The Prediction of Fatigue in Fibromyalgia

Abstract

Objectives: This research evaluated the roles of passive and active pain coping in predicting fatigue in fibromyalgia syndrome [FMS]. A model depicting the relationship between coping, pain, depression, and fatigue was examined in a longitudinal design.Methods: Fifty-two patients with objectively diagnosed FMS completed measures of active and passive pain coping from the Pain Management Inventory and participated in five consecutive monthly telephone interviews during which pain, depression, and fatigue were assessed. It was hypothesized that pain coping would contribute to fatigue by affecting pain and depression over the five-month period.Results: In analyses with aggregated [averaged] data, higher passive coping predicted greater pain and depression, which, in turn, were related to greater fatigue. Passive coping had no direct relationship with fatigue, and active coping did not predict model variables. When the monthly data were disaggregated by removing between-participants variability, pain contributed to fatigue directly, and indirectly, through depression.Conclusions: The data demonstrated that passive coping contributed to a dysfunctional cycle characterized by heightened pain and depressive symptomatology, leading to greater fatigue. The continued effort to develop effective interventions to reduce maladaptive coping efforts in FMS is warranted by these findings.