Rheumatology Medical News about Fibromyalgia, Chronic pain, Mood

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Cognitive and behavioral factors in fibromyalgia: Mood, goals, and task performance
Journal of Musculoskeletal Pain , 08/18/09

Vlaeyen JWS et al. – Review concludes that Mood-as-Input model may provide a framework to enhance our understanding of disability both due to avoidance behavior and activity overuse in patients with fibromyalgia; further research in this novel area s suggested.

Methods

Article reviews the existing theoretical models explaining task persistence in chronic pain, pointing at its strengths and weaknesses

Results

For chronic musculoskeletal pain, purely biomedical models appear insufficient
The prevailing Fear-Avoidance model postulates that:
- Catastrophic misinterpretations of pain give rise to fear of pain
- It subsequently leads to a cycle of avoidance of activity, disuse, and disability
For pain disability associated with task persistence and overuse, cognitive behavioral mechanisms have been a neglected area
One promising theoretical model is the so-called Mood-as-Input model
This model predicts that task performance results from the interaction between current mood and certain stop-rules
Novel feature of the Mood-as-Input model is that the effects of mood on task performance are dependent on motivational context variables (AMAC and FLDC):
- In AMAC context, negative mood signals the individual that not enough progress on the task has been made, leading to continuation with the task
- In the FLDC context, the opposite pattern is found; a negative mood signals that continuing with the task is no longer appropriate, thereby disengaging from the task
Thus, with different stop-rules, the same mood can have different motivational effects