Self-regulatory deficits in fibromyalgia and temporomandibular disorders

Lise Solberg Nes, Charles R. Carlson, Leslie J. Crofford, Reny De Leeuw, Suzanne C. Segerstrom

Research output: Contribution to journalArticlepeer-review

77 Scopus citations


Chronic pain conditions such as fibromyalgia (FM) and temporomandibular disorders (TMDs) are accompanied by complex interactions of cognitive, emotional, and physiological disturbances. Such conditions are complicated and draining to live with, and successful adaptation may depend on ability to self-regulate. Self-regulation involves capacity to exercise control and guide or alter reactions and behavior, abilities essential for human adjustment. Research indicates that self-regulatory strength is a limited source that can be depleted or fatigued, however, and the current study aimed to show that patients with FM and TMD are vulnerable to self-regulatory fatigue as a consequence of their condition. Patients (N = 50) and pain-free matched controls (N = 50) were exposed to an experimental self-regulation task followed by a persistence task. Patients displayed significantly less capacity to persist on the subsequent task compared with controls. In fact, patients exposed to low self-regulatory effort displayed similar low persistence to patients and controls exposed to high self-regulatory effort, indicating that patients with chronic pain conditions may be suffering from chronic self-regulatory fatigue. Baseline heart rate variability, blood glucose, and cortisol predicted persistence, more so for controls than for patients, and more so in the low vs. high self-regulation condition. Impact of chronic pain conditions on self-regulatory effort was mediated by pain, but not by any other factors. The current study suggests that patients with chronic pain conditions likely suffer from chronic self-regulatory fatigue, and underlines the importance of taking self-regulatory capacity into account when aiming to understand and treat these complex conditions.

Original languageEnglish
Pages (from-to)37-44
Number of pages8
Issue number1
StatePublished - Oct 2010

Bibliographical note

Funding Information:
This study was financially supported by a Grant from the University of Kentucky Clinical Research Development and Operations Center (CR-DOC; Protocol 07-0500), formerly the University of Kentucky General Clinical Research Center (GCRC). There are no conflicts of interest related to this manuscript or research project. The authors thank the CR-DOC for supporting and assisting with this research. The authors also thank John F. Wilson, Deidre B. Pereira, and Shawna L. Ehlers for helpful comments on a previous version of this manuscript, and would like to thank Jamie K. Johnson Hardy, Jenna Landenwich, and Cassandra Fallon for their assistance with data collection.


  • Fibromyalgia
  • Pain
  • Self-regulation
  • Self-regulatory deficits
  • Self-regulatory fatigue
  • Temporomandibular disorders

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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