Daily Affect Relations in Fibromyalgia Patients Reveal Positive Affective Disturbance
Daily Affect Relations in Fibromyalgia Patients Reveal Positive Affective Disturbance
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DOI：
10.1097/psy.0b013e31819e0a8b
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发表时间：
2009-05-01
影响因子：
3.3
通讯作者：
Davis, Mary C.
中科院分区：
文献类型：
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作者：
Finan, Patrick H.;Zautra, Alex J.;Davis, Mary C.
目的：检测纤维肌痛(FM)患者在负性情绪(NA)和疼痛背景下的日常积极情绪障碍，以确定与骨关节炎(OA)患者相比，FM患者是否体验到日常积极情感(PA)的缺失；B)FM患者与CIA患者在PA和NA的日常关系上是否不同；以及c)被诊断为CIA和FM的患者是否在主要结果方面与仅患有OA或仅患有FM的患者不同。方法：260名内科医生诊断为骨性关节炎(n=106)、FM(n=53)或OA/FM(n=101)的女性完成了为期30天的电子日记。参与者每天接受一次PA、NA和疼痛水平的评估。结果：多水平模型显示，FM患者的总体PA低于OA患者，并且呈现出更强的PA-NA的反向关系。分析进一步表明，在我们研究的三个组中，OA/FM组可能是受损最严重的。这一组是PA对这两种影响的滞后效应的原因，即PA天数高导致次日PA低而次日NA高。结论：与CIA患者相比，FM患者存在PA障碍。这种干扰反映在PA的总体缺陷以及在面对疼痛和NA时无法维持PA。同时患有骨性关节炎和FM的患者可能是FM的一个亚群，具有PA调节失调的特别风险。
Objectives: To examine daily positive affective disturbance in the context of negative affect (NA) and pain among patients with fibromyalgia (FM) to determine a) if FM patients experience a deficit in daily positive affect (PA) relative to osteoarthritis (OA) patients; b) if FM patients differ from CIA patients in the day-to-day relations of PA and NA; and c) if patients diagnosed with both CIA and FM differ from patients with either OA-only or FM-only with respect to major outcomes. Methods: A total of 260 women with physician-diagnosed OA (n = 106), FM (n = 53), or OA/FM (n = 101) completed a 30-day electronic diary. Participants were assessed once daily on levels of PA, NA, and pain. Results: Multilevel models indicated that FM patients had less overall PA than OA patients and exhibited a stronger inverse PA-NA relation. Analyses further suggest that the OA/FM group may have been the most impaired of the three included in our study. This group was responsible for a lagged effect of PA on both affects, whereby high PA days resulted in low next-day PA and high next-day NA. Conclusion: FM patients exhibit a PA disturbance compared with CIA patients. This disturbance is reflected by an overall deficit in PA and an inability to sustain PA in the face of pain and NA. Patients with both OA and FM may represent a subgroup of FM that is at particular risk for dysregulation of PA.