Pain, Emotion, and Functional Limits in Fibromyalgia
Pain, Emotion, and Functional Limits in Fibromyalgia
Although pain is a subjective experience, the truth is that given the unknown etiology of FM, there is a major interest in analyzing how the different approaches to its measurement (e.g., evoked pain vs. clinical pain) correlate to one another and are influenced by the same psychological processes. Thus, there are several self-reported methods used to evaluate pain intensity (e.g., numerical pain scale [NPS]). Additionally, pain also is examined by using quantitative methods such as pressure pain thresholds (PPT; Graven-Nielsen & Arendt-Nielsen, 2010).
Patients with FM present a higher sensitivity to pain when using various forms of painful stimulation, such as electrodermal, thermal, or pressure (Blumenstiel et al., 2011). Despite the relevance of this matter, little is known about the relationship between evoked and clinical pain reports. To our knowledge, there are few studies that have looked into this relationship systematically, and the few that have done so generally show little correlation between both types of pain (Geisser et al., 2007, Smith et al., 2011). Staud, Vierck, Robinson, and Price (2006)) suggested that the joint effect of evoked pain and negative effect might explain the higher percentage of variance in clinical pain reports.
Intervention studies in FM also can provide some useful information about the relationship between evoked and clinical pain. During follow-up in longitudinal treatment studies in FM, improvements in clinical pain scores were found not to be parallel to changes in evoked pain measures, which are not associated with the course of treatment or clinical improvement (Bernardy et al., 2010, Häuser et al., 2010, Sarzi-Puttini et al., 2011). These results suggest a certain independence and dissociation between both pain dimensions.
Most of the studies that analyze the relationship between psychological processes (e.g., self-efficacy and affect) and pain, some of which already have been mentioned, do use subjective pain measures (clinical pain), asking patients directly about their pain experience (self-reported pain; intensity in most occasions) through numeric or visual analog scales. Less known is the relationship between these processes and evoked pain measures, such as pressure pain sensitivity.
The purpose of this study was to assess the role of self-efficacy and affect (negative and positive) as mediators of the relationship between pain (self-reported pain and pressure pain sensitivity) on depression, anxiety, and functional limitation.
Pain as a Multidimensional Concept
Although pain is a subjective experience, the truth is that given the unknown etiology of FM, there is a major interest in analyzing how the different approaches to its measurement (e.g., evoked pain vs. clinical pain) correlate to one another and are influenced by the same psychological processes. Thus, there are several self-reported methods used to evaluate pain intensity (e.g., numerical pain scale [NPS]). Additionally, pain also is examined by using quantitative methods such as pressure pain thresholds (PPT; Graven-Nielsen & Arendt-Nielsen, 2010).
Patients with FM present a higher sensitivity to pain when using various forms of painful stimulation, such as electrodermal, thermal, or pressure (Blumenstiel et al., 2011). Despite the relevance of this matter, little is known about the relationship between evoked and clinical pain reports. To our knowledge, there are few studies that have looked into this relationship systematically, and the few that have done so generally show little correlation between both types of pain (Geisser et al., 2007, Smith et al., 2011). Staud, Vierck, Robinson, and Price (2006)) suggested that the joint effect of evoked pain and negative effect might explain the higher percentage of variance in clinical pain reports.
Intervention studies in FM also can provide some useful information about the relationship between evoked and clinical pain. During follow-up in longitudinal treatment studies in FM, improvements in clinical pain scores were found not to be parallel to changes in evoked pain measures, which are not associated with the course of treatment or clinical improvement (Bernardy et al., 2010, Häuser et al., 2010, Sarzi-Puttini et al., 2011). These results suggest a certain independence and dissociation between both pain dimensions.
Most of the studies that analyze the relationship between psychological processes (e.g., self-efficacy and affect) and pain, some of which already have been mentioned, do use subjective pain measures (clinical pain), asking patients directly about their pain experience (self-reported pain; intensity in most occasions) through numeric or visual analog scales. Less known is the relationship between these processes and evoked pain measures, such as pressure pain sensitivity.
The purpose of this study was to assess the role of self-efficacy and affect (negative and positive) as mediators of the relationship between pain (self-reported pain and pressure pain sensitivity) on depression, anxiety, and functional limitation.
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