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The "self" in pain: high levels of schema-enmeshment worsen fibromyalgia impact.
Paschali, Myrella; Lazaridou, Asimina; Vilsmark, Eric S; Lee, Jeungchan; Berry, Michael; Grahl, Arvina; Anzolin, Alessandra; Loggia, Marco; Napadow, Vitaly; Edwards, Robert R.
Afiliação
  • Paschali M; Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA. myrella.paschali@gmail.com.
  • Lazaridou A; Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.
  • Vilsmark ES; Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.
  • Lee J; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Berry M; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Grahl A; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Anzolin A; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Loggia M; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Napadow V; Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.
  • Edwards RR; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
BMC Musculoskelet Disord ; 22(1): 871, 2021 Oct 12.
Article em En | MEDLINE | ID: mdl-34641855
ABSTRACT

OBJECTIVE:

Chronic pain can have detrimental effects on quality of life and a profound impact on one's identity. The Pictorial Representation of Illness- and Self-Measure (PRISM), is a visual tool designed to measure the self-illness separation (SIS) that represents the degree of schema-enmeshment (i.e., the degree to which the self-schema and the illness-schema come to overlap). Our aim was to investigate the relationship between schema-enmeshment and pain-related outcomes in patients with fibromyalgia.

METHODS:

In this cross-sectional study, 114 patients with fibromyalgia completed self-report assessments of pain catastrophizing, pain severity and interference, impact of symptoms, anxiety, and depression. SIS was assessed using an iPad version of PRISM. Mediation analyses evaluated the mediating role of schema-enmeshment on the association between pain catastrophizing and fibromyalgia impact.

RESULTS:

A higher degree of schema-enmeshment was associated with greater pain catastrophizing, pain severity and interference, impact of symptoms, and depression. Moreover, a mediation analysis revealed that schema-enmeshment significantly mediated the association between pain catastrophizing and fibromyalgia impact (p < 0.001).

CONCLUSIONS:

Our results indicate that schema-enmeshment is associated with greater intrusiveness of chronic pain on everyday life, thereby posing significant limitations on the emotional and physical well-being of fibromyalgia patients. Schema-enmeshment also appears to partly account for the deleterious effect of pain catastrophizing on disease impact. The PRISM is a simple tool that may uniquely capture the extent to which chronic pain and illness infiltrates and affects one's self-concept.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibromialgia / Dor Crônica Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Humans Idioma: En Revista: BMC Musculoskelet Disord Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibromialgia / Dor Crônica Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Humans Idioma: En Revista: BMC Musculoskelet Disord Ano de publicação: 2021 Tipo de documento: Article