Patients' Beliefs About Their Lack of Pain Control in Primary Fibromyalgia Syndrome

Pastor, María Antonia; Salas, Esteban M. Martínez; López, Sonia Villegas; Rodriguez, Janice; Sánchez, S.; Pascual, Eliseo

doi:10.1093/rheumatology/32.6.484

Cited by 31 publications

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“…In studies of patients with chronic rheumatological pain conditions, a stronger belief in internal locus of control for pain has been associated with lower levels of physical and psychological symptoms, and better response to therapy [37-45]. In studies of patients with FM, internal locus of control has been associated with better affect, reduced symptom severity, and less disability in upper and lower extremity function [46] and generally improved levels of functional status [47]. Most patients with FM, however, are more external in their locus of control compared to other rheumatological conditions or patients with chronic pain generally [46,48,49].…”

Section: Evaluation Of Pain Processing In Fibromyalgiamentioning

confidence: 99%

Untitled

2006

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Techniques in neuroimaging such as functional magnetic resonance imaging (fMRI) have helped to provide insights into the role of supraspinal mechanisms in pain perception. This review focuses on studies that have applied fMRI in an attempt to gain a better understanding of the mechanisms involved in the processing of pain associated with fibromyalgia. This article provides an overview of the nociceptive system as it functions normally, reviews functional brain imaging methods, and integrates the existing literature utilizing fMRI to study central pain mechanisms in fibromyalgia. IntroductionFibromyalgia (FM) affects six to ten million Americans, [1] and the incidence is estimated to be one to four percent in the general population [2]. The symptoms associated with FM significantly affect patients' quality of life [3] and can lead to extensive use of health care services [4]. Fibromyalgia is experienced as a chronic, widespread pain condition accompanied by fatigue, tenderness, sleep disturbance, decrements in physical functioning, and disruptions in psychological functioning (for example, memory problems, diminished mental clarity, mood disturbances, and lack of well-being) [5,6]. To date, a precise cause of FM is unknown.The diagnostic criteria for FM are, in part, based upon a demonstration of tenderness in 11 of 18 defined muscular sites [7]. Recent evidence, however, suggests the tenderness is not confined to these sites in FM, but can be observed throughout the body, including non-muscular sites such as the thumb [8]. The general and widespread nature of pain in fibromyalgia strongly suggests the involvement of central mechanisms that facilitate bodily spontaneous pain and that increase sensitivity to painful blunt pressure. These central mechanisms may involve spinal or supraspinal modulation of normal peripheral input, or efferent mechanisms that alter pain sensitivity at the periphery. These underlying central mechanisms of FM are likely to be reflected in altered supraspinal processing and may originate, in part, at supraspinal sites.The ability to evaluate human supraspinal processing has been enhanced greatly by major advances in brain imaging techniques. These methods vary in invasiveness, and in temporal and spatial resolution. These procedures evaluate neural activity from cerebral blood flow or glucose metabolism, neurochemistry from resonance spectroscopy techniques, changes in the volume of anatomical structures, and the amount of receptor binding by specific ligands. The focus of this paper is to describe the recent use of functional brain imaging techniques in studies of FM. It begins with a description of the nociceptive system as it functions normally, follows with an overview of functional brain imaging methods, and concludes with a synopsis of functional magnetic resonance imaging (fMRI) findings, shedding light on aberrant central mechanisms responsible for the pain of FM. The nociceptive systemThe nociceptive system is a warning system of actual or imminent damage to the body. It...

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Section: Evaluation Of Pain Processing In Fibromyalgiamentioning

confidence: 99%

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2006

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“…19,20 LOC-I is associated with greater coping abilities 21 and to the use of more active 22 and adaptive 23,24 coping strategies. In contrast, LOC-C and LOC-P are associated to greater severity of pain and to pain interference in everyday life, [25][26][27] including reduced physical activity 28 and medication abuse. 29,30 Likewise, persons with predominant LOC-C are more catastrophist 31 and even more likely to suffer from post-traumatic stress, 32 while persons with predominant LOC-P make use of a higher number of behavioral coping strategies.…”

Section: Introductionmentioning

confidence: 99%

A Shortened Version of the Headache‐Specific Locus of Control Scale in Spanish Population

2010

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(Headache 2010;50:1335‐1345) Background and Objective.— Further questions need to be addressed in the evaluation of locus of control (LOC) in headaches, such as reducing scale length and adapting them to diverse cultural environments, as in the case of Spain. Methods.— We perform a confirmatory factor analysis of the most outstanding items contained in the Headache‐Specific Locus of Control Scale in the responses of 118 patients suffering from headaches who received assistance at public health care centers in the province of Seville (Spain). Results.— The adjustment was positive, thus confirming the original structure of 3 factors: internal locus of control (LOC‐I), health care professionals' LOC, and chance locus of control (LOC‐C). Scale validation was performed by examining associations both with headache clinical parameters and psychological measures. The latter included self‐efficacy, internal language, coping strategies, and pain behaviors. LOC‐C results deserve special mention, supporting the idea that it seems more important to avoid that patients develop LOC‐C rather than boosting LOC‐I and LOC‐P expectations. Conclusions.— The so‐called Headache‐Specific Locus of Control Scale‐Short Form 9 has turned out to be a parsimonious (9 items), valid, and reliable measure of headache LOC.

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“…The utility of the LOC construct within health and medical contexts has been extensively demonstrated across a broad variety of pathology [4][5][6][7][8][9]. There have also been some interesting and clinically relevant observations that the LOC construct may mediate health outcomes/status [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

The Chinese version of the multidimensional health locus of control scale form C in pregnancy

Martin

2006

Journal of Psychosomatic Research

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Patients' Beliefs About Their Lack of Pain Control in Primary Fibromyalgia Syndrome

Cited by 31 publications

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A Shortened Version of the Headache‐Specific Locus of Control Scale in Spanish Population

The Chinese version of the multidimensional health locus of control scale form C in pregnancy

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