No abstract

Fifty women with fibromyalgia syndrome (FS) recorded their sleep quality, pain intensity, and attention to pain for 30 days, using palm-top computers programmed as electronic interviewers. They described their previous night's sleep quality within one-half hour of awakening each day, and at randomly selected times in the morning, afternoon, and evening rated their present pain in 14 regions and attention to pain during the last 30 min. We analyzed the 30-day aggregates cross-sectionally at the across-persons level and the pooled data set of 1500 person-days at the within-persons level after adjusting for between-persons variation and autocorrelation. Poorer sleepers tended to report significantly more pain. A night of poorer sleep was followed by a significantly more painful day, and a more painful day was followed by a night of poorer sleep. Pain attention and sleep were unrelated at the across-persons level of analysis. But there was a significant bi-directional within-person association between pain attention and sleep quality that was not explained by changes in pain intensity.

For 75 consecutive days, 54 Ss with rheumatoid arthritis supplied daily reports of their mood and joint pain. After aggregating daily reports, the relation between chronic mood and chronic pain remained statistically significant when controlling for neuroticism, depression, disease activity, disability, and characteristic responses to increasing pain. Findings of a path analysis suggest that (a) individuals higher in neuroticism experience more chronic distress regardless of their responses to pain, their pain intensity, and depressive symptomatology, and (b) the relation between neuroticism and chronic pain is mediated by the propensity of high-neuroticism individuals to catastrophize their pain. Within-subject analyses that controlled for autocorrelation and linear trends in the time series revealed that 40% of the Ss experienced significantly worse moods on more painful days. Although individuals higher in neuroticism reported more intense pain and more negative mood, their daily mood was less strongly linked to their daily pain.

We examined the mood-related and pain-related consequences of daily stressors among 74 individuals with rheumatoid arthritis who supplied daily reports for 75 days. Meta-analyses of time series regression coefficients disclosed a significant same-day relation between events and mood but no consistent effects of events on same-day pain, next-day mood, or next-day pain. With distributional characteristics of the daily data controlled, Ss with more active inflammatory disease showed a greater positive relation of events with same-day and next-day pain, those with a recent history of more major life stressors showed a greater positive relation of events with next-day pain, and those with less social support showed a greater positive relation of events with next-day mood disturbance. Implications of these and other findings for theories of stress and adaptation and the methodological challenges of daily experience research are discussed.

To examine the influence of perceived pain control and pain benefit appraisals on adjustment to rheumatoid arthritis (RA), we followed fifty-four RA patients for seventy-five days. After completing measures of dispositional optimism and appraisals of control over, and benefits from, their chronic pain, participants reported each day their pain intensity, mood, and activity limitations due to pain. Controlling for disease activity and dispositional optimism, those who believed they had more control over their pain at the outset of the study experienced less daily pain. Daily pain also moderated the relation between control beliefs and adjustment as well as the relation between benefit appraisals and adjustment: With increased levels of pain, greater control was associated with less positive mood. But those who perceived more benefits and then experienced severe pain reported fewer days on which their activities were limited by their pain. These findings are discussed as they relate to current conceptions of control. ResumePendant 75 jours, nous avons suivi 54 patients souffrant de polyarthrite rhumatoide afin d'etudier rinfluencc, sur 1'adaptation a l'arthrite, de la perception qu'ont les patients du controle de la douleur et de leur evaluation des bienfaits qu'ils tirent de la maladie. Les patients ont tout d'abord evalue leur tendance a l'optimisme, Ie controle qu'ils exercaient sur la douleur chronique ainsi que les bienfaits qu'ils tiraient de la maladie. Us ont ensuite consign^, chaque jour, l'intensit£ de leur douleur, leur hurneur et les limites impos£es par la douleur a leurs activity?. En exercant un contrdle sur les manifestations de la maladie et sur la tendance a l'optimisme, les patients qui, au commencement dc I'etude, croyaient davantagc exercer un controle sur leur douleur, ont moins ressenti de douleur quotidiennement. En outre, la douleur eprouvee chaque jour a amoindri la relation entre la perception du contrdle et 1'adaptation des patients, ainsi que la relation entre l'estimation des bienfaits et 1'adaptation. En effet, lorsque l'intensite dc la douleur £tait forte, un contrCle accru correspondait a une humeur moins positive. Par contre, chez les patients qui percevaicnt plus de bienfaits et qui ont par la suite ressenti une douleur tres intense, le nombre de jours ou la douleur restreignait ies activites etait