Fibromyalgia and Stress


An altered reaction to stress is commonly seen in patients with FMS. Life stress factors may have been constant for a long time, but at one point or another, the patient reacts adversely to the stress. Such situations are difficult to measure but are commonly noted in the clinic.

This is one of the critical psychologic components of FMS, and there is a need for better instruments to measure it. The Family Inventory of Life Events (FILE) is a 71-item self-report instrument designed to record both normative and nonnormative life events and changes experienced by families. 79. This instrument also can be adapted to account for whether the life events are perceived as positive, negative, or having a neutral effect on the family. Patients with FMS and rheumatoid arthritis have similar scores using this inventory. 104 The Holmes-Rahe Life Events inventory (HRLEI) has been extensively studied in seeking relationships between stressful life events and physical disease. 5. Criticisms have been directed towards the underlying assumptions, as well as the construction of the scale, however. 4, 58. In one study, an association between FMS and stressful life events has been suggested using this instrument. 4 The Daily Hassles Scale" measures sources of daily frustration and stress. Higher scores have been noted in patients with FMS compared with controls, 31. and it has been suggested that this change explains most abnormalities in SCL-90 subscales, including anxiety and depression. 101. This scale lists hassles deemed to be important to middle-income North Americans, but it may not be as useful in other socioeconomic, cultural, and social groups.

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