Leslie A. Aaron

Psychosocial and health status variables independently predict health care seeking in fibromyalgia.

OBJECTIVE To determine whether variables derived from the self-regulatory model of health and illness behavior accurately predict status as a patient or nonpatient with fibromyalgia (FM). METHODS Subjects were 79 patients who met American College of Rheumatology (ACR) criteria for FM and 39 community residents who met ACR criteria for FM but had not sought medical care for their symptoms (nonpatients). Subjects were administered 14 measures that produced 6 domains of variables: background demographics and pain duration; psychiatric morbidity; and personality, environmental, cognitive, and health status factors. These domains were entered in 4 different hierarchical logistic regression analyses to predict status as patient or nonpatient. RESULTS The full regression model was statistically significant (P < 0.0001) and correctly identified 90.7% of the subjects with a sensitivity of 92.4% and a specificity of 87.2%. The best individual predictors of group status were self-reports of self-efficacy, negative affect, recent stressful events, and perceived pain. Relative to nonpatients, patients reported higher levels of negative affect and perceived pain and a greater number of recent stressful experiences, as well as lower levels of self-efficacy. CONCLUSION Consistent with the self-regulatory model of health and illness behavior, psychosocial and health status variables predict health care-seeking behavior in persons with FM independently of background demographics and psychiatric morbidity. These variables may influence the severity of symptoms experienced by persons with this disorder as well as their health care-seeking behavior, but they are not necessary to produce abnormal pain sensitivity in FM.

Stress, Coping, Social Support, and Illness

Social and behavioral scientists have a great deal to offer to public and private sector efforts directed toward health promotion and disease prevention. This chapter focuses on stress, coping, and social support. Research questions in these domains revolve around the interconnections among individuals’ emotions, motivation, goals, cognitions, and social relationships. The utility of such research lies in establishing behavioral predictors of individuals’ likelihood of becoming ill and the ease of their recovery from illness (Clark, 1994). A second contribution lies in the abilities of these fields to inform and guide health promotion and disease prevention intervention.