Journal of Behavioral Medicine

, Volume 28, Issue 5, pp 455–466 | Cite as

Health Goal Cognition and Adjustment in Women with Fibromyalgia

  • Nancy A. Hamilton
  • Paul Karoly
  • Alex J. Zautra

The purpose of this study was to identify individual differences in symptom-specific goal for persons diagnosed with fibromyalgia syndrome (FMS) and to determine whether those differences are related to adjustment outcomes. Women with FMS (N = 71) rank ordered 12 FMS-specific goals and completed a packet of psychosocial outcome measures. Cluster analysis suggested that there were three relatively homogeneous subgroups defined. Cluster 1 ranked goals related to seeking professional care higher than all other groups. Cluster 2 ranked self-sufficiency goals higher than the other two groups. Cluster 3 ranked social-validation goals higher than the other two clusters. Multivariate analyses of variance (MANOVAs) and post-hoc tests showed that goal profiles covaried with differences in pain, negative affect, goal-specific social support, general social support, goal-related interference, and negative life events. Differences between groups are discussed in the context of proposed relations between goals and environmental support.


fibromyalgia pain goals self-regulation social networks 


  1. Affleck, G., Tennen, H., Urrows, S., Higgins, P., Abeles, M., Hall, C., Karoly, P., and Newton, C. (1998). Fibromyalgia and women's pursuit of personal goals: A daily process analysis. Health Psychol. 17: 40–47.PubMedCrossRefGoogle Scholar
  2. Affleck, G., Tennen, H., Zautra, A., Urrows, S., Abeles, M., and Karoly, P. (2001). Women's pursuit of personal goals in daily life with fibromyalgia: A value-expectancy analysis. J. Consult. Clin. Psychol. 69: 587–596.PubMedCrossRefGoogle Scholar
  3. Aldenderfer, M. K., and Blashfield, R. K. (1984). Cluster analysis. Sage, Beverly Hills, CA.Google Scholar
  4. Aronoff, G. M. (1988). Myofascial pain syndrome and Fibromyalgia: A critical assessment and alternate view. Clin. J. Pain 14: 74–78.CrossRefGoogle Scholar
  5. Austin, J. T., and Vancouver, J. B. (1996). Goal constructs in psychology: Structure, process, and content. Psychol. Bull. 120: 338–375.CrossRefGoogle Scholar
  6. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Englewood Cliffs, NJ.Google Scholar
  7. Buchwald, D. (1996). Fiobromyalgia and chronic fatigue syndrome. Rheum. Dis. Clin. North Am. 22: 219–243.PubMedCrossRefGoogle Scholar
  8. Buckelew, S. P. (1989). Fibromyalgia: A rehabilitation approach. Am. J. Phys. Med. Rehabil. 68: 37–42.PubMedCrossRefGoogle Scholar
  9. Davis, M. C., Zautra, A. J., and Reich, J. W. (2001). Vulnerability to stress among women in chronic pain from fibromyalgia and osteoarthritis. Ann. Behav. Med. 23: 215–226.PubMedCrossRefGoogle Scholar
  10. Deci, E. L., and Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. Plenum, New York.Google Scholar
  11. Dohrenwend, B. P., Dohrenwend, B. S., Dodson, M., and Shrout, P. E. (1984). Symptoms, hassles, social supports, and life events: Problems of confounded measurements. J. Abnorm. Psychol. 93: 222–230.PubMedCrossRefGoogle Scholar
  12. Dweck, C. S. (1991). Self-theories and goals: Their role in motivation, personality, and development. In Dienstbier, R. A. (Ed.), Perspectives on motivation: Nebraska Symposium on Motivation, 1990, University of Nebraska Press, Lincoln, pp. 199–235.Google Scholar
  13. Emmons, R. A. (1999). The psychology of ultimate concerns: Motivation and spirituality in personality. Guilford Press, New York.Google Scholar
  14. Emmons, R. A., and Kaiser, H. A. (1996). Goal orientation and emotional well-being: Linking goals and affect through the self. In Martin, L. L., and Tesser, A. (Eds.), Striving and feeling. Erlbaum, Mahwah, NJ, pp. 79–98.Google Scholar
  15. Epstein, S. A., Kay, G., Clauw, D., Heaton, R., Klein, D., Krupp, L., Kuck, J., Leslie, V., Masur, D., Wagner, M., Waid, R., and Zisook, S. (1999). Psychiatric disorders in patients with fibromyalgia: A multicenter investigation. Psychosom.: J. Consult. Liasion Psychiatry 40: 57–63.Google Scholar
  16. Everitt, B. (1979). Cluster analysis. Wiley, New York.Google Scholar
  17. Ford, D. H. (1987). Humans as self-constructing living systems: A developmental perspective on behavior and personality. Earlbaum, Hillsdale, NJ.Google Scholar
  18. Ford, M. E. (1992). Motivating humans: Goals, emotions, and agency beliefs. Sage, Newbury Park, CA.Google Scholar
  19. Henriksson, P.K., Gundmark, I., Bengtsson, A., and Ek, A. (1992). Living with fibromyalgia, consequences for everyday life. Clin. J. Pain. 8:138–144.PubMedCrossRefGoogle Scholar
  20. Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychol. Rev. 94: 319–340.PubMedCrossRefGoogle Scholar
  21. Higgins, E. T., Shah, J., and Friedman, R. (1997). Emotional responses to goal attainment: Strength of regulatory focus as moderator. J. Pers. Soc. Psychol. 72: 515–525.PubMedCrossRefGoogle Scholar
  22. Holahan, C. J., Moos, R. H., Holahan, C. K., and Prennan, P. L. (1985). Social support, coping, and depressive symptoms in a late middle-aged sample of patients reporting cardiac illness. Health Psychol. 14: 152–163.CrossRefGoogle Scholar
  23. Karoly, P. (1991). Goal systems and health outcomes across the lifespan. In Schroeder, H. (Ed.), New directions in health psychology assessment. Hemisphere, Bristol, PA.Google Scholar
  24. Karoly, P. (1993). Goal systems: An organizing framework for clinical assessment and treatment planning. Psychol. Assess. 5: 273–280.CrossRefGoogle Scholar
  25. Karoly, P. (1999). A goal-systems-self-regulatory perspective on personality, psychopathology, and change. Rev. Gen. Psychol. 3: 264–291.CrossRefGoogle Scholar
  26. Karoly, P. J., and Jensen, M. P. (1987). Multimethod assessment of chronic pain. Pergamon Press, New York.Google Scholar
  27. Karoly, P., and Lecci, L. (1997). Motivational correlates self-reported persistent pain in young adults. Clin. J. Pain 13: 104–109.PubMedCrossRefGoogle Scholar
  28. Karoly, P., and Ruehlman, L. S. (1996). Motivational implications of pain: Chronicity, psychological distress, and work goal construal in a national sample of adults. Health Psychol. 15: 383–390.PubMedCrossRefGoogle Scholar
  29. Karoly, P., Ruehlman, L. S., Okun, M. A., Lutz, R. S., Newton, C., and Fairholme, C. (2005). Perceived self-regulation of exercise goals and interfering goals among regular and irregular exercisers: A life space analysis. Psychol. Sport Exerc.. 6:427–442.Google Scholar
  30. Little, B. R. (1999). Personality and motivation: Personal action and the conative evolution. In Pervin, L. A., and John, O. P. (Eds.), Handbook of personality: Theory and research, 2nd ed. Guilford Press, New York, NY, pp. 501–524.Google Scholar
  31. Locke, E. A., and Latheam, G. P. (1990). A theory of goal-setting and task performance. Prentice-Hall, Englewood Cliffs, NJ.Google Scholar
  32. McGregor, I., and Little, B. R. (1998). Personal projects, happiness, and meaning: On doing well and being yourself. J. Pers. Soc. Psychol. 74: 494–512.PubMedCrossRefGoogle Scholar
  33. Oettingen, G. (1999). Free fantasies about the future and the emergence of developmental goals. In Brandtstaedter, J., and Lerner, R. M. (Eds.), Action & self-development: Theory and research through the life span. Sage, Thousand Oaks, CA, pp. 315–342.Google Scholar
  34. Okifuji, A., Turk, D. C., and Marcus, D. A. (1997). A standardized manual tender point survey. I. Development and determination of a threshold point for the identification of positive tender points FM syndrome. J. Rheumatol. 2: 377–383.Google Scholar
  35. Polivy, J., and Herman, C.P. (2002). If at first you don't succeed: False hopes of self-change. Am. Psychol. 57: 677–689.PubMedCrossRefGoogle Scholar
  36. Rapkin, B. D., and Fischer, K. (1992). Framing the constructs of life satisfaction in terms of older adults’ personal goals. Psychol. Aging 7: 138–149.PubMedCrossRefGoogle Scholar
  37. Ryan, R. M., Sheldon, K. M., Kasser, T., and Deci, E. L. (1996). All goals are not created equal: An organismic perspective on the nature of goals and their regulation. In Gollwitzer, P. M., and Bargh, J. A. (Eds.), The psychology of action: Linking cognition and motivation to behavior. Guilford Press, New York, NY, pp. 7–26.Google Scholar
  38. Sherbourne, C., and Stewart, A. L. (1991). The MOS social support survey. Soc. Sci. Med. 32: 715–723.CrossRefGoogle Scholar
  39. Stein, N., Folkman, S., Trabasso, T., and Richards, T. A. (1997). Appraisal and goal processes as predictors of psychological well-being in bereaved caregivers. J. Pers. Soc. Psychol. 72: 872–874.PubMedCrossRefGoogle Scholar
  40. Terman, L. M., assisted by Baldwin, B. T., Bronson, E., Devoss, J. C., Fuller, F., Goodenought, F. L., Kelly, T. L., Lima, M., Marshall, H., Moore, A. H., Raubenheimer, A. S., Ruch, G. M., Willoughby, R. L., Wyman, J. B., and Yates, H. H. (1925). Mental and physical traits of a thousand gifted children: Vol 1 Genetic studies of genius. Stanford University Press, Stanford, CA.Google Scholar
  41. Turk, D. C. (2002). Suffering and dysfunction in fibromyalgia syndrome. J. Musculoskelet. Pain 10: 85–96.CrossRefGoogle Scholar
  42. Turner, J. C., Thorpe, P. K., and Meyer, D. K. (1998). Students’ reports of motivation and negative affect: A theoretical and empirical analysis. J. Educ. Psychol. 90: 758–771.CrossRefGoogle Scholar
  43. Watson, D., Clark, L. A., and Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. J. Pers. Soc. Psychol. 54: 1063–1070.PubMedCrossRefGoogle Scholar
  44. Wolfe, F., Smythe, H. A., Yunus, M. B., Bennett, R. M., Bombardier, C., Goldenberg, D. L., Tugwell, P., Campbell, S. M., Abeles, M., Clark, P., Fam, A. G., Farber, S. J., Fiechtner, J. J., Franklin, C. M., Gatter, R. A., Hamaty, D., Lessard, J., Lichtbroun, A. S., Masi, A. T., McCain, G. A., Reynolds, W. J., Romano, T. J., Russel, I. J., and Sheon, R. P. (1990). The American college of rheumatology 1990 criteria for the classification of fibromyalgia: Report of the multicenter criteria committee. Arth. Rheum. 33: 160–172.CrossRefGoogle Scholar
  45. Zautra, A. J., Guarnaccia, C. A., and Dohrenwend, B. P. (1986). Measuring small life-events. Am. J. Comm. Psychol. 14: 629–653.CrossRefGoogle Scholar
  46. Zautra, A. J., Hamilton, N. A., and Burke, H. M. (1999). Comparison of stress responses in women with two types of chronic pain: Fibromyalgia and osteoarthritis. Cogn. Ther. Res. 23: 209–230.Google Scholar
  47. Zautra, A. J., Hoffman, J., Potter, P. T., Matt, K. S., Yocum, D., and Castro, L. (1997). Examination of changes in interpersonal stress as a factor in disease exacerbations among women with rheumatoid arthritis. An. Behav. Med. 19: 279–286.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Nancy A. Hamilton
    • 1
    • 3
  • Paul Karoly
    • 2
  • Alex J. Zautra
    • 2
  1. 1.Department of PsychologyUniversity of KansasLawrenceU.S.
  2. 2.Department of PsychologyArizona State UniversityPhoenixU.S.
  3. 3.Department of PsychologyLawrenceU.S.

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