Cognitive Factors in Fibromyalgia: The Role of Self-Concept and Identity Related Conflicts

Abstract

Fibromyalgia is a syndrome characterized by the presence of diffuse and chronic musculoskeletal pain of unknown etiology. Clinical diagnosis and the merely palliative treatments considerably affect the patient's experience and the chronic course of the disease. Therefore, several authors have emphasized the need to explore issues related to self in these patients. The repertory grid technique (RGT), derived from personal construct theory, is a method designed to assess the patient's construction of self and others. A group of women with fibromyalgia (n = 30) and a control group (n = 30) were assessed using RGT. Women with fibromyalgia also completed the Fibromyalgia Impact Questionnaire and a visualanalogue scale for pain, and painful tender points were explored. Results suggest that these women had a higher present self–ideal self discrepancy and a lower perceived adequacy of others, and it was more likely to find implicative dilemmas among them compared to controls. These dilemmas are a type of cognitive conflict in which the symptom is construed as “enmeshed” with positive characteristics of the self. Finally, implications of these results for the psychological treatment of fibromyalgia are suggested to give a more central role to self-identity issues and to the related cognitive conflicts.

Cognitive conflicts and symptom severity in dysthymia: “I’d rather be good than happy”

“…Results obtained in this study were in line with previous findings, 13,[15][16][17][18] which consistently pointed towards a higher rate of IDs in clinical samples. We found IDs in over two thirds of dysthymic patients in contrast to only 39% of controls.…”

“…It is considered an instrument with high methodological quality, versatility and with a promising applicability. 27 It has already been applied to personal constructs of depressed 23 and other patients, 17 but not of dysthymics and the content of the constructs forming IDs has not been analysed. Feixas et al 26 reported a high reliability index for the CSPC (Cohen's Kappa=0.93).…”

“…The extant research [15][16][17] on this kind of cognitive structure suggests that cognitive conflicts, and specially IDs, are a common phenomenon cutting across a variety of diagnostic categories. However, it seems reasonable to hypothesize that IDs, which provide an explanation for resistance to change, might play a noticeable role in depression and dysthymia taking into account their high rates of relapse and recurrence and the tendency towards a chronic course of the disease.…”

Self-Construction, Cognitive Conflicts, and Disordered Eating Attitudes in Young Women

“…Methodologically, it is based on the study of cognitive conflicts using the Repertory Grid Technique (RGT) (see Feixas, Saúl & Ávila-Espada, 2009) which has already been applied to several clinical problems (Benasayag, Feixas, Mearin, Saúl & Laso, 2004;Carretero, Feixas, Pellugrini & Saúl, 2001;Compañ et al, 2011;Feixas, Cipriano & Varlotta-Domínguez, 2007;Feixas, Montebruno, Dada, del Castillo & Compañ, 2010;Feixas, Saúl & Ávila-Espada, 2009;Montesano, Feixas & Varlotta, 2009) and has led us to the elaboration of a treatment manual (Feixas & Saúl, 2005;Serna, Feixas & Fernandes, 2005). In our proposal we consider two types of cognitive conflicts that might reflect personal dilemma: dilemmatic constructs and implicative dilemmas.…”

Changes in the Construct Systems of First-Year University Students: Impact on Psychological Symptoms and Problem-Solving Skills

“…Several studies have shown that individuals from clinical samples presented more IDs than those from nonclinical samples (e.g., Compañ et al, 2011;Feixas, Montebruno, Dada, Del Castillo, & Compañ, 2010;Fernandes et al, 2005) and that in clinical samples the number of psychological symptoms was associated with the number of IDs . In addition, studies on psychotherapy have shown that a decrease in symptoms is accompanied by a decrease in the number of IDs, after a psychotherapeutic intervention (Feixas, Saúl, Winter, & Watson, 2008;Fernandes, 2007).…”