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.
Buckelew SP, Parker JC, Keefe FJ, Deuser WE, Crews TM, Conway R, Kay
DR, Hewett JE