Screening for pain-persistence and pain-avoidance patterns in fibromyalgia
S van Koulil1, F W Kraaimaat, W van Lankveld
1Department of Medical Psychology, Nijmegen Medical Center, Radboud University, Nijmegen, The Netherlands. s.vankoulil@mps.umcn.nl
Background:
The heterogeneity of patients regarding pain-related cognitive-behavioral mechanisms, such as pain-avoidance and pain-persistence patterns, has been proposed to underlie varying treatment outcomes in patients with fibromyalgia (FM).
Purpose:
To investigate the validity of a screening instrument to discriminate between pain-persistence and pain-avoidance patterns in FM.
Method:
In a three-part study, a self-reported screening instrument that assesses pain-avoidance behavior was used to distinguish patients with pain-persistence and pain-avoidance patterns. The resultant groups were compared with regard to several pain-related cognitive-behavioral factors, performance on a physical fitness test, and with regard to the judgments of trained therapists based on a semi-structured interview.
Results:
The validity of the screening instrument to distinguish between pain-avoidance and pain-persistence patterns was supported by other validated self-report questionnaires for pain-related cognitive-behavioral factors, physical exercise tests, as well as by a high correspondence with blinded therapist judgment after intake assessments.
Conclusion:
These findings suggest that a short self-report screening instrument can be used to distinguish between pain-avoidance and pain-persistence patterns within the heterogeneous population of FM patients, which offers promising possibilities to improve treatment efficacy by tailoring treatment to specific patient patterns.
