Psychological Functioning in Women With Fibromyalgia: A Grounded Theory Study

Abstract

The aim of this study was to elucidate psychological functioning and psychological processes in women with fibromyalgia. Twenty-one females with fibromyalgia (aged 26-72 years) were interviewed in-depth. The interviews were analysed in line with grounded theory. A core concept, "unprotected self," mirroring childhood conditions and adult psychological functioning, was identified. Intense activity or hypomanic helpfulness often was used as self-regulation in adult life. Later an increased exposure to mental load is accompanied by reduction of cognitive functioning and generalised pain. The phase of persistence of fibromyalgia is marked by reduction of cognitive functions, unprotected psychological functioning, and increased mental load as from crisis and somatic symptoms.

Life events stress and chronic pain

“…Notwithstanding limitations of cross sectional life stress research including the present one, this study confi rms importance of stressful life events in pathogenesis and maintenance of chronic pain. Longitudinal data considering multidimensional factors in combination with use of sophisticated interview based strategies (Wentz, Lindberg & Hallberg, 2004) may facilitate the exploration of causal relationship between stress and pain. Furthermore, the study underlines the importance of examining the occurrence of life events beyond its simple count and suggests scrutinizing the specifi city of these events.…”

Chronic fatigue syndrome, fibromyalgia, and related illnesses: a clinical model of assessment and intervention

“…Apart from performance demands, patients may find leisurely activities aversive because their thinking patterns, if not intently focused on external obligations, will naturally settle on highly negative perceptions of themselves, e.g., laziness or badness (Johnson et al, 1997;Wentz, Lindberg, & Hallberg, 2004). Thus, their dedication to almost continuous high-effort activities appears to serve in part the purpose of effectively blocking these negative self-reflections.…”

The role of life stress in fibromyalgia

“…However, fibromyalgia researchers should be aware of recent methodologic advances in the area of life stress research, such as the use of sophisticated interview-based strategies that may reveal subtle "inner stressors" associated with personality features and life history [15], as well as "ecologic momentary assessment," "experience sampling" methods, and "multivariate time series" that allow a detailed longitudinal view on the impact of daily life stressors on symptoms [31,32].…”

“…From a totally different perspective, Wentz et al [15] focused on fibromyalgia patients' life stress by using qualitative research strategies based on "grounded theory". The authors concluded that their fibromyalgia patients were pre-morbidly characterized by the core feature of "an unprotected self," which they overcompensated by intense activity or hypomanic helpfulness.…”