The role of stress transactional theory on the development of fibromyalgia: a structural equation model

The aim of this paper is to evaluate the efficacy of a model based on the Lazarus & Folkman's transactional theory of stress to explain perceived stress and symptoms in a sample of people with fibromyalgia.

The design was an open, cross-sectional, uncontrolled study. Subjects were contacted through internet. A self-administered questionnaire was used that contained each of the variables included in the model. To perform the statistical analysis we used structural equation models.

We evaluated 165 people who reported to have fibromyalgia diagnosis, 93.9% were female. According to PHQ-15 categories, used to measure symptoms, 83% of the participants were in the highest level of somatic symptom severity. FIQ was used to evaluate fibromyalgia impact, its maximum score is 100 points; taking into account mean and standard deviation, the samples are severely affected by fibromyalgia. We estimated five structural models; fifth model confirmed that some personal and social resources (self-esteem, self-efficacy, social support) perform as predictors of perceived stress level explaining 53% of its variance. This perceived stress was predictor of a latent variable indicated by symptoms and FIQ, and it explained 31% of its variance. Goodness of fit index was adequate.

The study suggests the important role that perceived stress has in the fibromyalgia impact and the symptoms severity. This model can help to adequate and establish targets for the psychological treatments included in multidisciplinary programs for this disorder.