Wentz Symptom Fluctuation in Fibromyalgia

Environmental, Psychological and Psychobiological Influences
1. Auflage 2013
ISBN: 978-3-11-031380-2
Verlag: De Gruyter
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 196 Seiten

Reihe: Health, Medicine and Human Development

Fibromyalgia is a syndrome of wide spread pain that is known from all parts of the world. An aspect of the syndrome of fibromyalgia is fluctuation as in onset of pain, variation in the level of symptoms, time off from pain and recovery from pain and other symptoms. The analysis of these fluctuations might create a basis for solid suggestions regarding the nature of the syn-drome itself. E.g. the pain level is well known to vary with mental and physical load including exposure to cold. Simultaneously, fibromyalgia has been found to mean an altered balance in the autonomic nervous system. In the first section of the book a developmental stage or life before fibromyalgia is covered. Intra- and interpersonal patterns based on narrations of the afflicted are pictured. Identified patterns are psychometrically examined and environmental as well as psychobiological patterns are accounted for. In the mid-section of the book life with fibromyalgia is scrutinized including biomarkers. Patterns regarding variation in the level of pain, gaps in fibromyalgia pain and environmental factors influencing these gaps are related. The effect on life, symptoms and defense measures is elucidated from the angle of mental load. The last sections portrait psychological and environmental influences concerning recovery, but especially the striking phenomenon of recovery being scarce. Special attention is paid to cognitive-emotional functioning, the need to target dissociation and environmental influences on maintenance.

Autoren/Hrsg.

Wentz, Kerstin

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Klinische und Innere Medizin Neurologie, Klinische Neurowissenschaft
• Sozialwissenschaften Psychologie Psychologische Disziplinen Gesundheitspsychologie
• Sozialwissenschaften Psychologie Allgemeine Psychologie Biologische Psychologie, Neuropsychologie

Inhaltsverzeichnis

1;Introduction;9
2;What is the meaning of the label fibromyalgia?;9
3;What are the settings of fibromyalgia?;10
4;Long lasting musculoskeletal pain, long lasting widespread pain and fibromyalgia;12
5;References;14
6;Section I: The developmental phase of symptoms;17
6.1;1 Fibromyalgia seen through the life histories of the afflicted women;19
6.1.1;1.1 Introduction;19
6.1.2;1.2 Our study;21
6.1.3;1.3 What did we find?;25
6.1.4;1.4 An overstrained self as a child;26
6.1.5;1.5 An adult woman with an unprotected self; high load, self loading and dissociation of unmanageable mental content;28
6.1.6;1.6 Compensating strategies;32
6.1.7;1.7 Discussion;35
6.1.8;1.8 Why women?;36
6.1.9;1.9 Chronic illness;36
6.1.10;1.10 Limitations;37
6.1.11;References;38
6.2;2 Dissociative and self-loading patterns in adult life;41
6.2.1;2.1 Introduction;41
6.2.2;2.2 Our study;43
6.2.3;2.3 Our findings;46
6.2.4;2.4 Discussion;55
6.2.5;2.5 Is “ unsuccessful†dissociation …;57
6.2.6;2.6 … effective in a fibromyalgia development process?;57
6.2.7;2.7 The I myself scale;58
6.2.8;2.8 Limitations;59
6.2.9;2.9 Acknowledgements;59
6.2.10;References;60
6.3;3 Psychological, psychobiological and environmental patterns during the developmental phase;63
6.3.1;3.1 Environmental stressors;63
6.3.2;3.2 Psychological and somatic load from trauma as accidents;64
6.3.3;3.3 Abuse and neglect;64
6.3.4;3.4 Localized pain, high load, monotonous tasks, or bullying in working life;66
6.3.5;3.5 Relentless load from premorbid over activity;67
6.3.6;3.6 Aging;67
6.3.7;3.7 Difficulties sleeping;68
6.3.8;References;70
6.4;4 Increase in mental load: life events as triggers of generalized pain;73
6.4.1;4.1 Mental load;73
6.4.2;4.2 Discussion;75
6.4.3;References;75
7;Section II: Living with fibromyalgia;77
7.1;5 The phase of living with fibromyalgia;79
7.1.1;5.1 A continued high level of mental load;79
7.1.2;5.2 Reduction of cognitive functioning;80
7.1.3;5.3 Discussion;81
7.1.4;5.4 Could such a tentative model be verified?;83
7.1.5;References;84
7.2;6 Variation in the level of pain;85
7.2.1;6.1 To live under stress and to be more reactive to stress when stress induces more clinical pain;85
7.2.2;6.2 Pain inhibitory function and invariability in pain;88
7.2.3;6.3 Naturalistic data;89
7.2.4;6.4 Working conditions at work and at home;89
7.2.5;6.5 Sleep;91
7.2.6;6.6 Exercise;92
7.2.7;6.7 Emotions and emotional processing;94
7.2.8;6.8 Suppression, dissociation, and pain;96
7.2.9;6.9 Dissociation;97
7.2.10;6.10 Being overactive;98
7.2.11;6.11 Association is the opposite of dissociation, suppression, or controlling;98
7.2.12;6.12 Group treatment, significant others, and substantial gaps in pain;100
7.2.13;6.13 Addressing emotional processing deficits;102
7.2.14;6.14 Addressing ANS unbalance;104
7.2.15;6.15 The ANS and biofeedback;104
7.2.16;References;105
7.3;7 Dissociation interferes with gaps in pain;109
7.3.1;7.1 Introduction;109
7.3.2;7.2 Level of symptoms;110
7.3.3;7.3 Gaps in pain;110
7.3.4;7.4 Psychosocial processes and fibromyalgia processes connected;111
7.3.5;7.5 The study;111
7.3.6;7.6 This is what was found;113
7.3.7;7.7 Keeping distress out of sight;115
7.3.8;7.8 Discontinued crisis or not accepting;117
7.3.9;7.9 Not planning a pain gap;118
7.3.10;7.10 Losing the unplanned pain gap;119
7.3.11;7.11 Acceptance/creating pain gaps;120
7.3.12;7.12 Discussion;121
7.3.13;7.13 The fragile balance of the pain-gaps;122
7.3.14;7.14 Adapting to impairment;123
7.3.15;7.15 Dissociation;123
7.3.16;7.16 Transformation as rehabilitation;124
7.3.17;7.17 Limitations;125
7.3.18;7.18 Acknowledgement;125
7.3.19;References;125
8;Section III: Recovery from fibromyalgia;127
8.1;8 Women ’ s narrations on the process of recovery from fibromyalgia;129
8.1.1;8.1 Introduction;129
8.1.2;8.2 Our sample;131
8.1.3;8.3 What did we find?;132
8.1.4;8.4 Strong but not enough to be weak;133
8.1.5;8.5 Increase in mental load – development of fibromyalgia;136
8.1.6;8.6 Challenge of fibromyalgia;137
8.1.7;8.7 Decrease in mental load – symptom remission;139
8.1.8;8.8 On parole – strengthened enough to be weak;140
8.1.9;8.9 Discussion;141
8.1.10;8.10 Patterns compared;142
8.1.11;8.11 Transformation as a remedy?;143
8.1.12;8.12 Implications for treatment and prevention;144
8.1.13;8.13 Methodological considerations;145
8.1.14;8.14 Conclusions;145
8.1.15;8.15 Acknowledgements;146
8.1.16;References;146
9;Section IV: Environmental, psychological and psychobiological fluctuations;149
9.1;9 Factors influencing onset, level of symptoms, gaps in pain, recovery and maintenance;151
9.1.1;9.1 The onset;151
9.1.2;9.2 Environmental aspects;151
9.1.3;9.3 Psychological aspects;152
9.1.4;9.4 Psychobiological aspects;152
9.1.5;9.5 Level of symptoms;153
9.1.6;9.6 Psychobiological influence;153
9.1.7;9.7 Psychological influence;154
9.1.8;9.8 Environmental influence;156
9.1.9;9.9 Gaps in fibromyalgia pain;157
9.1.10;9.10 Psychological context;157
9.1.11;9.11 Environmental regulation;158
9.1.12;9.12 Recovery;158
9.1.13;9.13 Psychobiological processes;160
9.1.14;9.14 Environmental context;160
9.1.15;9.15 Maintenance as in a maintained level of stress?;161
9.1.16;9.16 Psychological functioning;162
9.1.17;9.17 Impaired cognitive functioning is a part of a cognitive-emotional pattern;163
9.1.18;9.18 Psychobiological dysregulation;165
9.1.19;9.19 Working life;167
9.1.20;9.20 Knowledge and power;168
9.1.21;9.21 Discussion;169
9.1.22;9.22 Chronic or traumatic stress: cognitive and physiological correlates;170
9.1.23;9.23 Inflammation;172
9.1.24;9.24 Considerations on treatment. What are the targets and the means?;173
9.1.25;References;175
10;Section V: Acknowledgements;181
11;About the author;183
12;Acknowledgements;183
13;Index;185

Über Autor(innen)

Kerstin Wentz, Occupational and Environmental Medicine Sahlgrenska University Hospital and University of Gothenburg, Sweden.