Suffering and Dysfunction in Fibromyalgia Syndrome

SUMMARY

Objectives: To describe the plight of the person with fibromyalgia syndrome [FMS], the psychosocial and behavioral factors that contribute to the extent of suffering experienced, and the heterogeneity of patient subgroups that characterize adaptation and response to treatment.

Findings: People diagnosed with FMS are confronted with a range of factors the influence there perception, adaptation, and response to treatment. Three subgroups of FMS patients have been identified using cluster analytic procedures. One subgroup is characterized by high levels of pain, perceived interference of symptoms with life, affective distress and social support, and low levels of perceived control and activity– “Dysfunctional.” The unique characteristics of a second subgroup, relative to other FMS patients, relates to their perceptions of little support from significant others and a high degree of negative responses to their reports of symptoms– “Interpersonally Distressed.” Compared to the other two groups, the third group reported lower levels of pain, emotional distress, and higher levels of perceived control over symptoms, and were more active– “Adaptive Copers.” The percentage of patients classified within each of the three groups were roughly equivalent. The three subgroups respond differentially to a standard interdisciplinary rehabilitation program.

Conclusions: Successful treatment of patients diagnosed with FMS will require attention to important individual differences in patients' perceptions, modes of responding, and responses by significant others in addition to physical factors associated with FMS.

KEYWORDS:

• Disability
• expectations
• pain behaviors
• patient heterogeneity
• treatment matching