Coping styles in fibromyalgia: effect of co-morbid posttraumatic stress disorder

被引:18
作者
Ablin, Jacob N. [1 ,2 ]
Cohen, Hagit [3 ]
Neumann, Lily [4 ]
Kaplan, Zeev [3 ]
Buskila, Dan [5 ]
机构
[1] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, IL-64239 Tel Aviv, Israel
[2] Tel Aviv Univ, Sackler Fac Med, IL-64239 Tel Aviv, Israel
[3] Ben Gurion Univ Negev, Anxiety & Stress Res Unit, Minist Hlth Mental Hlth Ctr, IL-84105 Beer Sheva, Israel
[4] Ben Gurion Univ Negev, Fac Hlth Sci, Dept Epidemiol, IL-84105 Beer Sheva, Israel
[5] Soroka Med Ctr, Dept Med, Rheumat Dis Unit, IL-84101 Beer Sheva, Israel
关键词
fibromyalgia; posttraumatic stress disorder; PTSD; coping style; traumatic experience;
D O I
10.1007/s00296-007-0496-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To analyze coping styles of fibromyalgia (FM) patients with specific emphasis on differences in coping styles between fibromyalgia patients with and without post traumatic stress disorder (PTSD). Seventy-seven consecutive patients (40 women and 37 men) who fulfilled ACR criteria for FM, and 48 healthy controls, completed questionnaires measuring prevalence and severity of PTSD symptoms, including the structured clinical interview for DSM-III-R-non-patient edition (SCID-NP) and the clinician administered PTSD scale (CAPS). Subjects were divided into two groups based on the presence or absence of PTSD symptoms. Subsequently, coping styles were measured using the Albert Einstein College of Medicine (AECOM) Coping Style Questionnaire. Student t tests were used to compare the means of quantitative variables, and proportions were compared by Chi square tests. Analysis of variance (ANOVA) was used to compare the scores of the FM patients with and without PTSD, as well as to estimate the effect of gender on psychiatric variables. FM patients exhibit significantly higher levels of suppression (P < 0.00001), help-seeking (P < 0.007), replacement (P < 0.003), substitution (P < 0.002), and reversal (P < 0.004) compared with healthy controls. FM patients with PTSD and without PTSD differed significantly only on the suppression subscale (P < 0.02). FM patients that have PTSD presented higher suppression scores compared to FM patients without PTSD. No significant difference was noted on scales of minimization, help-seeking, replacement, blame, substitution, mapping, and reversal. Our results have delineated coping patterns of FM patients, identifying suppression, help-seeking, replacement, substitution and replacement as strategies more common among these patients. We further identified suppression as the only coping style significantly more common among FM patients with co-morbid PTSD then among FM patients without such a diagnosis. Our results may serve to further characterize cognitive and behavioral aspects of FM patients and subsequently guide therapeutic interventions.
引用
收藏
页码:649 / 656
页数:8
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