Pain coping mechanisms in fibromyalgia (FM): relationship to pain & functional outcomes

OBJECTIVE. To evaluate the factor structure of the Coping Strategies
Questionnaire (CSQ) in patients with fibromyalgia (FM) and to
compare the factors derived from this measure, along with the
active and passive pain coping scales of the Pain Management
Inventory (PMI) in predicting pain, depression, quality of
well being (QWB), and pain behavior concurrently and over

METHODS. One hundred twenty-two patients with FM were
recruited from medical clinics, the community, and support
groups. Eligible patients completed a battery of self-report
measures of pain and psychosocial functioning at baseline
assessment before random assignment to a clinical trial. A
subset of 69 patients who completed the clinical trial were
readministered the same battery 3 mo later. Data were analyzed
within the baseline period, and from the baseline period to
posttreatment to evaluate the predictive effects of coping
strategies on clinical outcomes.

RESULTS. Principal components
analysis of the CSQ revealed Coping Attempts (CA) and Pain
Control and Rational Thinking (PCRT) factors, which have been
found in other patient populations with chronic pain.
Hierarchical multiple regression analyses revealed that high
active coping and low PCRT contributed to higher concurrent
pain, while low active coping and high passive coping were
related to greater concurrent depression and pain behavior,
respectively. Controlling for baseline scores on criterion
measures, longitudinal multiple regression analyses
demonstrated that high active coping and low PCRT scores
contributed to greater pain, greater depression, and lower QWB
at posttreatment, while low PCRT alone predicted greater pain

CONCLUSION. The results show the import of the pain
coping construct in FM and highlight the negative contribution
of low perceived control over pain and high active coping to a
range of pain outcomes. The findings on low perceived control
converge with data on other chronic pain populations, while
the role of active coping appears to be detrimental in FM, in
contrast to its positive effects in patients with rheumatoid

Nicassio PM, Schoenfeld-Smith K, Radojevic V, Schuman C

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