Pain-Coping Strategies of women with fibromyalgia: Relationship to pain, fatigue, and quality of life

Objectives: To describe the pain-coping strategies of women with fibromyalgia [FMS]; to compare the factor structure of the Coping Strategies Questionnaire [CSQ] to other reports; and to determine whether pain-coping strategies are predictive of pain, fatigue, poor sleep, and quality of life. Methods: One hundred twenty consecutive patients with FMS who were tested prior to a six-month multidisciplinary treatment program completed the CSQ, along with several other self-report measures, a tender point examination, and syndrome/demographic information. Seventy-one patients completed the program and were retested. Results: At the pretest, FMS patients were most likely to use self-empowerment statements, ignore pain, and attempt to increase their activity level. Ninety percent used at least one catastrophizing strategy. At program completion, posttest evaluations of ability to control and decrease pain had increased significantly. Three distinct factors emerged from the analysis of the CSQ: a cognitive [COG], an active [ACT], and the well-known pain control and rational thinking [PCRT]. Pain control and rational thinking was predictive of poor sleep at pretest and pain at posttest; however, depression was most strongly predictive of all symptoms and quality of life. Conclusions: Fibromyalgia patients use a wide variety of coping strategies. In general, use of the positive strategies is associated with positive outcomes. Depression, catastrophizing, and a negative evaluation of ability to control and decrease pain are the major factors that significantly impact symptoms and quality of life.