Fibromyalgia (FM) is a lifelong central nervous system disorder that is precipitated by a range of biological, psycho-cognitive, and social factors. The aims of this exploratory study were to (a) identify biopsychosocial and cognitive factors that may affect an individual’s response to FM, (b) determine whether individuals with FM can be grouped into homogeneous subgroups based on biopsychosocial factors associated with response to FM, and (c) compare subgroup differences in health outcomes and life satisfaction. This study included 302 participants with FM. Principal components analysis yielded three sets of biopsychosocial factors that may affect response to FM (i.e., protective, cognitive-affective, and physical factors). Based on these three factors, a cluster analysis was performed, which produced three homogeneous subgroups: (a) the moderate amount of problems group, (b) the least amount of problems group, and (c) the many problems group. Analysis of variance (ANOVA) results indicated that these three subgroups differed significantly in terms of health outcomes and life satisfaction. The findings of this study broaden the existing literature related to understanding FM from a multidimensional symptom response perspective and contribute to the development and validation of biopsychosocial interventions for people with FM.
AbelesA.PillingerM.SolitarB.AbelesM. (2007). Narrative review: The pathophysiology of fibromyalgia. Annals of Internal Medicine, 146, 726–734.
2.
AlghadirA. H.AnwerS.IqbalA.IqbalZ. A. (2018). Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. Journal of Pain Research, 11, 851–856. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927184/pdf/jpr-11-851.pdf
3.
AndrewJ.AndrewM. J. (2017). Disability handbook. Aspen Professional Services.
4.
ArnoldL. M.CroffordL. J.MartinS. A.YoungJ. P.SharmaU. (2007). The effect of anxiety and depression on improvements in pain in a randomized, controlled trial of pregabalin for treatment of fibromyalgia. Pain Medicine, 8, 633–638.
5.
BeltN. K.KronholmE.KauppiM. J. (2009). Sleep problems in fibromyalgia and rheumatoid arthritis compared with the general population. Clinical & Experimental Rheumatology, 27, 35–41.
6.
BennettR. M.JonesJ.TurkD. C.RussellI. J.MatallanaL. (2007). An internet survey of 2,596 people with fibromyalgia. BMC Musculoskeletal Disorders, 8, 27–38.
7.
BennettR. M.NelsonD. (2006). Cognitive behavioral therapy for fibromyalgia. Nature Clinical Practice Rheumatology, 2(8), 416–424.
8.
BervenN. L.HubertL. J. (1977). Complete-link clustering as a complement to factor analysis: A comparison to factor analysis used alone. Journal of Vocational Behavior, 10, 69–81.
9.
BishopM. L. (2012). Psychosocial adaptation to chronic illness and disability: Current status and considerations for new directions. In TorielloP. J.BishopM. L.RumrillP. D. (Eds.), New directions in rehabilitation counseling: Creative responses to professional, clinical, and educational challenges (pp. 25–53). Aspen Professional Services.
10.
BlakeJ. D.BodinC. (2002). An overview of assistive technology for persons with multiple sclerosis. Journal of Rehabilitation Research and Development, 39(2), 299–312.
11.
BoonstraA. M.RenemanM. F.StewartR. E.PostM. W.Schiphorst PreuperH. R. (2012). Life satisfaction in patients with chronic musculoskeletal pain and its predictors. Quality of Life Research, 22, 93–101.
12.
BuschA. J.WebberS. C.BrachaniecM.BidondeJ.Bello-HaasV.Dal DanyliwA. D.. . . SchachterC. L. (2011). Exercise therapy for fibromyalgia. Current Pain and Headache Reports, 15(5), 358–367. https://doi.org/10.1007/s11916-011-0214-2
13.
CarverC. (1997). You want to measure coping but your protocol’s too long: Consider the brief COPE. International Journal of Behavioral Medicine, 4, 92–100.
14.
ChanF.YaghmaianR.ChenX.WuJ. R.LeeB.IwanagaK.TaoJ. (2019). The World Health Organization International Classification of Functioning, Disability and Health as a framework for rehabilitation assessment. In StrauserD.TanseyT. N.ChanF. (Eds.), Assessment in rehabilitation and mental health counseling (pp. 16–35). Springer.
15.
ChouC. C.ChanF.ChanY. C.PhillipsB.DitchmanN.KaseroffA. (2013). Positive psychology theory, research, and practice: A primer for the rehabilitation counseling professionals. Rehabilitation Research, Policy, & Education, 27, 131–153.
16.
ChronisterJ. A.JohnsonE. K.BervenN. L. (2006). Measuring social support in rehabilitation. Disability & Rehabilitation, 28, 75–84.
17.
CohenS.KamarckT.MermelsteinR. (1983). A global measures of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396.
18.
CohenS.WilliamsonG. (1988). Perceived stress in a probability sample of the US. In SpacapamS.OskampS. (Eds.), The social psychology of health: Claremont symposium on applied social psychology (pp. 31–67). SAGE.
19.
De SouzaJ. B.GoffauxP.JulienN.PotvinS.CharestJ.MarchandS. (2009). Fibromyalgia subgroups: Profiling distinct subgroups using the Fibromyalgia Impact Questionnaire. A preliminary study. Rheumatology International, 29, 509–515.
20.
DienerE.EmmonsR. A.LarsenR. J.GriffinS. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71–75.
21.
DiStefanoC.ZhuM.MîndrilăD. (2009). Understanding and using factor scores: Considerations for the applied researcher. Practical Assessment, Research, and Evaluation, 14, Article 20.
22.
DunnD. S.ElliottT. R. (2008). The place and promise of theory in rehabilitation psychology research. Rehabilitation Psychology, 53, 254–267.
23.
FarrarJ. T.YoungJ. P.LaMoreauxL.WerthJ. L.PooleR. M. (2001). Clinical importance of changes in chronic pain intensity measures on an 11-point numerical rating scale. Pain, 94, 149–158.
24.
FloydF. J.WidamanK. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299.
25.
Galvez-SánchezC. M.Reyes del PasoG.DuschekS. (2018). Cognitive impairments in fibromyalgia syndrome: Associations with positive and negative affect, alexithymia, pain catastrophizing and self-esteem. Frontiers in Psychology, 9, Article 377. https://doi.org/10.3389/fpsyg.2018.00377
26.
GargN.DeodharA. (2012). New and modified fibromyalgia diagnostic criteria: Ambiguity, uncertainty, and difficulties complicate diagnosis and management. The Journal of Musculoskeletal Medicine, 29(1), 13–15.
27.
GarinO.Ayuso-MateosJ. L.AlmansaJ.NietoM.ChatterjiS.VilagutG.FerrerM. (2010). Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health and Quality of Life Outcomes, 8, Article 51.
28.
GatchelR. J.PengY. B.PetersM. L.FuchsP. N.TurkD. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133, 581–624.
29.
GiesserB. S. (2015). Exercise in the management of persons with multiple sclerosis. Therapeutic Advances in Neurological Disorders, 8(3), 123–130. https://doi.org/10.1177/1756285615576663
30.
GreenS. E. (2001). “Oh, those therapists will become your best friends”: Maternal satisfaction with clinics providing physical, occupational, and speech therapy services to children with disabilities. Sociology of Health and Illness, 23, 796–829.
31.
GorsuchR. L. (1983). Factor analysis (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.
32.
HairJ. F.BlackW. C.BabinB. J.AndersonR. E.TathamR. L. (2006). Multivariate data analysis (6th ed.). Pearson Education.
33.
HaysR. D.MartinS. A.SestiA. M.SpritzerK. L. (2005). Psychometric properties of the medical outcomes study sleep measure. Sleep Medicine, 6(1), 41–44.
34.
HenrikssonC.LiedbergG. (2000). Factors of importance for work disability in women with fibromyalgia. Journal of Rheumatology, 27, 1271–1276.
35.
HindD.CotterJ.Thake BradburnM.CooperC.IsaacC.HouseA. (2014). Cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: A systematic review and meta-analysis. BMC Psychiatry, 14, Article 5.
KochL.RumrillP. (2017). Rehabilitation counseling and emerging disabilities. Springer.
38.
LiedbergG. M.HenrikssonC. M. (2002). Factors of importance for work disability in women with fibromyalgia: An interview study. Arthritis Care & Research, 47, 266–274.
39.
LinC. (2009). Evaluating the transactional theory of coping as a psychosocial adaptation model for Taiwanese with spinal cord injury: A multiple regression analysis [Unpublished doctoral dissertation]. University of Wisconsin–Madison.
40.
LinkB. G.StrueningE. L.Neese-ToddS.AsmussenS.PhelanJ. C. (2001). Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services, 52(12), 1621–1626.
41.
LivnehH.McMahonB.RumrillP. (2019). The duality of human experience: Perspectives from psychosocial adaptation to chronic illness and disability—Historical views and theoretical models. Rehabilitation Counseling Bulletin, 62(2), 67–77.
42.
LoevingerB.ShirtcliffE.MullerD.AlonsoC.CoeC. (2012). Delineating psychological and biomedical profiles in a heterogeneous fibromyalgia population using cluster analysis. Clinical Rheumatology, 31, 677–685.
43.
LöweB.DeckerO.MüllerS.BrählerE.SchellbergD.HerzogW.HerzbergP. Y. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 46, 266–274.
44.
LucianoJ. V.Ayuso-MateosJ. L.Fern ándezA.Serrano-BlancoA.RocaM.HaroJ. M. (2010). Psychometric properties of the twelve item World Health Organization Disability Assessment Schedule II (WHO-DAS II) in Spanish primary care patients with a first major depressive episode. Journal of Affective Disorders, 121, 52–58.
45.
LuoX.GeorgeM. L.KakourasI.EdwardsC. L.PietrobonR.RichardsonW.HeyL. (2003). Reliability, validity, and responsiveness of the Short Form 12-Item Survey (SF-12) in patients with back pain. Spine, 28, 1739–1745.
46.
LuszczynskaA.ScholzU.SchwarzerR. (2005). The General Self-Efficacy Scale: Multicultural validation studies. The Journal of Psychology, 139, 439–457.
47.
MasiA. T.WhiteK. P.PilcherJ. J. (2002). Person-centered approach to care, teaching, and research in fibromyalgia syndrome: Justification from biopsychosocial perspectives in populations. Seminars in Arthritis and Rheumatism, 32(2), 71–93.
48.
MendozaT. R.WangX. S.CleelandC. S.MorrisseyM.JohnsonB. A.WendtJ. K.HuberS. L. (1999). The rapid assessment of fatigue severity in cancer patients. Cancer, 85, 1186–1196.
49.
MillerS. M.ChanF. (2008). Predictors of life satisfaction in individuals with intellectual disabilities. Journal of Intellectual Disability Research, 52, 1039–1047.
50.
MitoloM.VenneriA.WilkinsonI. D.SharrackB. (2015). Cognitive rehabilitation in multiple sclerosis: A systematic review. Journal of the Neurological Sciences, 354(1–2), P1–P9.https://doi.org/10.1016/j.jns.2015.05.004
51.
MullerV.PeeblesM. C.ChiuC. Y.IwanagaK.TangX.BrooksJ.EagleD.ChanF. (2017). Association of employment and health and well-being in fibromyalgia. Journal of Rehabilitation, 83(3), 37–43.
NunnallyJ. C. (1978). Psychometric theory. McGraw-Hill.
55.
PalacioA.UribeC.LiH. (2010, April). Use and costs of healthcare resources in fibromyalgia: A case-control comparison [Paper presentation]. Academy of Managed Care Pharmacy, 22nd Annual Meeting and Showcase, San Diego, CA, United States.
56.
PavotW.DienerE. (1993). Review of the Satisfaction with Life Scale. Psychological Assessment, 5, 164–172.
57.
PenrodJ. R.BernatskyS.AdamV.BaronM.DayanN.DobkinP. L. (2004). Health services costs and their determinants in women with fibromyalgia. Journal of Rheumatology, 31, 1391–1398.
58.
RobinsonR. L.BirnbaumH. G.MorleyM. A.SisitskyT.GreenbergP. E.ClaxtonA. J. (2003). Economic cost and epidemiological characteristics of patients with fibromyalgia claims. Journal of Rheumatology, 30, 1318–1325.
59.
RoesslerR.RubinS.RumrillP. (2018). Case management and rehabilitation counseling: Procedures and techniques (5th ed.). Pro-Ed.
60.
RutledgeD. N.MouttapaM.WoodP. B. (2009). Symptom clusters in fibromyalgia: Potential utility in patient assessment and treatment evaluation. Nursing Research, 58, 359–367.
61.
RyanC. J.De VonH. A.HorneR.KingK. B.MilnerK.MoserD. K.QuinnJ. R.RosenfeldA.HwangS. Y.ZerwicJ. J. (2007). Symptom clusters in acute myocardial infarction: A secondary data analysis. Nursing Research, 56, 72–81.
62.
DolnicarS.GrünB.LeischF.SchmidtK. (2014). Required sample sizes for data-driven market segmentation analyses in tourism. Journal of Travel Research, 53(3), 296–306.
63.
SchwarzerR.JerusalemM. (1995). Generalized Self-Efficacy scale. In WeinmanJ.WrightS.JohnstonM. (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). NFER-Nelson.
64.
SmartJ. (2016). Disability, society, and the individual (3rd ed.). Pro-Ed.
65.
SmedemaS. M.YaghmaianR. A.RuizD.MullerV.UmucuE.ChanF. (2016). Psychometric validation of the World Health Organization disability assessment schedule 2.0-12-item version in persons with fibromyalgia syndrome. Journal of Rehabilitation, 82(3), 28–35.
66.
SmithB. W.DalenJ.WigginsK.TooleyE.ChristopherP.BernardJ. (2008). The Brief Resilience Scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine, 15, 194–200.
67.
SulsJ.RothmanA. (2004). Evolution of the biopsychosocial model: Prospects and challenges for health psychology. Health Psychology, 23, 119–125.
68.
TabachnickB. G.FidellL. S. (2007). Using multivariate statistics. Pearson/Allyn & Bacon.
69.
ThongM. S.Van DijkS.NoordzijM.BoeschotenE. W.KredietR. T.DekkerF. W.KapteinA. A. (2008). Symptom clusters in incident dialysis patients: Associations with clinical variables and quality of life. Nephrology Dialysis Transplantation, 24, 225–230.
70.
TurkD. C.FlorH. (1999). Chronic pain: A biobehavioral perspective. In GatchelR.TurkD. C. (Eds.), Psychosocial factors in pain: Critical perspectives (pp. 18–34). Guilford.
71.
TurkD. C.OkifujiA.SinclairJ. D.StarzT. W. (1998). Differential responses by psychosocial subgroups of fibromyalgia syndrome patients to an interdisciplinary treatment. Arthritis Care & Research, 11, 397–404.
72.
Viala-DantenM.MartinS.GuilleminI.HaysR. D. (2008). Evaluation of the reliability and validity of the medical outcomes study sleep scale in patients with painful diabetic peripheral neuropathy during an international clinical trial. Health and Quality of Life Outcomes, 6, 113.
73.
WallaceJ.KassS. J.StannyC. J. (2002). The Cognitive Failures Questionnaire revisited: Dimensions and correlates. Journal of General Psychology, 129, 238–256.
74.
WilliamsonA.HoggartB. (2005). Pain: A review of three commonly used pain rating scales. Journal of Clinical Nursing, 14(7), 798–804.
75.
WilsonH. D.RobinsonJ. P.TurkD. C. (2009). Toward the identification of symptom patterns in people with fibromyalgia. Arthritis Care & Research, 61, 527–534.
76.
WolfeF.ClauwD. J.FitzcharlesM. A.GoldenbergD. I.KatzR. S.MeaseP.. . . YunusM. B. (2010). The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia. Arthritis Care & Research, 62(5), 600–610.
77.
YaelG.NancyC.JohnD. (2019). Money management in multiple sclerosis: The role of cognitive, motor, and affective factors. Frontiers in Neurology, 10, Article 1128. https://doi.org/10.3389/fneur.2019.01128
78.
ZimetG. D.DahlemN. W.ZimetS. G.FarleyG. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41.
