Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-18T08:25:36.584Z Has data issue: false hasContentIssue false

Predictors of the Pain Perception and Self-Efficacy for Pain Control in Patients with Fibromyalgia

Published online by Cambridge University Press:  10 January 2013

Ana I. Sánchez*
Affiliation:
Universidad de Granada (Spain)
M. Pilar Martínez
Affiliation:
Universidad de Granada (Spain)
Elena Miró
Affiliation:
Universidad de Granada (Spain)
Ana Medina
Affiliation:
Universidad de Granada (Spain)
*
Correspondence concerning this article should be addressed to Ana Isabel Sánchez. Facultad de Psicología. Universidad de Granada. 18071 Granada. (Spain). Phone: +34-958244275. E-mail: aisabel@ugr.es

Abstract

Objective: This study analyzes the role of a number of cognitive-affective dimensions in the experience and coping of pain in patients with fibromyalgia (FM). Specifically, it was examined whether anxiety, depression, pain catastrophizing and pain-related anxiety predict the pain perception and the self-efficacy expectations in these patients. Method: Seventy-four fibromyalgia patients were asked to complete a questionnaire survey including the Chronic Pain Self-Efficacy Scale, the Hospital Anxiety and Depression Scale, the Pain Anxiety Symptoms Scale-20, the Pain Catastrophizing Scale, and the Short-form McGill Pain Questionnaire. Results: Some relevant correlation and predicting patterns were identified. Physiological anxiety was the best predictor of the sensorial dimension of pain. Pain fear was a significant predictor of the pain intensity. Helplessness was the best predictor of the affective dimension of pain, whereas depression was a significant predicting variable of the self-efficacy expectations. Conclusions: This study shows the relevance of the pain-related anxiety in the pain perception, and of the depression in the self-efficacy expectations in FM patients. Clinical applications of the findings and further research lines in this area are discussed.

En este estudio se analiza el rol de diversas dimensiones cognitivo-afectivas en la experiencia y afrontamiento del dolor de personas con fibromialgia (FM). Específicamente, se examina si la ansiedad, la depresión, la catastrofización del dolor y la ansiedad ante el dolor predicen la percepción del dolor y las expectativas de autoeficacia en estos pacientes. Método: 74 pacientes con FM completaron una batería de cuestionarios entre los que se incluía el Cuestionario de Autoeficacia en Dolor Crónico, la Escala de Ansiedad y Depresión en el Hospital, la Escala de Síntomas de Ansiedad ante el Dolor-20, la Escala de Catastrofización del Dolor y la versión corta del Cuestionario de Dolor de McGill. Resultados: Se identificaron algunos patrones correlacionales y predictivos relevantes. La ansiedad fisiológica fue el mejor predictor de la dimensión sensorial del dolor. El miedo al dolor fue un predictor significativo de la intensidad del dolor. La indefensión fue el mejor predictor de la dimensión afectiva del dolor, mientras que la depresión fue una variable predictora significativa de las expectativas de autoeficacia. Conclusiones: Este estudio pone de manifiesto la relevancia de la ansiedad ante el dolor en la percepción del dolor y de la depresión en las expectativas de autoeficacia en pacientes con FM. Se discuten las aplicaciones clínicas de los resultados y se señalan futuras líneas de investigación en este área.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, K. O., Dowds, B. N., Pelletz, R. E., Edwards, W. T., & Peeters-Asdourian, C. (1995). Development and initial validation of a scale to measure self-efficacy beliefs in patients with chronic pain. Pain, 63, 7784. doi:10.1016/0304-3959(95)00021-JCrossRefGoogle ScholarPubMed
Arnsteins, P., Caudill, M., Mandle, C. L., Norris, A., & Beasley, R. (1999). Self-efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80, 483491.CrossRefGoogle Scholar
Caro, I., & Ibáñez, E. (1992). La Escala Hospitalaria de Ansiedad y Depresión: su utilización práctica en psicología de la salud [The Hospital Anxiety and Depression Scale. Its practical use in Health Psychology]. Boletín de Psicología, 36, 4369.Google Scholar
Coons, M. J., Hadjistavropoulos, H. D., & Asmundson., G. J. (2004). Factor structure and psychometric properties of the Pain Anxiety Symptoms Scale-20 in a community physiotherapy clinic sample. European Journal of Pain, 8, 511516. doi:10.1016/j.ejpain.2003.11.018CrossRefGoogle Scholar
De Gier, M., Peters, M. L., & Vlaeyen, J. W. S. (2003). Fear of pain, physical performance, and attentional processes in patients with fibromyalgia. Pain, 104, 121130.CrossRefGoogle ScholarPubMed
García-Campayo, J., Rodero, R., Alda, M., Sobradiel, N., Montero, J., & Moreno, S. (2008). Validación de la versión española de la Escala de Catastrofización ante el Dolor (Pain Catastrophizing Scale) en la fibromialgia [Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia]. Medicina Clínica, 131, 487493.CrossRefGoogle Scholar
Gormsen, L., Rosenberg, R., Bach, F. W., & Jensen, T. S. (2009). Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain. European Journal of Pain, 14(2), 18. doi:10.1016/j.ejpain.2009.03.010Google ScholarPubMed
Gracely, R. H., Geisser, M. E., Giesecke, T., Grant, M. A., Petzke, F., Williams, D. A., & Clauw, D. J. (2004). Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain, 127, 835843. doi:10.1093/brain/awh098CrossRefGoogle ScholarPubMed
Hassett, A. I., Cone, J., Patella, S. J., & Sigal, L. H. (2000). The role of catastrophizing in the pain and depression of women with fibromyalgia syndrome. Rheumatism, 43, 24932500. doi:10.1002/1529-0131(200011)43:11<2493::AID-ANR17>3.0.CO;2-W3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Herrero, M. J., Blanch, J., Peri, J. M., De Pablo, J., Pintor, L., & Bulbena, A. (2003). A validation study of the Hospital Anxiety and Depression Scale (HADS) in a Spanish population. General Hospital Psychiatry, 25, 277283. doi:10.1016/S0163-8343(03)00043-4CrossRefGoogle Scholar
Herrero, A. M., Ramírez-Maestre, C., & González, V. (2008). Personality, cognitive appraisal and adjustment in chronic pain patients. The Spanish Journal of Psychology, 11, 531542.CrossRefGoogle ScholarPubMed
Lázaro, C., Caseras, X., Whizar-Lugo, V. M., Wenk, R., Baldioceda, F., Bernal, R., … Baños, J. E. (2001). Psychometric properties of a Spanish version of the McGill Pain Questionnaire in several Spanish-speaking countries. The Clinical Journal of Pain, 17, 365374.CrossRefGoogle ScholarPubMed
Leeuw, M., Goossens, M. E. J. B., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. S. (2007). The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine, 30, 7794. doi:10.1007/s10865-006-9085-0CrossRefGoogle ScholarPubMed
Malt, E. A., Olafsson, S., Lund, A., & Ursin, H. (2002). Factors explaining variance in perceived pain in women with fibromyalgia. Musculoskeletal Disorders, 3. Retrieved from: http://www.biomedcentral.com/1471-2474/3/12Google ScholarPubMed
Máñez, I., Fenollosa, P., Martínez-Azucena, A., & Salazar, A. (2005). Calidad del sueño, dolor y depression en fibromialgia [Sleep quality, pain and depression in fibromyalgia]. Revista de la Sociedad Española de Dolor, 12, 491500.Google Scholar
Martín-Aragón, M., Pastor, M. A., Lledó, A., Terol, M. C., Rodríguez-Marín, J., & López-Roig, S. (2001). Percepción de control en el síndrome fibromiálgico: variables relacionadas [Control perception in fibromyalgia syndrome: related variables] Psicothema, 13, 586591Google Scholar
Martín-Aragón, M., Pastor, M. A., Rodríguez-Marín, J., March, M. J., Lledó, A., López-Roig, S., & Terol, M. C. (1999). Percepción de autoeficacia en dolor crónico: Adaptación y validación de la Chronic Pain Self-Efficacy Scale [Perceived self-efficacy in chronic pain: Adaptation and validation of the Chronic Pain Self-Efficacy Scale]. Revista de Psicología de la Salud, 11, 5375.Google Scholar
McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): Preliminary development and validity. Pain Research and Management, 7, 4550.CrossRefGoogle Scholar
Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain, 30, 191197. doi:10.1016/0304-3959(87)91074-8CrossRefGoogle ScholarPubMed
Menzies, V., Taylor, A. G., & Bourguignon, C. (2006). Effects of guided imagery on outcomes of pain, functional status, and self-Efficacy in persons diagnosed with fibromyalgia. The Journal of Alternative and Complementary Medicine, 12, 2330. doi:10.1089/acm.2006.12.23CrossRefGoogle ScholarPubMed
Nelson, P. J., & Tucker, S. (2006). Developing an intervention to alter catastrophizing in persons with fibromyalgia. Orthopaedic Nursing, 2, 205214. doi:10.1097/00006416-200605000-00011Google Scholar
Pérez-Pareja, F. J., Borrás, C., Palmer, A., Sesé, A., Molina, F., & Gonzalvo, J. (2004). Fibromialgia y emociones negativas [Fibromyalgia and negative emotions]. Psicothema, 16, 415420.Google Scholar
Rodero, B., García-Campayo, J., Casanueva, B., & Sobradiel, N. (2008). Exposición en imaginación como tratamiento del catastrofismo en fibromialgia: un estudio piloto [Imagined exposure in catastrophizing and fibromyalgia. A pilot study]. Actas Españolas de Psiquiatría, 36, 223226.Google Scholar
Roelofs, J., McCracken, L., Peters, M. L., Crombez, G., van Breukelen, G., & Vlaeyen, J. W. S. (2004). Psychometric evaluation of the Pain Anxiety Symptoms Scale (PASS) in chronic pain patients. Journal of Behavioral Medicine, 27, 167183. doi:10.1023/B:JOBM.0000019850.51400.a6CrossRefGoogle ScholarPubMed
Samwel, H. J., Evers, A. W., Crul, B. J., & Kraaimaat, F. W. (2006). The role of helplessness, fear of pain, and passive pain-coping in chronic pain patients. Clinical Journal of Pain, 22, 245251. doi:10.1097/01.ajp.0000173019.72365.f5CrossRefGoogle ScholarPubMed
Sardá, J., Nicholas, M., Asghari, A., & Pimenta, C. (2009). The contribution of self-efficacy and depression to disability and work status in chronic pain patients: A comparison between Australian and Brazilian samples. European Journal of Pain, 13, 189195.CrossRefGoogle ScholarPubMed
Sullivan, M. J. L., Bishop, S., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7, 524532. doi:10.1037//1040-3590.7.4.524CrossRefGoogle Scholar
Turk, D. C., Robinson, J. P., & Burwinkle, T. (2004). Prevalence of fear of pain and activity in patients with fibromyalgia syndrome. Journal of Pain, 5, 483490. doi:10.1016/j.jpain.2004.08.002CrossRefGoogle ScholarPubMed
Vallejo, M. A., Comeche, M. I., Ortega, J., Rodríguez, M. F., & Díaz, M. (2009). Las expectativas de autoeficacia y el ajuste emocional en el afrontamiento de la fibromialgia [Expectations of self-efficacy and emotional adjustment in coping with fibromyalgia]. Escritos de Psicología, 2, 2834.CrossRefGoogle Scholar
Vlaeyen, J. W. S., & Linton, S.J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85, 317332. doi:10.1016/S0304-3959(99)00242-0CrossRefGoogle ScholarPubMed
White, K. P., Nielson, W. R., Harth., M., Ostbye, T., & Speechle, M. (2002). Chronic widespread musculoskeletal pain with or without fibromyalgia: Psychological distress in a representative community adult sample. Journal of Rheumatology, 29, 588594.Google ScholarPubMed
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psiquiátrica Scandinavica, 67, 361370. doi:10.1111/j.1600-0447.1983.tb09716.xCrossRefGoogle ScholarPubMed