Assessment of psychological distress in fibromyalgia

纤维肌痛心理困扰的评估

• 批准号: 6474994
• 负责人: JOHN B WINFIELD
• 金额: $ 11.98万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-01 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6474994
• 关键词: attitude; behavioral /social science research tag; chronic pain; clinical research; fibromyalgia; human subject; lifestyle; pain threshold; psychological adaptation; psychological stressor

The bases for the decreased pain threshold and pain tolerance that is characteristic of people with fibromyalgia remain to be clarified. In addition to biological variables, such as gender, central sensitization, "wind-up" (abnormal temporal summation of pain), and central dysregulation of several axes of the stress response, cognitive, behavioral, emotional, environmental, and cultural variables appear to contribute importantly to the chronic pain experience and associated symptomatology in this disorder. A common denominator linking both biological and psychosocial contributors in this regard may be psychologic distress. The applicant's preliminary data are consistent with the hypothesis that psychological distress lowers pain threshold and, therefore, contributes to widespread allodynia and hyperalgesia in fibromyalgia. The immediate objective of this proposal is to use established databases from a cohort of patients with fibromyalgia and other rheumatologic conditions to define some of the individual differences that underlie the development and perpetuation of chronic widespread pain. This will be accomplished through the following Specific Aims: Aim 1, to determine the association of psychological distress with pain threshold and tolerance using thermal and ischemic pain techniques; Aim 2, to determine whether helplessness, optimism, and pessimism are associated with defined patterns of self-reported pain, pressure pain threshold and distress in patients with fibromyalgia and other rheumatologic disorders; and Aim 3, to determine whether our preliminary data showing an inverse relationship of distress and pressure pain threshold in fibromyalgia and other rheumatic disease patients receiving care in an academic medical center also obtain for patients in the community. Aim 3 will allow us to determine the generalizability of our preliminary data through comparisons of the UNC Arthritis Clinic Database, which consists of information on consecutive patients obtained from completion of a self-report questionnaire, Activities and Lifestyle Index and pressure pain threshold by algometry at 4 fibromyalgia tender points and the NC Rheumatologists Database also based on the Activities and Lifestyle Index completed by patients of rheumatologists in private practice in North Carolina; in addition, cross-sectional - data concerning the relationship of psychological distress and pressure pain threshold by algometry will be obtained in a subset of patients with fibromyalgia and other diagnoses under the care of NC rheumatologists.

纤维肌痛患者的痛阈值降低和疼痛耐受性降低的基础仍有待阐明。除了生物变量，如性别、中枢敏感化、“上弦”(疼痛的异常时间总和)和应激反应的几个轴的中枢失调，认知、行为、情绪、环境和文化变量似乎对这种疾病的慢性疼痛体验和相关症状学有重要贡献。在这方面，将生理和心理社会因素联系在一起的一个共同因素可能是心理困扰。申请者的初步数据是 与心理困扰降低痛阈值，从而导致纤维肌痛中广泛的痛觉过敏和痛觉过敏的假设一致。这项建议的直接目标是使用纤维肌痛和其他风湿病患者队列中已建立的数据库来确定慢性广泛性疼痛的发展和永久存在的一些个体差异。这将会实现的 通过以下具体目标：目标1，利用热痛和缺血疼痛技术，确定心理痛苦与疼痛阈值和耐受性之间的关系；目标2， 确定无助、乐观和悲观是否与纤维肌痛和其他风湿性疾病患者的自我报告疼痛、压力痛阈值和痛苦的定义模式相关；以及目标3，确定我们的初步数据是否也适用于社区患者，这些数据显示在纤维肌痛和其他风湿病患者中接受治疗的纤维肌痛和其他风湿病患者的痛苦和压力痛阈值呈负相关。AIM 3将使我们能够通过比较UNC关节炎临床数据库来确定我们的初步数据的概括性，该数据库包括通过完成自我报告问卷获得的连续患者的信息、活动和生活方式指数以及在4个纤维肌痛压痛点和NC处通过痛觉测量获得的压力痛阈值 风湿科医生数据库还基于北卡罗来纳州风湿科医生患者在私人执业时完成的活动和生活方式指数；此外，关于心理痛苦和压力痛阈值之间关系的横断面数据 在NC风湿科医生的护理下，将在纤维肌痛和其他诊断的患者子集中进行痛觉测量。