Academic journal article The Spanish Journal of Psychology

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

Academic journal article The Spanish Journal of Psychology

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

Article excerpt

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 Shortform 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.

Keywords: fibromyalgia, anxiety, depression, catastrophizing, pain anxiety, self-efficacy expectations.

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.

Palabras clave: fibromialgia, ansiedad, depresión, catastrofización, ansiedad ante el dolor, expectativas de autoeficacia.

Fibromyalgia (FM) is a chronic pain condition characterized by different symptoms, including chronic diffuse pain, and increased sensitivity to pain at certain characteristic points of the body. The etiology of FM is unknown. Studies performed in chronic pain patients, including FM sufferers, have highlighted the role performed by certain variables in pain perception, including most notably pain catastrophizing, fear of pain, expectations of self-efficacy, emotional alterations, and personality profiles (Hassett, Cone, Patella & Sigal, 2000; Pérez-Pareja et al., 2004; Samwel, Evers, Crul & Kraaimaat, 2006). In this last variable Herrero, Ramírez-Maestre and Gónzalez (2008) observed that certain clinical personality patterns were associated with poor adjustment to chronic pain.

The relationship between FM and psychological distress (anxiety and depression) has been studied by different researchers. Gormsen, Rosenberg, Bach and Jensen (2009) observed that chronic pain patients with FM and neuropathic pain (NP) had significantly more depression than healthy controls. …

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