Abstract
The purpose of this study was to investigate the association among daily stressors, cognitive rumination, and fibromyalgia symptoms using time-series methodology and to determine whether autocorrelation was present in the self-report data. Twelve female fibromyalgia subjects monitored their daily level of stressors, cognitive rumination, and fibromyalgia symptoms for 30–35 days. Time-series regression analyses indicated that there was a positive association between previous-day stressors and fibromyalgia symptoms for one subject and between previous-day cognitive rumination and fibromyalgia symptoms for four subjects. For 7 out of 12 subjects autocorrelation was present, and generalized least-squares methods were used with these subjects. These results indicate that ordinary least-squares methods may often not be appropriate for within-subject designs with self-report data. These results also question the often reported stressor-physical symptom association. This study illustrates a useful methodology and analysis to investigate psychosocial-physical symptom associations.
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Banks, J., and Gannon, L. (1988). Hardiness as a style of appraisal: A prospective study of life events, hassles, and somatic symptomatology.Am. J. Commun. Psychol. 16: 25–37.
Borkovec, T. D., Robinson, E., Pruzinsky, T., and DePree, J. A. (1983). Preliminary exploration of worry: Some characteristics and processes.Behav. Res. Ther. 21: 9–16.
Brantley, P. J., Waggoner, C. D., Jones, G. N., and Rappaport, N. R. (1987). A daily stress inventory: Development, reliability, and validity.J. Behav. Med. 10: 61–74.
Brantley, P. J., Dietz, L. S., McKnight, G. T., Jones, G. N., and Tulley, R. (1988). Convergence between the daily stress inventory and endocrine measures of stress.J. Consult. Clin. Psychol. 56: 549–551.
Campbell, S. M., Clark, S., Tindall, E. A., Forehand, M. E., and Bennett, R. M. (1983). Clinical characteristics of fibrositis.Arth. Rheuma. 26: 817–824.
Cohen, J., and Cohen, P. (1975).Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, 2nd ed., Erlbaum, Hillsdale, NJ.
Cohen, S., and Wills, T. A. (1985). Stress, social support, and the buffering hypothesis.Psychol. Bull. 98: 310–357.
Costa, P. T., Jr., and McCrae, R. R. (1987). Neuroticism, somatic complaints, and disease: Is the bark worse than the bite?J. Personal. 55: 299–316.
Daily, P. A., Bishop, G. D., Russell, I. J., and Fletcher, E. M. (1990). Psychological stress and the fibrositis/fibromyalgia syndrome.J. Rheumatol. 17: 1380–1385.
Delongis, A., Coyne, J. C., Dakof, G., Folkman, S., and Lazarus, R. S. (1982). Relationship of daily hassles, uplifts, and major life events to health status.Health Psychol. 1: 119–136.
Delongis, A., Folkman, S., and Lazarus, R. S. (1988). The impact of daily stress on health and mood: Psychological and social resources as mediators.J. Personal. Soc. Psychol. 54: 486–495.
Gannon, L., Banks, J., Shelton, D., and Luchetta, T. (1989). The mediating effects of psychophysiological reactivity and recovery on the relationship between environmental stress and illness.J. Psychosom. Res. 33: 167–175.
Garrett, D. V., Brantley, P. J., Jones, G. N., and McKnight, G. T. (1991). The relation between daily stress and Crohn's disease.J. Behav. Med. 14: 87–96.
Greenwood, K. M., and Matyas, T. A. (1990). Problems with the application of interrupted time series analysis for brief single-subject data.Behav. Assess. 12: 355–370.
Harms-Ringdahl, K., Carlsson, A. M., Edholm, J., Raustorp, A., Svensson, T., and Toresson, H. (1986). Pain assessment with different intensity scales in response to loading of joint structures.Pain 27: 401–411.
Hirsch, B. J. (1980). Natural support systems and coping with major life changes.Am. J. Commun. Psychol. 8: 159–172.
Huitema, B. E., and McKean, J. W. (1991). Autocorrelation estimation and inference with small samples.Psychol. Bull. 110: 291–304.
Johnston, J. (1984).Econometric Methods, 3rd ed., McGraw Hill, New York.
Kerns, R. D., Finn, P., and Haythornthwaite, J. (1988). Self monitored pain intensity: Psychometric properties and clinical utility.J. Behav. Med. 11: 71–82.
Kobasa, S. C., and Maddi, S. R. (1981). Personality and constitution as mediators in the stress-illness relationship.J. Health Soc. Psychol. 42: 368–378.
Kohler, T., and Haimerl, C. (1990). Daily stress as a trigger of migraine attacks: Results of thirteen single-subject studies.J. Consult. Clin. Psychol. 58: 870–872.
Lazarus, R. S., and Folkman, S. (1984).Stress Appraisal and Coping. Springer, New York.
Levor, R. M., Cohen, M. J., Naliboff, B. D., and McArthur, D. (1986). Psychosocial precursors and correlates of migraine headache.J. Consult. Clin. Psychol. 54: 347–353.
Longo, D. J., and Clum, G. A. (1989). Psychosocial factors affecting genital herpes recurrences: Linear vs mediating models.J. Psychosom. Res. 33: 161–166.
O'Leary, A. (1985). Self-efficacy and health.Behav. Res. Ther. 23: 437–451.
Pennebaker, J. W. (1982).The Psychology of Physical Symptoms. Springer-Verlag, New York.
Pennebaker, J. W., and O'Heeron, R. C. (1984). Confiding in others and illness rate among spouses of suicide and accidental-death victims.J. Abnorm. Psychol. 93: 473–476.
Price, D. D., McGrath, P. A., Rafii, A., and Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain.Pain 17: 45–56.
Sharpley, F. C., and Alavosius, M. P. (1988). Autocorrelation in behavioral data: An alternative perspective.Behav. Assess. 10: 243–251.
Smolen, R. C. (1988).A time-series analysis of pain and affect in a patient with fibromyalgia. Paper presented at the annual meeting of the Association for Advancement of Behavior Therapy, New York, Nov.
SPSS Inc. (1987). SPSS/PC+ Trends V2.0, SPSS, Chicago.
Suen, H. K. (1987). On the epistemology of autocorrelation in applied behavior analysis.Behav. Assess. 9: 113–124
Vaeroy, H., Qiao, Z., Morkrid, L., and Forre, O. (1989). Altered sympathetic nervous system response in patients with fibromyalgia.J. Rheumatol. 16: 1460–1465.
Wampold, B. E. (ed.) (1988). The autocorrelation debate.Behav. Assess. 10 (special issue).
Watson, D. (1988). Intraindividual and interindividual analyses of positive and negative affect: Their relation to health complaints, perceived stress, and daily activities.J. Personal. Soc. Psychol. 54: 1020–1030.
Watson, D., and Pennebaker, J. W. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity.Psychol. Rev. 96: 234–254.
Wolfe, F. (1986). The clinical syndrome of fibrositis.Am. J. Med. 81 (Suppl. 3A): 7–13.
Wolfe, F., Hawley, D. J., Cathey, M. A., Caro, X., and Russell, I. J. (1985). Fibrositis: Symptom frequency and criteria for diagnosis.J. Rheumatol. 12: 1159–1163.
Wolfe, F., Smythe, H., Yunis, M., Bennett, R., Bombardier, C., Goldenberg, D.,et al. (1990). The American College of Rheumatology 1990 criteria for the classification of fibromyalgia.Arth. Rheum. 33: 160–172.
Yunus, M. B., Masi, A. T., and Aldag, J. C. (1989a). Preliminary criteria for primary fibromyalgia syndrome (PFS): Multivariate analysis of a consecutive series of PFS, other pain patients, and normal subjects.Clin. Exp. Rheumatol. 7: 63–69.
Yunus, M. B., Masi, A. T., and Aldag, J. C. (1989b). A controlled study of primary fibromyalgia syndrome: Clinical features and association with other functional syndromes.J. Rheumatol. 16: 62–71.
Yunus, M. B., Masi, A. T., Calabro, J. J., Miller, K. A., and Feigenbaum, S. L. (1981). Primary fibromyalgia (fibrositis): Clinical study of 50 patients with matched normal controls.Semin. Arth. Rheum. 11: 151–171.
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Hazlett, R.L., Haynes, S.N. Fibromyalgia: A time-series analysis of the stressor-physical symptom association. J Behav Med 15, 541–558 (1992). https://doi.org/10.1007/BF00844855
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DOI: https://doi.org/10.1007/BF00844855