{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T23:47:45Z","timestamp":1780444065866,"version":"3.54.1"},"reference-count":83,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union","award":["PI17\/00858"],"award-info":[{"award-number":["PI17\/00858"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>The aim of this study was twofold: to explore the concordance between two measures of physical activity (accelerometer and IPAQ) among female fibromyalgia (FM) patients, as well as to examine the impact of psychosocial variables (catastrophism, activity avoidance) on walking among these patients. Helplessness, activity avoidance, and commitment to physical activity were evaluated in 132 FM women. After the first assessment, an accelerometer was placed by a psychologist on each participant for seven consecutive days. Eight days later, accelerometers were collected, and participants were evaluated again using the IPAQ. Two models were tested to analyze mediation and a moderated mediation effect. The mediating role of activity avoidance between helplessness and minutes walked was corroborated regarding the objective measure of walking. The effect of helplessness on minutes walked during a week was mediated by activity avoidance and assessed by accelerometers. Cognitive variables played a contextual role when trying to promote exercise. Activity avoidance must be understood as a key variable in physical activity promotion, specifically in the promotion of walking with the aim to do exercise in individuals with FM.<\/jats:p>","DOI":"10.3390\/ejihpe14080142","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T13:10:28Z","timestamp":1721913028000},"page":"2126-2139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["How to Promote Walking in Women with Fibromyalgia: A Look at Catastrophizing, Goal Conflict, and Avoidance from a Self-Emotional Regulatory Perspective"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2687-6732","authenticated-orcid":false,"given":"Carmen","family":"Ecija","sequence":"first","affiliation":[{"name":"Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s\/n, 28922 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0642-2824","authenticated-orcid":false,"given":"Lorena","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s\/n, 28922 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4989-9099","authenticated-orcid":false,"given":"Patricia","family":"Catal\u00e1","sequence":"additional","affiliation":[{"name":"Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s\/n, 28922 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-5921","authenticated-orcid":false,"given":"Cecilia","family":"Pe\u00f1acoba","sequence":"additional","affiliation":[{"name":"Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s\/n, 28922 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/acr.20140","article-title":"The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity","volume":"62","author":"Wolfe","year":"2010","journal-title":"Arthrit. Care Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.1136\/annrheumdis-2017-211587","article-title":"EULAR recommendations for management of fibromyalgia","volume":"76","author":"Macfarlane","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.2147\/OARRR.S252748","article-title":"Comorbidity of Fibromyalgia in Primary Knee Osteoarthritis: Potential Impact on Functional Status and Quality of Life","volume":"12","author":"Mahgoub","year":"2020","journal-title":"Open Access Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1097\/j.pain.0000000000000553","article-title":"Obstacles to activity pacing","volume":"157","author":"Cane","year":"2016","journal-title":"Pain"},{"key":"ref_5","first-page":"83","article-title":"Association of sedentary time and physical activity with pain, fatigue, and impact of fibromyalgia: The al-\u00c1ndalus study","volume":"27","author":"Ruiz","year":"2015","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.rehab.2019.06.017","article-title":"Physical and psychological paths toward less severe fibromyalgia: A structural equation model","volume":"63","author":"McVeigh","year":"2020","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.jpain.2016.12.006","article-title":"Evidenced-Based Guidelines on the Treatment of Fibromyalgia Patients: Are They Consistent and If Not, Why Not? Have Effective Psychological Treatments Been Overlooked?","volume":"18","author":"Thieme","year":"2017","journal-title":"J. Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1007\/s00296-019-04270-3","article-title":"Behaviour change interventions targeting physical activity in adults with fibromyalgia: A systematic review","volume":"39","author":"Maguire","year":"2019","journal-title":"Rheumatol. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1007\/s00296-019-04323-7","article-title":"Performance of the American College of Rheumatology 2016 criteria for fibromyalgia in a referral care setting","volume":"39","author":"Ahmed","year":"2019","journal-title":"Rheumatol. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.apmr.2014.12.003","article-title":"Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis","volume":"96","author":"Tully","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_11","first-page":"2475","article-title":"Do women with fibromyalgia adhere to walking for exercise programs to improve their health? Systematic review and meta-analysis","volume":"40","year":"2017","journal-title":"Disabil. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1177\/1054773816646339","article-title":"Walking Beliefs in Women with Fibromyalgia: Clinical Profile and Impact on Walking Behavior","volume":"26","author":"Pastor","year":"2017","journal-title":"Clin. Nurs. Res."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Bidonde, J., Boden, C., Foulds, H., and Kim, S.Y. (2021). Physical Activity and Exercise Training for Adults with Fibromyalgia. Fibromyalgia Syndrome, Springer International Publishing.","DOI":"10.1007\/978-3-030-78638-0_6"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1016\/j.semarthrit.2020.02.003","article-title":"What we already know about the effects of exercise in patients with fibromyalgia: An umbrella review","volume":"50","author":"Andrade","year":"2020","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_15","first-page":"CD010842","article-title":"Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: A mixed methods review","volume":"4","author":"Hurley","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Polaski, A.M., Phelps, A.L., Kostek, M.C., Szucs, K.A., and Kolber, B.J. (2019). Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0210418"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1590\/1806-9282.65.10.1265","article-title":"Multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our experience and literature review","volume":"65","author":"Chiaramonte","year":"2019","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S0304-3959(99)00242-0","article-title":"Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art","volume":"85","author":"Vlaeyen","year":"2000","journal-title":"Pain"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s10880-018-9543-1","article-title":"Catastrophizing, Acceptance, and Coping as Mediators Between Pain and Emotional Distress and Disability in Fibromyalgia","volume":"25","author":"Lami","year":"2018","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/AJP.0000000000000526","article-title":"Pain-related Activity Management Patterns and Function in Patients with Fibromyalgia Syndrome","volume":"34","author":"Racine","year":"2018","journal-title":"Clin. J. Pain"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1037\/hea0000578","article-title":"Cognitive behavior therapy combined with exercise for adults with chronic diseases: Systematic review and meta-analysis","volume":"37","author":"Bernard","year":"2018","journal-title":"Heal. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Roig, S., Ecija, C., Pe\u00f1acoba, C., Ivorra, S., Nardi-Rodr\u00edguez, A., Lecuona, O., and Pastor-Mira, M.A. (2022). Assessing Walking Programs in Fibromyalgia: A Concordance Study between Measures. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19052995"},{"key":"ref_23","first-page":"1649","article-title":"Objective and subjective measures of physical functioning in women with fibromyalgia: What type of measure is associated most clearly with subjective well-being?","volume":"43","author":"Acosta","year":"2019","journal-title":"Disabil. Rehabil."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"\u00c9cija, C., Luque-Reca, O., Suso-Ribera, C., Catala, P., and Pe\u00f1acoba, C. (2020). Associations of Cognitive Fusion and Pain Catastrophizing with Fibromyalgia Impact through Fatigue, Pain Severity, and Depression: An Exploratory Study Using Structural Equation Modeling. J. Clin. Med., 9.","DOI":"10.3390\/jcm9061763"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1038\/nrrheum.2011.2","article-title":"Pain, catastrophizing, and depression in the rheumatic diseases","volume":"7","author":"Edwards","year":"2011","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_26","first-page":"195","article-title":"Psychological aspects of persistent pain: Current state of the science","volume":"5","author":"Keefe","year":"2004","journal-title":"J. Pain"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1586\/ern.09.34","article-title":"Pain catastrophizing: A critical review","volume":"9","author":"Quartana","year":"2009","journal-title":"Expert. Rev. Neurother."},{"key":"ref_28","first-page":"1","article-title":"Pain Catastrophizing and Its Relationship with Health Out-comes: Does Pain Intensity Matter?","volume":"2017","author":"Botella","year":"2017","journal-title":"Pain Res. Manag."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Whitaker, M.M., Odell, D., Deboeck, P.R., Stefanucci, J.K., and Okifuji, A. (2024). Increased Pain Variability in Patients With Chronic Pain: A Role for Pain Catastrophizing. J. Pain, 104494. in press.","DOI":"10.1016\/j.jpain.2024.02.008"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1891\/0889-8391.26.2.130","article-title":"Targeting Catastrophic Thinking to Promote Return to Work in Individuals with Fibromyalgia","volume":"26","author":"Sullivan","year":"2012","journal-title":"J. Cogn. Psychother."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.pain.2007.09.014","article-title":"Worry and chronic pain: A misdirected problem solving model","volume":"132","author":"Eccleston","year":"2007","journal-title":"Pain"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/S0005-7967(99)00062-5","article-title":"Worrying about chronic pain: Vigilance to threat and misdirected problem solving","volume":"38","author":"Aldrich","year":"2000","journal-title":"Behav. Res. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1007\/s10067-013-2277-4","article-title":"Fear of movement and avoidance behaviour toward physical activity in chronic-fatigue syndrome and fibromyalgia: State of the art and implications for clinical practice","volume":"32","author":"Nijs","year":"2013","journal-title":"Clin. Rheumatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jpain.2013.10.014","article-title":"The Psychological Flexibility Model: A Basis for Integration and Progress in Psychological Approaches to Chronic Pain Management","volume":"15","author":"McCracken","year":"2014","journal-title":"J. Pain"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.ypmed.2006.12.008","article-title":"The effect of walking on fitness, fatness and resting blood pressure: A meta-analysis of randomised, controlled trials","volume":"44","author":"Murphy","year":"2007","journal-title":"Prev. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ypmed.2014.12.041","article-title":"The effect of walking on risk factors for cardio-vascular disease: An updated systematic review and meta-analysis of randomized control trials","volume":"72","author":"Murtagh","year":"2015","journal-title":"Prev. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"S185","DOI":"10.1080\/17437199.2011.569937","article-title":"Dynamic pain\u2013emotion relations in chronic pain: A theoretical review of moderation studies","volume":"7","author":"Dima","year":"2013","journal-title":"Heal. Psychol. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1007\/s10880-021-09762-8","article-title":"Are Pacing Patterns Really Based on Value Goals? Exploring the Contextual Role of Pain Acceptance and Pain Catastrophizing in Women with Fibromyalgia","volume":"28","author":"Ecija","year":"2021","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Pastor-Mira, M., L\u00f3pez-Roig, S., Toribio, E., Mart\u00ednez-Zaragoza, F., Nardi-Rodr\u00edguez, A., and Pe\u00f1acoba, C. (2022). Pain-Related Worrying and Goal Preferences Determine Walking Persistence in Women with Fibromyalgia. Int. J. Environ. Res. Public Heal., 19.","DOI":"10.3390\/ijerph19031513"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/AJP.0000000000001010","article-title":"Exploring the Preference for Fatigue-avoidance Goals as a Mediator Between Pain Catastrophizing, Functional Impairment, and Walking Behavior in Women with Fibromyalgia","volume":"38","author":"Velasco","year":"2021","journal-title":"Clin. J. Pain"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/070674370805300402","article-title":"Psychological Approaches in the Treatment of Chronic Pain Patients\u2014When Pills, Scalpels, and Needles are Not Enough","volume":"53","author":"Turk","year":"2008","journal-title":"Can. J. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"13038","DOI":"10.1007\/s12144-021-02525-6","article-title":"Moving minds: Mental health and wellbeing benefits of a 50-day workplace physical activity program","volume":"42","author":"Hallam","year":"2022","journal-title":"Curr. Psychol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"101715","DOI":"10.1016\/j.psychsport.2020.101715","article-title":"Assessing physical activity through questionnaires\u2014A consensus of best practices and future directions","volume":"50","author":"Nigg","year":"2020","journal-title":"Psychol. Sport. Exerc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1017\/SJP.2021.30","article-title":"Fibromyalgia as a heterogeneous condition: Subgroups of patients based on physical symptoms and cognitive-affective variables related to pain","volume":"24","author":"Prados","year":"2021","journal-title":"Span. J. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1177\/1054773820973273","article-title":"Is Perfectionism Always Dysfunctional? Looking into Its Interaction with Activity Patterns in Women with Fibromyalgia","volume":"30","author":"Ecija","year":"2020","journal-title":"Clin. Nurs. Res."},{"key":"ref_46","first-page":"257","article-title":"Exploring the contextual role of pain severity as a moderator of the relationship between activity patterns and the physical and mental functioning of women with fibromyalgia","volume":"25","author":"Catala","year":"2020","journal-title":"Eur. J. Pain"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Collado-Mateo, D., Lav\u00edn-P\u00e9rez, A., Pe\u00f1acoba, C., Del Coso, J., Leyton-Rom\u00e1n, M., Luque-Casado, A., Gasque, P., Fern\u00e1ndez-Del-Olmo, M., and Amado-Alonso, D. (2021). Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18042023"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Luthi, F., Vuistiner, P., Favre, C., Hilfiker, R., and L\u00e9ger, B. (2018). Avoidance, pacing, or persistence in multidisciplinary functional rehabilitation for chronic musculoskeletal pain: An observational study with cross-sectional and longitudinal analyses. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0203329"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.pmn.2021.05.007","article-title":"Assessing Self-Efficacy for Physical Activity and Walking Exercise in Women with Fibromyalgia","volume":"22","author":"Nardi","year":"2021","journal-title":"Pain Manag. Nurs."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/S0272-7358(03)00070-9","article-title":"Contemporary behavioral activation treatments for depression: Procedures, principles, and progress","volume":"23","author":"Hopko","year":"2003","journal-title":"Clin. Psychol. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.jpain.2017.01.005","article-title":"Change in \u201cSelf-as-Context\u201d (\u201cPerspective-Taking\u201d) Occurs in Acceptance and Commitment Therapy for People with Chronic Pain and Is Associated with Improved Functioning","volume":"18","author":"Yu","year":"2017","journal-title":"J. Pain"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/AJP.0000000000000096","article-title":"A Self-Regulation Perspective on Avoidance and Persistence Behavior in Chronic Pain","volume":"31","author":"Kindermans","year":"2015","journal-title":"Clin. J. Pain"},{"key":"ref_53","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":"Wolfe","year":"2016","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Wolfe, F., Walitt, B., Perrot, S., Rasker, J.J., and H\u00e4user, W. (2018). Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0203755"},{"key":"ref_55","first-page":"487","article-title":"Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia","volume":"131","author":"Rodero","year":"2008","journal-title":"Med. Clin."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/00002508-200103000-00008","article-title":"Theoretical Perspectives on the Relation Between Catastrophizing and Pain","volume":"17","author":"Sullivan","year":"2001","journal-title":"Clin. J. Pain"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jpain.2015.12.009","article-title":"Development and Initial Validation of the Activity Patterns Scale in Patients with Chronic Pain","volume":"17","author":"Esteve","year":"2015","journal-title":"J. Pain"},{"key":"ref_58","first-page":"329","article-title":"The discordance between subjectively and objectively measured physical function in women with fibromyalgia: Association with catastrophizing and self-efficacy cognitions. The al-\u00c1ndalus project","volume":"40","author":"Aparicio","year":"2016","journal-title":"Disabil. Rehabil."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1016\/j.pain.2011.02.018","article-title":"Goals matter: Both achievement and pain-avoidance goals are associated with pain severity and disability in patients with low back and upper extremity pain","volume":"152","author":"Karsdorp","year":"2011","journal-title":"Pain"},{"key":"ref_60","first-page":"129","article-title":"Pain assessment: Global use of the Brief Pain Inventory","volume":"23","author":"Cleeland","year":"1994","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/0304-3959(96)03078-3","article-title":"The use of multiple-item scales for pain intensity measurement in chronic pain patients","volume":"67","author":"Jensen","year":"1996","journal-title":"Pain"},{"key":"ref_62","first-page":"643","article-title":"Validation of the Short Form of the Brief Pain Inventory (BPI-SF) in Spanish Patients with Non-Cancer-Related Pain","volume":"15","author":"Herdman","year":"2014","journal-title":"Pain Pract."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1080\/02640414.2013.803594","article-title":"Comparison of physical activity estimates using International Physical Activity Questionnaire (IPAQ) and accelerometry in fibromyalgia patients: The Al-Andalus study","volume":"31","author":"Delgado","year":"2013","journal-title":"J. Sports Sci."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/art.20779","article-title":"Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome","volume":"52","author":"Kop","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.1016\/j.jsams.2009.10.331","article-title":"The pedometer-based community intervention \u201c10,000 Steps Ghent\u201d: Who used a pedometer and who increased their steps?","volume":"12","author":"Brown","year":"2010","journal-title":"J. Sci. Med. Sport"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"403","DOI":"10.3758\/s13428-016-0827-9","article-title":"Mean centering, multicollinearity, and moderators in multiple re-gression: The reconciliation redux","volume":"49","author":"Iacobucci","year":"2017","journal-title":"Behav. Res. Methods"},{"key":"ref_67","unstructured":"Aiken, L.S., West, S.G., and Reno, R.R. (1991). Multiple Regression: Testing and Interpreting Interactions, Sage."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/00273171.2014.962683","article-title":"An Index and Test of Linear Moderated Mediation","volume":"50","author":"Hayes","year":"2015","journal-title":"Multivar. Behav. Res."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Deegan, O., Fullen, B.M., Casey, M.B., Segurado, R., Hearty, C., and Doody, C.M. (2022). Protocol: Combined online interactive mindfulness and exercise programme (MOVE-Online) compared with a self-management guide for adults with chronic pain: Protocol for a randomised controlled feasibility trial. BMJ Open, 12.","DOI":"10.1136\/bmjopen-2021-058265"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Asad-Cabrera, I., Borrueco-S\u00e1nchez, J., L\u00f3pez-S\u00e1nchez, C., Lopez-Moral, A., Mungu\u00eda-izquierdo, D., and Bueno-Antequera, J. (2024). Behavioral Change Techniques to Increase Adherence to Physical Activity in Severe Mental Disorders: The Psychiactive Project. Combining Exercise and Psychotherapy to Treat Mental Health, IGI Global.","DOI":"10.4018\/978-1-6684-6040-5.ch011"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1016\/j.jpain.2022.07.003","article-title":"Fitbit Activity, Quota-Based Pacing, and Physical and Emotional Functioning Among Adults with Chronic Pain","volume":"23","author":"Grunberg","year":"2022","journal-title":"J. Pain"},{"key":"ref_72","first-page":"255","article-title":"Patients with Fibromyalgia Reporting Severe Pain but Low Impact of the Syndrome: Clinical and Pain-Related Cognitive Features","volume":"20","author":"Slim","year":"2019","journal-title":"Pain Pr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/10547738211034307","article-title":"What Does the Psychological Flexibility Model Contribute to the Relationship Between Depression and Disability in Chronic Pain? The Role of Cognitive Fusion and Pain Acceptance","volume":"31","author":"Ecija","year":"2022","journal-title":"Clin. Nurs. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.msksp.2017.12.003","article-title":"The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials","volume":"34","author":"Sitthipornvorakul","year":"2018","journal-title":"Musculoskelet. Sci. Pr."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Cheng, S.-T., Leung, C.M.C., Chan, K.L., Chen, P.P., Chow, Y.F., Chung, J.W.Y., Law, A.C.B., Lee, J.S.W., Leung, E.M.F., and Tam, C.W.C. (2018). The relationship of self-efficacy to catastrophizing and depressive symptoms in community-dwelling older adults with chronic pain: A moderated mediation model. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0203964"},{"key":"ref_76","first-page":"94","article-title":"Multi-dimensional fatigue inventory: Spanish adaptation and psychometric properties for fibromyalgia patients. The Al-andalus study","volume":"30","author":"Romero","year":"2012","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Vallejo, M.A., Vallejo-Slocker, L., Offenbaecher, M., Hirsch, J.K., Toussaint, L.L., Kohls, N., Sirois, F., and Rivera, J. (2021). Psychological Flexibility Is Key for Reducing the Severity and Impact of Fibromyalgia. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18147300"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/AJP.0b013e3182385392","article-title":"Fear-Avoidance Model of Chronic Pain","volume":"28","author":"Crombez","year":"2012","journal-title":"Clin. J. Pain"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.cobeha.2018.12.007","article-title":"From fear of movement-related pain and avoidance to chronic pain disability: A state-of-the-art review","volume":"26","author":"Meulders","year":"2019","journal-title":"Curr. Opin. Behav. Sci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/AJP.0000000000000786","article-title":"Pain Unstuck","volume":"36","author":"Tabor","year":"2020","journal-title":"Clin. J. Pain"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s12529-015-9519-6","article-title":"Do Flexible Goal Adjustment and Acceptance Help Preserve Quality of Life in Patients with Multiple Sclerosis?","volume":"23","author":"Debruyne","year":"2016","journal-title":"Int. J. Behav. Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1111\/hex.12346","article-title":"Self-management support from the perspective of patients with a chronic con-dition: A thematic synthesis of qualitative studies","volume":"19","author":"Dwarswaard","year":"2016","journal-title":"Health Expect."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1093\/pm\/pnab247","article-title":"Are positive psychology interventions efficacious in chronic pain treatment? A systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"Braunwalder","year":"2022","journal-title":"Pain Med."}],"container-title":["European Journal of Investigation in Health, Psychology and Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2254-9625\/14\/8\/142\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:22:30Z","timestamp":1760109750000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2254-9625\/14\/8\/142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,24]]},"references-count":83,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["ejihpe14080142"],"URL":"https:\/\/doi.org\/10.3390\/ejihpe14080142","relation":{},"ISSN":["2254-9625"],"issn-type":[{"value":"2254-9625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,24]]}}}