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Diotaiuti P, Corrado S, Mancone S, Cavicchiolo E, Chirico A, Siqueira TC, Andrade A. A psychometric evaluation of the Italian short version of the Fear of Pain Questionnaire-III: Psychometric properties, measurement invariance across gender, convergent, and discriminant validity. Front Psychol 2023; 13:1087055. [PMID: 36726497 PMCID: PMC9886064 DOI: 10.3389/fpsyg.2022.1087055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The Fear of Pain Questionnaire-III (FPQ-III) is a self-assessment instrument developed specifically to measure fear based on various pain stimuli converging on three factors: severe pain, medical pain, and minor pain. It actually remains the most studied and internationally used tool even in its short versions. The aim of this work was to propose a new validation study oriented to confirm the good psychometric properties of a short model of the FPQ-III for the Italian context. Methods A large sample of participants was recruited (n = 1,064) and Exploratory Factor Analysis (EFA) as well as Confirmatory Factor Analysis (CFA) were performed. Measurement invariance of the FPQ-III across gender was also evaluated. In order to examine convergent validity, a further convenient sample (n = 292) was used and variables related to the individual's pain experience, locus of control and coping orientations were assessed. A final discriminant assessment using experimental manipulation through fear eliciting videos was performed. Results The three factors structure of the 13-item version of the questionnaire was confirmed (χ2 = 148.092, CFI = 0.971, TLI = 0.962, RMSEA = 0.046, RMSEA 90% CI = 0.037-0.056) as well as the measurement invariance across gender. Item internal reliability was satisfactory. The results provided evidence of the good predictive validity of the FPQ-III and the discriminant assessment demonstrated that the instrument is suitable in detecting changes in fear of pain induced by specific situational conditions. Discussion The scale in this short version is suitable for quickly and efficiently gathering information about the perceived intensity of such anticipatory fears that might affect even the healthy person dysfunctionally.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy,*Correspondence: Pierluigi Diotaiuti,
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Elisa Cavicchiolo
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, Rome, Italy
| | - Thais Cristina Siqueira
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Alexandro Andrade
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
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Asaba E, Sy M, Pineda RC, Aldrich R, Anzai T, Bontje P, Bratun U, Farias L, Kapanadze M, Šuc L, Åkesson E. Return to work after COVID-19: an international perspective. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2022. [DOI: 10.1080/14473828.2022.2045819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Eric Asaba
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
- Unit for Research, Education, Development, & Innovation, Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Michael Sy
- National Teacher Training Center for the Health Professions, University of the Philippines Manilla, Manila, Philippines
| | - Roi Charles Pineda
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Rebecca Aldrich
- Herman Ostrow School of Dentistry, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Tetsuya Anzai
- Faculty of Health Sciences, Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Peter Bontje
- Faculty of Health Sciences, Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Urša Bratun
- Faculty of Health Sciences, Department of Occupational Therapy, University of Ljubljana, Ljubljana, Slovenia
| | - Lisette Farias
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Maria Kapanadze
- Department of Occupational Therapy, University School of Nursing and Occupational Therapy of Terrassa (EUIT), Autonomous University of Barcelona, Barcelona, Spain
| | - Lea Šuc
- Department of Occupational Therapy, University Rehabilitation Institute Republic of Slovenia, Ljubljana, Slovenia
| | - Elisabet Åkesson
- Unit for Research, Education, Development, & Innovation, Stockholms Sjukhem Foundation, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
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Abstract
Fibromyalgia (FM) is a condition of chronic widespread pain (CWP) that can occur throughout the life cycle and is likely underrecognized in older patients. FM is associated with considerable suffering and reduction in quality of life and may occur as a unique condition, but in older patients is most likely to be associated with another medical illness. Understood mechanistically to be a sensitization of the nervous system, recently identified as nociplastic pain, FM is accepted as a valid medical illness that requires a positive diagnosis and directed treatments. The cornerstone of treatments for FM are nonpharmacologic interventions, with the understanding that medications provide only modest benefit for most patients, and with particular concern about adverse effects in older patients. If FM is not recognized, treatments may be misdirected to the other medical condition, with failure to address FM symptoms, leading to overall poor outcome. In contrast, new complaints in older patients should not immediately be attributed to FM, and physicians should be vigilant to ensure that onset of a new illness is not ignored. As FM is most often a lifelong condition, patients should be encouraged to identify their own personal strategies that can attenuate symptoms, especially when symptoms flare. Continued life participation should be the outcome goal.
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Affiliation(s)
- Amir Minerbi
- Institute for Pain Medicine, Rambam Health Campus, Haifa, Israel.,Ruth and Bruce Rapaport Faculty of Medicine, Technion, Haifa, Israel
| | - Mary-Ann Fitzcharles
- Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. .,Division of Rheumatology, McGill University Health Centre, Montreal, QC, Canada.
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Mukhida K, Carroll W, Arseneault R. Does work have to be so painful? A review of the literature examining the effects of fibromyalgia on the working experience from the patient perspective. CANADIAN JOURNAL OF PAIN-REVUE CANADIENNE DE LA DOULEUR 2020; 4:268-286. [PMID: 33987505 PMCID: PMC7951172 DOI: 10.1080/24740527.2020.1820858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Chronic pain conditions, such as fibromyalgia, adversely affect individuals’ abilities to work. Aim The aim of this study was to examine, from the perspective of patients, the effects that fibromyalgia symptoms had on their ability to work, the challenges that they encountered in the workplace that did not foster their continued employment, and the types of modifications to their work or workplace that they thought would facilitate their productivity and ability to work. Methods A scoping review method, applying techniques of systematic review, was used to conduct a research synthesis of the literature regarding fibromyalgia and work that looked at this issue from the patient perspective. Results A variety of themes emerged from the analysis and could be broadly categorized into (1) the work experience was a challenging one with which to cope; (2) relationships were strained at work; (3) clinical symptoms had repercussions on subjects’ attitudes toward work and the relation to life outside of work; and (4) a variety of possible solutions were considered to help subjects better cope with fibromyalgia and work. Conclusions Strategies that potentially could foster continued employment of patients with fibromyalgia include those at the micro, meso, and macro levels. Health care providers can support patients’ employment goals by collaborating with patients and their employers, dispelling stigma regarding the illness, and providing practical and specific advice regarding workplace accommodations.
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Affiliation(s)
- K Mukhida
- Pain Management Unit, Department of Anesthesiology, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - W Carroll
- Department of Management, Sobey School of Business, Saint Mary's University, Halifax, Nova Scotia, Canada
| | - R Arseneault
- Department of Management, Sobey School of Business, Saint Mary's University, Halifax, Nova Scotia, Canada
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de Wit M, Wind H, Hulshof CTJ, Frings-Dresen MHW. Person-related factors associated with work participation in employees with health problems: a systematic review. Int Arch Occup Environ Health 2018; 91:497-512. [PMID: 29700608 PMCID: PMC6002456 DOI: 10.1007/s00420-018-1308-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/18/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of this systematic review was to explore and provide systematically assessed information about the association between person-related factors and work participation of people with health problems. The research question was: what is the association between selected person-related factors and work participation of workers with health problems? METHODS A systematic review was carried out in PubMed and PsycINFO to search for original papers published between January 2007 and February 2017. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. The quality of evidence was assessed using the GRADE framework for prognostic studies. RESULTS In total, 113 studies were included, all of which addressed the association between person-related factors and work participation. The factors positively associated with work participation were positive expectations regarding recovery or return to work, optimism, self-efficacy, motivation, feelings of control, and perceived health. The factors negatively associated with work participation were fear-avoidance beliefs, perceived work-relatedness of the health problem, and catastrophizing. Different coping strategies had a negative or a positive relationship with work participation. CONCLUSIONS The results of this review provide more insight into the associations between different cognitions and perceptions and work participation. The results of this study suggest that person-related factors should be considered by occupational- and insurance physicians when they diagnose, evaluate or provide treatment to employees. Further research is required to determine how these physicians could obtain and apply such information and whether its application leads to a better quality of care.
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Affiliation(s)
- Mariska de Wit
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - Haije Wind
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
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Palstam A, Mannerkorpi K. Work Ability in Fibromyalgia: An Update in the 21st Century. Curr Rheumatol Rev 2017; 13:180-187. [PMID: 28464770 PMCID: PMC5759171 DOI: 10.2174/1573397113666170502152955] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fibromyalgia (FM) is characterized by persistent widespread pain, increased pain sensitivity and tenderness. People with FM also report activity limitations and impaired work ability. OBJECTIVE This article aims to compile the findings of recently published research on work ability in people with fibromyalgia, and to present how work ability is influenced by various aspects. METHODS A systematic search of the literature published from the year 2000 and onwards was conducted. Thirtyfour articles were included in the review. RESULT Symptom severity was found to influence work ability in people with FM. Physically demanding jobs and work tasks were especially troublesome and were reported to constitute higher risks pof work disability. Working people with FM seemed to hold a careful balancing act to manage the risk of overload where well-functioning strategies such as making a career change, working part-time, and developing personal skills were necessary for managing work, in the short- and long term. The support of management and colleagues enabled people with FM to manage the risk of overload at work. Treatment studies evaluating work disability as outcome in FM are scarce. None of the included studies presented any effects on measures of sick-leave or work disability compared with a control group. CONCLUSION More studies of treatment effects on outcomes related to work ability in people with FM, and more longitudinal studies to explore long-term effects of symptoms on work ability and sick leave, are needed in order to be able to plan evidence based rehabilitation to improve or maintain work ability in people with FM.
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Affiliation(s)
- Annie Palstam
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Kaisa Mannerkorpi
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
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Frank A. Vocational Rehabilitation: Supporting Ill or Disabled Individuals in (to) Work: A UK Perspective. Healthcare (Basel) 2016; 4:E46. [PMID: 27438864 PMCID: PMC5041047 DOI: 10.3390/healthcare4030046] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 11/17/2022] Open
Abstract
Work is important for one's self-esteem, social standing and ability to participate in the community as well as for the material advantages it brings to individuals and their families. The evidence suggests that the benefits of employment outweigh the risks of work and are greater than the risks of long-term unemployment or sickness absence. Individuals may be born with physical or intellectual disadvantages (e.g., cerebral palsy), or they may be acquired during childhood or adult life. Some progressive conditions may present in childhood or adolescence (e.g., some muscular dystrophies) and these need to be distinguished from those presenting later in life (e.g., trauma, stroke). Vocational rehabilitation (VR) thus takes three forms: preparing those with a disability, health or mental health condition for the world of work, job retention for those in work and assisting those out of work into new work. Important components of VR consist of the attributes of the individual, the skills/knowledge of their health professionals, the knowledge and attitudes of actual or potential employers and the assistance that is provided by the state or other insurance facility. Charities are playing an increasing role.
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Affiliation(s)
- Andrew Frank
- Vocational Rehabilitation Association, 42 The Croft, High Barnet, Herts EN5 2TL, UK.
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Middlesex, UB8 3PH, UK.
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Gignac MAM, Cao X, McAlpine J. Availability, Need for, and Use of Work Accommodations and Benefits: Are They Related to Employment Outcomes in People With Arthritis? Arthritis Care Res (Hoboken) 2015; 67:855-64. [DOI: 10.1002/acr.22508] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 10/08/2014] [Accepted: 10/28/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Monique A. M. Gignac
- Institute for Work and Health; Toronto Western Research Institute; and Dalla Lana School of Public Health; University of Toronto; Toronto Ontario Canada
| | - Xingshan Cao
- Toronto Western Research Institute; Toronto Ontario Canada
| | - Jessica McAlpine
- Institute for Work and Health and Toronto Western Research Institute; Toronto Ontario Canada
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Amutio A, Franco C, Pérez-Fuentes MDC, Gázquez JJ, Mercader I. Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients. Front Psychol 2015; 5:1572. [PMID: 25628591 PMCID: PMC4290530 DOI: 10.3389/fpsyg.2014.01572] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/19/2014] [Indexed: 12/22/2022] Open
Abstract
Fibromyalgia is a disabling syndrome. Results obtained with different therapies are very limited to date. The goal of this study was to verify whether the application of a mindfulness-based training program was effective in modifying anger, anxiety, and depression levels in a group of women diagnosed with fibromyalgia. This study is an experimental trial that employed a waiting list control group. Measures were taken at three different times: pretest, posttest, and follow-up. The statistical analyses revealed a significant reduction of anger (trait) levels, internal expression of anger, state anxiety, and depression in the experimental group as compared to the control group, as well as a significant increase in internal control of anger. It can be concluded that the mindfulness-based treatment was effective after 7 weeks. These results were maintained 3 months after the end of the intervention.
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Affiliation(s)
- Alberto Amutio
- Department of Social Psychology and Methodology of the Behavioral Sciences, Faculty of Psychology, University of the Basque Country San Sebastián, Spain
| | - Clemente Franco
- Department of Psychology, Faculty of Educational Sciences and Health, University of Almería Almeríaw, Spain
| | | | - José J Gázquez
- Department of Psychology, Faculty of Educational Sciences and Health, University of Almería Almeríaw, Spain
| | - Isabel Mercader
- Department of Psychology, Faculty of Educational Sciences and Health, University of Almería Almeríaw, Spain
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Briones-Vozmediano E, Ronda-Pérez E, Vives-Cases C. [Fibromyalgia patients' perceptions of the impact of the disease in the workplace]. Aten Primaria 2014; 47:205-12. [PMID: 25073746 PMCID: PMC6985610 DOI: 10.1016/j.aprim.2014.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 02/02/2014] [Accepted: 06/13/2014] [Indexed: 11/30/2022] Open
Abstract
Objetivo Explorar las percepciones de pacientes con fibromialgia (FM) sobre los problemas que experimentan en el ámbito laboral, para analizar cómo se enfrentan a ellos y se adaptan a las limitaciones derivadas de los síntomas de esta enfermedad. Diseño Estudio cualitativo exploratorio realizado en 2009. Emplazamiento Asociaciones de pacientes con FM de la Comunidad Valenciana (España). Participantes Dieciséis personas (13 mujeres y 3 hombres) diagnosticadas de FM por un reumatólogo, de distintas edades y ocupaciones, seleccionadas a partir de informantes clave y por la técnica de bola de nieve. Método Muestreo pragmático. Entrevistas semiestructuradas hasta alcanzar la saturación de la información cuando no emergían contenidos nuevos. Análisis de contenido cualitativo utilizando el software informático Atlas.ti-5 para generar y asignar códigos, formar categorías e identificar un tema latente. Resultados Se identificaron 4 categorías: las dificultades para cumplir las exigencias laborales, la necesidad de apoyo social en el entorno laboral, las estrategias adoptadas para continuar trabajando y la resistencia a abandonar el mercado de trabajo. De forma transversal a estas categorías emergió un tema: la disposición de permanecer o reincorporarse al mercado laboral. Conclusiones Se requiere atender las necesidades específicas de los pacientes con el fin de que logren permanecer en el mercado laboral, de acuerdo a sus capacidades. Para ello, emerge la necesidad de programas de sensibilización sobre las consecuencias de la FM en el entorno laboral para lograr la colaboración de los directivos, empresarios, profesionales de Atención Primaria y médicos del trabajo.
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Affiliation(s)
- Erica Briones-Vozmediano
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; Sociedad Española de Epidemiología (SEE), España.
| | - Elena Ronda-Pérez
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; Sociedad Española de Epidemiología (SEE), España; CIBER de epidemiología y salud pública (CIBERESP), Barcelona, España; Centro de Investigación en Salud Laboral (CISAL), España
| | - Carmen Vives-Cases
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; Sociedad Española de Epidemiología (SEE), España; CIBER de epidemiología y salud pública (CIBERESP), Barcelona, España
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Johnston M, Dixon D. Developing an integrated biomedical and behavioural theory of functioning and disability: adding models of behaviour to the ICF framework. Health Psychol Rev 2013; 8:381-403. [DOI: 10.1080/17437199.2013.855592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Torres X, Bailles E, Valdes M, Gutierrez F, Peri JM, Arias A, Gomez E, Collado A. Personality does not distinguish people with fibromyalgia but identifies subgroups of patients. Gen Hosp Psychiatry 2013; 35:640-8. [PMID: 24035635 DOI: 10.1016/j.genhosppsych.2013.07.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 07/29/2013] [Accepted: 07/31/2013] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The objectives were to compare the personality of fibromyalgia (FM) patients with other chronic painful and nonpainful disorders considering the confusion due to psychopathology and to assess the clustering of FM patients according to their personality profile. METHODS Differences in the NEO Five-Factor Inventory between FM, non-FM chronic pain and drug-resistant epileptic patients were assessed including the confounding effect of demographics and psychopathological status by multivariate regression analysis. Clustering of FM patients was assessed by two-step cluster analysis. Differences in clinical severity and psychosocial problems between subgroups and their outcome 6 months after multidisciplinary treatment were assessed. RESULTS The final sample comprised 874 patients. Once the effect of confounding variables was considered, clinically nonsignificant differences in personality were observed between groups. FM patients could, however, be grouped into two clusters. Cluster 1 was characterized by higher neuroticism and lower extraversion and showed a worse pretreatment clinical state including more psychosocial problems. In spite of having reached a wider general improvement at 6-month follow-up, Cluster 1 patients remained more anxious and depressed. CONCLUSIONS Identifying personality-based subgroups of FM might allow implementing specific preventive strategies. FM treatment might be optimized by increasing medication compliance, improving therapeutic alliance and testing different therapeutic options and treatment sequencing for each personality subgroup.
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Affiliation(s)
- Xavier Torres
- Institut Clínic de Neurociències, Hospital Clínic de Barcelona.
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Abstract
Fibromyalgia is a primary brain disorder or a result of peripheral dysfunctions inducing brain alterations, with underlying mechanisms that partially overlap with other painful conditions. Although there are methodologic variations, neuroimaging studies propose neural correlations to clinical findings of abnormal pain modulation in fibromyalgia. Growing evidences of specific differences of brain activations in resting states and pain-evoked conditions confirm clinical hyperalgesia and impaired inhibitory descending systems, and also demonstrate cognitive-affective influences on painful experiences, leading to augmented pain-processing. Functional data of neural activation abnormalities parallel structural findings of gray matter atrophy, alterations of intrinsic connectivity networks, and variations in metabolites levels along multiple pathways. Data from positron-emission tomography, single-photon-emission-computed tomography, blood-oxygen-level-dependent, voxel-based morphometry, diffusion tensor imaging, default mode network analysis, and spectroscopy enable the understanding of fibromyalgia pathophysiology, and favor the future establishment of more tailored treatments.
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Affiliation(s)
- Liliana Lourenço Jorge
- Hospital Israelita Albert Einstein and Instituto de Reabilitação Lucy Montoro, Avenida Albert Einstein, 627 3rd Floor Block D, 05651901, Morumbi, Sao Paulo, Brazil.
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Fitzcharles MA, Ste-Marie PA, Pereira JX. Fibromyalgia: evolving concepts over the past 2 decades. CMAJ 2013; 185:E645-51. [PMID: 23649418 DOI: 10.1503/cmaj.121414] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Gignac MAM, Jetha A, Bowring J, Beaton DE, Badley EM. Management of work disability in rheumatic conditions: a review of non-pharmacological interventions. Best Pract Res Clin Rheumatol 2013; 26:369-86. [PMID: 22867932 DOI: 10.1016/j.berh.2012.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 04/25/2012] [Indexed: 01/03/2023]
Abstract
Because of its substantial personal social and economic costs, workforce participation among individuals with rheumatic diseases has received considerable research attention. This chapter reviews non-pharmacological employment interventions for people with rheumatic diseases, focussing on the comprehensiveness of interventions, whether they have been targeted to those groups identified as most at risk, and intervention outcomes and effectiveness. Findings highlight that early diagnosis and treatment of rheumatic diseases may not be enough to keep individuals employed and that comprehensive work interventions may have positive psychological effects, as well as result in increased work participation. However, we lack data addressing the optimum time to intervene and subgroup analyses to determine whether some groups are at increased risk for poor work outcomes. Consistent inclusion of behavioural and psychological outcomes to evaluate interventions and compare studies is also needed, along with cost-benefit studies, to determine the long-term feasibility of work interventions.
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Affiliation(s)
- Monique A M Gignac
- Arthritis Community Research & Evaluation Unit, Toronto Western Research Institute, ON, Canada.
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Malin K, Littlejohn GO. Psychological control is a key modulator of fibromyalgia symptoms and comorbidities. J Pain Res 2012; 5:463-71. [PMID: 23152697 PMCID: PMC3496525 DOI: 10.2147/jpr.s37056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective We hypothesized that fibromyalgia (FM) patients would report lower levels of psychological control mechanisms and that higher levels of control would moderate key symptoms associated with FM, such as pain, fatigue, perceived stress, and mood disturbance. Methods Ninety-eight women with FM diagnosed according to American College of Rheumatology criteria and 35 matched pain-free women were identified. Applied questionnaires included the Fibromyalgia Impact Questionnaire, Profile of Mood States, Perceived Control of Internal States Scale, Perceived Stress Scale, and Mastery Scale. Differences were sought using t-tests, one-way analysis of variance, bivariate correlations, and multiple regression analysis. Results Comparison between FM patients and healthy individuals found significant differences in control (Perceived Control of Internal States Scale and Mastery Scale), pain, perceived stress, fatigue, confusion, and mood disturbance (all P < 0.001). There were significant associations found between both high and low levels of control on stress, mood, pain, and fatigue (P < 0.001–0.05). Strong negative correlations were present between internal control and perceived stress (P < 0.0005). Conclusion FM patients use significantly different control styles compared with healthy individuals. Levels and type of psychological control buffer mood, stress, fatigue, and pain in FM. Control appears to be an important “up-stream” process in FM mechanisms and is amenable to intervention.
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Affiliation(s)
- Katrina Malin
- Departments of Medicine and Rheumatology, Monash University and Monash Medical Centre, Melbourne, Australia
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Webb JW, Batchelor J, Meares S, Taylor A, Marsh NV. Effort Test Failure: Toward a Predictive Model. Clin Neuropsychol 2012; 26:1377-96. [DOI: 10.1080/13854046.2012.728248] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rooij AD, Roorda LD, Otten RH, van der Leeden M, Dekker J, Steultjens MP. Predictors of multidisciplinary treatment outcome in fibromyalgia:a systematic review. Disabil Rehabil 2012; 35:437-49. [DOI: 10.3109/09638288.2012.699582] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Description of a Half-Day Interprofessional Fibromyalgia Clinic with an Evaluation of Patient Satisfaction. Am J Phys Med Rehabil 2011; 90:825-33. [DOI: 10.1097/phm.0b013e31821f6ed3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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[Medium-term effects of a multimodal therapy on patients with fibromyalgia. Results of a controlled efficacy study]. Schmerz 2011; 25:55-61. [PMID: 21258823 DOI: 10.1007/s00482-010-1003-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Fibromyalgia shows a chronic course of the disease in most cases. Multimodal therapy has short-term effects but only intensive forms of therapy attain long-term effects. As part of an inpatient rehabilitation program a multimodal pain treatment including cognitive-behavioral therapy was conducted in order to evaluate medium-term effects. METHOD The German pain questionnaire (DSF), the hospital anxiety and depression scale (HADS-D), the chronic pain questionnaire (FESV), the short form questionnaire on indicators of rehabilitation status (IRES-24) and the self-efficacy scale (ASES-D) were distributed to 166 fibromyalgia patients (intervention group n=116; control group n=50) before and after rehabilitation as well as 6 months after treatment. RESULTS The intervention group showed better results regarding symptoms (pain intensity, anxiety, depression), state of health (somatic health, psychological well-being, functioning in everyday life) and self-efficacy. CONCLUSIONS Based on the positive medium-term effects on functioning in everyday life and self-efficacy there is evidence that patients benefit from multimodal rehabilitation programs including integrative patient education.
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Hsu MC, Schubiner H, Lumley MA, Stracks JS, Clauw DJ, Williams DA. Sustained pain reduction through affective self-awareness in fibromyalgia: a randomized controlled trial. J Gen Intern Med 2010; 25:1064-70. [PMID: 20532650 PMCID: PMC2955480 DOI: 10.1007/s11606-010-1418-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 05/06/2010] [Accepted: 05/19/2010] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Affect and how it is regulated plays a role in pain perception, maintenance of pain, and its resolution. This randomized, controlled trial evaluated an innovative affective self-awareness (ASA) intervention, which was designed to reduce pain and improve functioning in individuals with fibromyalgia. PARTICIPANTS AND METHODS Forty-five women with fibromyalgia were randomized to a manualized ASA intervention (n = 24) or wait-list control (n = 21). The intervention began with a one-time physician consultation, followed by 3 weekly, 2-h group sessions based upon a mind-body model of pain. Sessions focused on structured written emotional disclosure and emotional awareness exercises. Outcomes in both conditions were measured by a blinded assessor at baseline, post-intervention, and 6-month follow-up. MEASURES The primary outcome was pain severity (Brief Pain Inventory); secondary outcomes included tender-point threshold and physical function (SF-36 Physical Component Summary). Intent-to-treat analyses compared groups on outcomes using analysis of covariance and on the proportion of patients achieving ≥ 30% and ≥ 50% pain reduction at 6 months. RESULTS Adjusting for baseline scores, the intervention group had significantly lower pain severity (p < 0.001), higher self-reported physical function (p < 0.001), and higher tender-point threshold (p = 0.02) at 6 months compared to the control group. From baseline to 6 months, 45.8% of the ASA intervention group had ≥ 30% reduction in pain severity, compared to none of the controls (p < 0.001). CONCLUSIONS The affective self-awareness intervention improved pain, tenderness, and self-reported physical function for at least 6 months in women with fibromyalgia compared to wait-list control. This study suggests the value of interventions targeting emotional processes in fibromyalgia, although further studies should evaluate the efficacy of this intervention relative to active controls.
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Affiliation(s)
- Michael C. Hsu
- Department of Physical Medicine & Rehabilitation, Kaiser-Permanente Northwest, Portland, OR USA
| | - Howard Schubiner
- Department of Internal Medicine, St. John Health/Providence Hospital and Medical Centers, 16001 W. Nine Mile Rd, Southfield, MI 48075 USA
- School of Medicine, Wayne State University, Detroit, MI USA
| | - Mark A. Lumley
- School of Medicine, Wayne State University, Detroit, MI USA
- Department of Psychology, Wayne State University, Detroit, MI USA
| | - John S. Stracks
- Department of Family Medicine, Northwestern University, Chicago, IL USA
| | - Daniel J. Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI USA
- Department of Medicine, University of Michigan, Ann Arbor, MI USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - David A. Williams
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI USA
- Department of Medicine, University of Michigan, Ann Arbor, MI USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI USA
- Department of Psychology, University of Michigan, Ann Arbor, MI USA
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