Cognitive resources and stress recovery in Fibromyalgia Syndrome

A team of researchers at a Spanish university have suggested that several cognitive-behavioural techniques commonly employed in the treatment of Fibromyalgia Syndrome may help patients to find the correct equilibrium between stress and recovery and that the modification of self-efficacy beliefs and pain control expectancies are fundamental in managing the condition.¹

One hundred and thirty women with Fibromyalgia Syndrome (Fibro) took part in the study. The researchers evaluated a structural equation model (SEM) of linkages between the cognitive control resources (illness-specific efficacy beliefs and internal pain control expectancies) of the women, their stress/recovery state, and their affective discomfort.

The results were consistent with the proposal that stress/recovery balance mediates the relationship between cognitive resources and affective discomfort. ¹

In addition, direct effects of cognitive resources on function limitation were observed - in other words, the women with Fibro who were considered to have good cognitive resources had less functional limitations. ¹

The researchers also noted that pain intensity and symptoms were direct predictors of the affective discomfort.

Based on the results, the researchers concluded that several cognitive-behavioural techniques commonly employed in the treatment of Fibro are indicated as strategies aimed at finding the correct equilibrium between stress and recovery.

They also concluded that the modification of self-efficacy beliefs and pain control expectancies are fundamental in managing Fibro. Catastrophisation is widely accepted to be a problem amongst all kinds of pain patents because of the effects it has on the inhibitory/excitatory pain pathways and the pain centres of the brain. Catastrophisation is where you think the worst about your symptoms - e.g. hurting a little bit, panicking that the pain will become severe, won't ease and can't be managed and then getting stressed and adapting your behaviour, possibly stopping exercise or social activities, even though you are not yet in severe pain and may not have been in severe pain if you hadn't castrophised. Cognitive behavioural therapy is widely used in chronic pain management to help prevent this problem and part of this is the modification of self-efficacy beliefs and pain control expectancies.

References:

1. González Gutiérrez JL, Peñacoba Puente C, Velasco Furlong L, López-López A, Mercado Romero F, Barjola Valero P. [Cognitive resources of perceived control, stress-recovery processes and affective discomfort in fibromyalgia.][Article in Spanish] Psicothema. 2009 Aug;21(3):359-68.