Vulnerability to stress among women in chronic pain from fibromyalgia and osteoarthritis
Vulnerability to stress among women in chronic pain from fibromyalgia and osteoarthritis
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DOI：
10.1207/s15324796abm2303_9
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发表时间：
2001-06-01
影响因子：
3.8
通讯作者：
Reich, JW
中科院分区：
文献类型：
--
作者：
Davis, MC;Zautra, AJ;Reich, JW
在两项调查中，我们研究了纤维肌痛综合征（FMS）和骨关节炎（OA）两种肌肉骨骼疾病慢性疼痛妇女对压力负面影响的脆弱性。在研究1中，有101名50至78岁的女性参与者。50例患有FMS，29例患有OA膝关节疼痛并计划进行膝关节手术，22例患有OA但未计划手术。横断面分析显示，三组在人口统计学变量、人格属性、负性情感、积极应对和感知社会支持方面具有可比性。正如预期的那样，FMS和OA手术女性报告了相似的身体疼痛水平，两组的评分均高于OA非手术女性。然而，FMS的妇女报告较差的情绪和身体健康，积极的影响，质量较差的社会环境，更频繁地使用回避处理疼痛比这两组妇女与OA。此外，社会支持的感知和使用密切相关的感知社会压力只有在FMS组。在研究2中，我们对41名37至74岁的女性进行了实验性的负面情绪和压力处理：20名女性患有FMS，21名女性患有OA。每组的参与者被随机分配到一个消极的情绪诱导或中性情绪（控制）的条件，然后所有的参与者讨论了30分钟的紧张的人际关系事件。压力相关的疼痛增加加剧了女性FMS，但不是女性OA的消极情绪诱导，压力过程中的疼痛与FMS，但不是女性OA的积极影响减少。这些发现表明，在患有慢性疼痛的女性中，患有FMS的女性可能特别容易受到社会压力的负面影响。与OA患者相比，他们拥有较少的积极情感资源，使用较少有效的疼痛应对策略，并且拥有更多受限制的社交网络，特别是那些经历相似程度ain的人。在某些情况下，他们似乎也会经历更长时间的压力相关疼痛增加，所有这些都可能导致积极影响的降低和随着时间的推移压力反应的增加。
In two investigations, we studied vulnerability to the negative effects of stress among women in chron ic pain from 2 types of musculoskeletal illnesses, fibromyalgia syndrome (FMS) and osteoarthritis (OA). In Study 1, there were 101 female participants 50 to 78 years old. 50 had FMS, 29 had OA knee pain and were scheduled for knee surgery, and 22 had OA but were not planning surgery. Cross-sectional analyses showed that the three groups were comparable on demographic variables, personality attributes, negative affect, active coping, and perceived social support. As expected, FMS and OA surgery women reported similar levels of bodily pain, and both groups scored higher than OA nonsurgery women. However women with FMS reported poorer emotional and physical health, lower positive affect, a poorer quality social milieu, and more frequent use of avoidant coping with pain than did both groups of women with OA. Moreover, the perception and use of social support were closely tied to perceived social stress only among the FMS group. In Study 2, we experimentally manipulated negative mood and stress in 41 women 37 to 74 years old: 20 women had FMS, and 21 women had OA. Participants from each group were randomly assigned to either a negative mood induction or a neutral mood (control) condition, and then all participants discussed a stressful interpersonal event for 30 min. Stress-related increases in pain were exacerbated by negative mood induction among women with FMS but not women with OA, and pain during stress was associated with decreases in positive affect in women with FMS but not women with OA. These findings suggest that among women with chronic pain, those with FMS may be particularly vulnerable to the negative effects of social stress. They have fewer positive affective resources, use less effective pain-coping strategies, and have more constrained social networks than their counterparts with OA, particularly those who experience similar levels of ain. They also seem to experience more prolonged stress-related increases in pain under certain circumstances, all of which may contribute to a lowering of positive affect and increased stress reactivity over time.