Predictors of pain and functioning over time in fibromyalgia syndrome: An autoregressive path analysis
Article first published online: 30 JAN 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 2, pages 251–256, February 2013
How to Cite
Van Liew, C., Brown, K. C., Cronan, T. A., Bigatti, S. M. and Kothari, D. J. (2013), Predictors of pain and functioning over time in fibromyalgia syndrome: An autoregressive path analysis. Arthritis Care Res, 65: 251–256. doi: 10.1002/acr.21792
- Issue published online: 30 JAN 2013
- Article first published online: 30 JAN 2013
- Accepted manuscript online: 17 JUL 2012 12:46PM EST
- Manuscript Accepted: 27 JUN 2012
- Manuscript Received: 30 APR 2012
- NIH. Grant Number: AR-44020
Fibromyalgia is a disabling, chronic pain condition of unknown etiology. Although many factors have been recognized as important contributors to the pain experiences and functional abilities of fibromyalgia patients, the factors that are most impactful (and therefore represent optimal targets for intervention) are still unclear. The aim of the present study was to examine the pathways among depression, self-efficacy, pain, and physical functioning in a large sample of fibromyalgia patients over a 1-year timeframe.
Data from 462 participants (441 women) were analyzed using an autoregressive path analytical model with first- and second-order cross-lagged effects.
Self-efficacy was the only significant predictor of depression, physical functioning, and pain intensity ratings across time. Physical functioning at 6 months predicted self-efficacy at 1 year; no other factors related significantly to self-efficacy in the model.
Our model suggests that self-efficacy is a salient factor in fibromyalgia symptomatology. Our findings support designing interventions that use a multimodal approach, with an explicit focus on combining exercise (or other means) to improve physical functioning and psychotherapy (e.g., cognitive–behavioral therapy) with the intention of reprocessing the functional improvements and the implications of these improvements for the patients' ability to manage their fibromyalgia symptoms. By doing so, self-efficacy should be enhanced, and this would produce the greatest and broadest benefits for fibromyalgia patients.