Reich John W, Johnson Lisa M, Zautra Alex J, Davis Mary C
Department of Psychology, Arizona State University, Tempe, Arizona 85287-1104, USA.
J Behav Med. 2006 Aug;29(4):307-16. doi: 10.1007/s10865-006-9054-7. Epub 2006 May 6.
Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain condition poorly understood in terms of etiology and treatment by both physicians and patients. This condition of "uncertainty of illness" was examined as a variable involved in the adjustment of FMS patients, relating it to their depression, anxiety, affect, and coping styles. Fifty-one community-residing FMS patients provided self-report information on subsets of adjustment variables. Both cross-sectional and more dynamic longitudinal analyses showed that illness uncertainty was significantly associated with anxiety, negative affect, and avoidant and passive coping. Its positive relationship with depression was eliminated when a control variable, pain helplessness, was included as a covariate. Longitudinally, illness uncertainty interacted with interpersonally stressful daily events in predicting reports of reduced positive affect, suggesting that illness uncertainty acts as a risk factor for affective disturbances during stressful times. Implications of these results for therapeutic interventions are discussed.
纤维肌痛综合征（FMS）是一种慢性肌肉骨骼疼痛疾病，医生和患者对其病因和治疗的了解都很有限。这种“疾病不确定性”状况被作为一个与FMS患者适应情况相关的变量进行研究，将其与患者的抑郁、焦虑、情感及应对方式联系起来。51名居住在社区的FMS患者提供了关于适应变量子集的自我报告信息。横断面分析和更具动态性的纵向分析均显示，疾病不确定性与焦虑、消极情感以及回避和被动应对显著相关。当将控制变量疼痛无助感作为协变量纳入分析时，其与抑郁的正相关关系消失。纵向来看，在预测积极情感减少的报告时，疾病不确定性与人际压力大的日常事件存在相互作用，这表明疾病不确定性在压力时期是情感障碍的一个风险因素。文中讨论了这些结果对治疗干预的意义。
