of the STAI, Form Y, by Spielberger.]","author":"L Pedrabissi","year":"1989","journal-title":"Giunti Organ Spec"},{"key":"pone.0324457.ref048","first-page":"27","article-title":"The italian versions of the beck anxiety inventory and the beck depression inventory-II: psychometric properties and discriminant power","author":"C Sica","year":"2007","journal-title":"Lead-Edge Psychol Tests Test Res"},{"issue":"1","key":"pone.0324457.ref049","first-page":"210","article-title":"Beck depression inventory-II","volume":"1","author":"Inventory-Ii BD","year":"2010","journal-title":"Corsini Encycl Psychol"},{"issue":"6","key":"pone.0324457.ref050","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1093\/schbul\/sbs068","article-title":"The validity of the 16-item version of the prodromal questionnaire (PQ-16) to screen for ultra high risk of developing psychosis in the general help-seeking population","volume":"38","author":"H Ising","year":"2012","journal-title":"Schizophr Bull"},{"key":"pone.0324457.ref051","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.schres.2018.03.023","article-title":"The Italian version of the 16-item prodromal questionnaire (iPQ-16): field-test and psychometric features","volume":"199","author":"P Lorenzo","year":"2018","journal-title":"Schizophr Res"},{"issue":"4","key":"pone.0324457.ref052","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1111\/eip.12362","article-title":"Screening for psychosis risk among adolescents in Child and Adolescent Mental Health Services: a description of the first step with the 16-item version of the Prodromal Questionnaire (PQ-16)","volume":"12","author":"Y de Jong","year":"2018","journal-title":"Early Interv Psychiatry"},{"key":"pone.0324457.ref053","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1348\/014466504772812959","article-title":"Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students","volume":"43","author":"P Gilbert","year":"2004","journal-title":"Br J Clin Psychol"},{"issue":"2","key":"pone.0324457.ref054","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/15298868.2015.1095794","article-title":"The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self","volume":"15","author":"N Petrocchi","year":"2016","journal-title":"Self Identity"},{"key":"pone.0324457.ref055","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3233\/BMR-1999-132-306","article-title":"Behavioral constituents of chronic pain acceptance: results from factor analysis of the chronic pain acceptance questionnaire","volume":"13","author":"L McCracken","year":"1999","journal-title":"J Back Musculoskelet Rehabil"},{"issue":"8","key":"pone.0324457.ref056","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1177\/1359105310365576","article-title":"The psychometric properties of the chronic pain acceptance questionnaire in Italian patients with chronic pain","volume":"15","author":"O Bernini","year":"2010","journal-title":"J Health Psychol"},{"issue":"5","key":"pone.0324457.ref057","first-page":"728","article-title":"The fibromyalgia impact questionnaire: development and validation","volume":"18","author":"CS Burckhardt","year":"1991","journal-title":"J Rheumatol"},{"issue":"2","key":"pone.0324457.ref058","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/17439760500510833","article-title":"Positive emotion dispositions differentially associated with Big five personality and attachment style","volume":"1","author":"M Shiota","year":"2006","journal-title":"J Posit Psychol"},{"issue":"3","key":"pone.0324457.ref059","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0245545","article-title":"Positive emotion dispositions and emotion regulation in the Italian population","volume":"16","author":"A Chirico","year":"2021","journal-title":"PLoS One"},{"issue":"432","key":"pone.0324457.ref060","doi-asserted-by":"crossref","DOI":"10.1126\/scisignal.aad1932","article-title":"Avoiding common pitfalls when clustering biological data","volume":"9","author":"T Ronan","year":"2016","journal-title":"Sci Signal"},{"key":"pone.0324457.ref061","doi-asserted-by":"crossref","first-page":"115265","DOI":"10.1016\/j.psychres.2023.115265","article-title":"An overview of clustering methods with guidelines for application in mental health research","volume":"327","author":"C Gao","year":"2023","journal-title":"Psychiatry Res"},{"issue":"3","key":"pone.0324457.ref062","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0002-9459(24)09931-5","article-title":"Residual analysis in regression","volume":"49","author":"J Belloto","year":"1985","journal-title":"Am J Pharm Educ"},{"issue":"1","key":"pone.0324457.ref063","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12859-017-1996-y","article-title":"diceR: an R package for class discovery using an ensemble driven approach","volume":"19","author":"DS Chiu","year":"2018","journal-title":"BMC Bioinformatics"},{"key":"pone.0324457.ref064","article-title":"Ensemble clustering: A practical tutorial","author":"C Gao","year":"2024","journal-title":"PsyArXiv"},{"key":"pone.0324457.ref065","article-title":"Measuring distribution similarities between samples: a distribution-free overlapping index","author":"M Pastore","year":"2019","journal-title":"Front Psychol"},{"issue":"330","key":"pone.0324457.ref066","first-page":"904","article-title":"An asymptotic \u03c72 test for the equality of two correlation matrices","volume":"65","author":"RI Jennrich","year":"1970","journal-title":"J Am Stat Assoc"},{"issue":"1","key":"pone.0324457.ref067","doi-asserted-by":"crossref","first-page":"215","DOI":"10.13189\/ms.2022.100120","article-title":"The power of test of Jennrich statistic with robust methods in testing the equality of correlation matrices","volume":"10","author":"B Zaini","year":"2022","journal-title":"Math Stat"},{"issue":"9596","key":"pone.0324457.ref068","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The strengthening the reporting of observational studies in epidemiology (strobe) statement: guidelines for reporting observational studies","volume":"370","author":"E Von Elm","year":"2007","journal-title":"Lancet"},{"issue":"2","key":"pone.0324457.ref069","doi-asserted-by":"crossref","first-page":"600","DOI":"10.3390\/ijerph18020600","article-title":"Responses to Stress: Investigating the Role of Gender, Social Relationships, and Touch Avoidance in Italy","volume":"18","author":"M Passarelli","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0324457.ref070","doi-asserted-by":"crossref","DOI":"10.1523\/ENEURO.0138-15.2016","article-title":"Touch perception altered by chronic pain and by opioid 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Salaffi","year":"2024","journal-title":"Clin Exp Rheumatol"},{"issue":"2","key":"pone.0324457.ref075","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s40122-013-0016-9","article-title":"Management of fibromyalgia syndrome: review of evidence","volume":"2","author":"A Okifuji","year":"2013","journal-title":"Pain Ther"},{"key":"pone.0324457.ref076","first-page":"1","article-title":"Diagnostic difficulty, delayed diagnosis, and increased tendencies of surgical treatment in fibromyalgia syndrome","author":"S K\u00fclek\u00e7io\u011flu","year":"2022","journal-title":"Clin Rheumatol"},{"issue":"4","key":"pone.0324457.ref077","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s40122-022-00418-5","article-title":"Stigma and chronic pain","volume":"11","author":"F Perugino","year":"2022","journal-title":"Pain Ther"},{"issue":"3","key":"pone.0324457.ref078","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1192\/apt.bp.107.005264","article-title":"Introducing 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