Self-efficacy and pain behavior among subjects with fibromyalgia

Abstract

Given the lack of objective physical measures for assessing fibromyalgia syndrome (FS), the role of pain assessment is particularly important. The role of psychological factors is controversial among FS patients. This study was designed to better understand the relationship between pain behaviors and psychological variables. Specifically, this study (1) refined a pain behavior observation (PBO) methodology for use with FS patients, (2) determined whether stretching is a valid pain behavior, and (3) assessed whether psychological variables including self-efficacy and/or depression can predict pain behaviors after controlling for disease severity and age. The 73 FS subjects meeting the American College of Rheumatology classification system completed questionnaires measuring self-efficacy, depression, and pain. Trained physicians conducted tender-point examinations. Subjects were video-taped using a standardized procedure. Two trained raters independently coded all pain behaviors. Kappa coefficients and correlations among pain behaviors and self-reported pain indicated that the PBO method was both reliable and valid. However, the newly defined pain behavior 'stretching' was found to be negatively associated with self-reported pain. Hierarchical multiple regression (MR) analyses revealed that depression did not predict pain behavior over and above myalgic scores and age; however, in 3 separate MR analyses, self-efficacy for function, pain, and other symptoms each predicted pain behavior over and above myalgic scores and age. This study indicated that the original pain behavior scoring methodology is appropriate for use with the FS population and should not be modified to include the pain behavior 'stretching'. Self-efficacy was related to pain behavior while depression was not among this FS sample.

967 Construct Validity of the Illness Cognition Questionnaire: Robustness of Three‐factor Structure Across Patients With Chronic Pain and Chronic Fatigue

“…Some studies found evidence for the beneficial effects of perceived control over symptoms (8,9). Conversely, the repeated experience of lack of control over aversive events may result in helplessness (10).…”

Biopsychosocial functioning and pain self-efficacy in chronic low back pain patients

“…Little research involving CLBP patients includes all three levels of biopsychosocial functioning [52]. Studies on CLBP often investigate behavioral and psychological functioning (e.g., disability, pain behaviors, self-efficacy, and catastrophizing [9,[12][13][15][16][24][25]), but few studies include social functioning (e.g., social expectations, relationships, or social support [10,52]). Hence, our finding that social functioning predicts PSE and pain severity reiterates the importance of understanding social functioning in the overall model of chronic pain.…”

“…It has been reported that individuals with higher PSE tend to report higher rates of biopsychosocial functioning and lower pain severity [21][22][23]. Self-efficacy beliefs are often used to predict pain tolerance and psychological aspects of the pain experience [2,9,16,[24][25][26][27]. Specifically, those with higher self-efficacy rate pain stimuli as much less unpleasant than those with lower self-efficacy [26] and exhibit fewer pain behaviors [24][25].…”

“…Self-efficacy beliefs are often used to predict pain tolerance and psychological aspects of the pain experience [2,9,16,[24][25][26][27]. Specifically, those with higher self-efficacy rate pain stimuli as much less unpleasant than those with lower self-efficacy [26] and exhibit fewer pain behaviors [24][25]. In addition, researchers have indicated that increases in PSE for pain control may increase the usage of coping strategies, which results in reduced levels of disability [16].…”

Behavioural evaluation in patients affected by chronic pain: a preliminary study

“…Several studies have found a low or moderate correlation between an objective measure of the patients' global behaviour and a subjective measure of the perceived pain intensity [13][14][15][16][17]. It was also observed that the strength of the correlation in question could depend on various factors: the chronicity of the pain, the moment in which the subjective evaluation was carried out, and the type of pain behaviour observed and tested [9].…”