{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:01:25Z","timestamp":1760234485804,"version":"build-2065373602"},"reference-count":72,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["PSI2016-79566-C2-1-R"],"award-info":[{"award-number":["PSI2016-79566-C2-1-R"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fondo de Investigaci\u00f3n en Salud. Instituto de Salud Carlos III","award":["PI17\/00858"],"award-info":[{"award-number":["PI17\/00858"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: The psychological flexibility model states that activity patterns are not deemed to be intrinsically functional or dysfunctional; it is considered that underlying factors, such as personal goals and contextual factors, are what will determine their effects on disability. Pain catastrophizing has frequently been associated with several important pain-related outcomes. Despite its recent conceptualization within affective\u2013motivational approaches, its moderating role between activity patterns and dysfunction has not been analyzed. Methods: This study analyzes the moderating role of pain catastrophizing and its dimensions (Pain Catastrophizing Scale) between activity patterns (Activity Patterns Scale) and disease impact (Fibromyalgia Impact Questionnaire\u2014Revised) in 491 women with fibromyalgia. Results: Activity avoidance (p &lt; 0.001), excessive persistence (p &lt; 0.001) and pacing (p &lt; 0.01) patterns were positively associated with fibromyalgia impact. Helplessness shows a moderating role between pain avoidance (B = 0.100, t =2.30, p = 0.021, [0.01, 0.18]), excessive persistence (B = \u22120.09, t = \u22122.24, p = 0.02, [\u22120.18, \u22120.01]), pain persistence (B = \u22120.10, t = \u22122.04, p = 0.04, [\u22120.19, \u22120.004]) and functioning. Conclusion: Helplessness (within pain catastrophizing) is a relevant variable within psychological flexibility models applied to activity patterns. Specifically, pain avoidance is especially dysfunctional in patients with high helplessness. To improve excessive persistence and pain persistence, it is necessary to reduce helplessness before regulating activity patterns.<\/jats:p>","DOI":"10.3390\/ijerph18105394","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T12:17:16Z","timestamp":1621340236000},"page":"5394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Activity Patterns and Functioning. A Contextual\u2013Functional Approach to Pain Catastrophizing in Women with Fibromyalgia"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-5921","authenticated-orcid":false,"given":"Cecilia","family":"Pe\u00f1acoba","sequence":"first","affiliation":[{"name":"Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s\/n, 28922 Alcorc\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria \u00c1ngeles","family":"Pastor-Mira","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Health, Miguel Hern\u00e1ndez University, Crtra Alicante-Valencia, km.8,7, 03550 San Juan, Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2655-1017","authenticated-orcid":false,"given":"Carlos","family":"Suso-Ribera","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Vicent Sos Baynat, 15, 12006 Castell\u00f3n de la Plana, Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3219-4973","authenticated-orcid":false,"given":"Ainara","family":"Nardi-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Health, Miguel Hern\u00e1ndez University, Crtra Alicante-Valencia, km.8,7, 03550 San Juan, Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sof\u00eda","family":"L\u00f3pez-Roig","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Health, Miguel Hern\u00e1ndez University, Crtra Alicante-Valencia, km.8,7, 03550 San Juan, Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1037\/a0035747","article-title":"Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research","volume":"69","author":"Ehde","year":"2014","journal-title":"Am. 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