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- All Subjects: Fatigue--Psychological aspects.
- All Subjects: Induced Thermal Pain
- Creators: Yeung, Wan
Description
Fibromyalgia (FM) is a chronic pain condition characterized by debilitating fatigue. This study examined the dynamic relation between interpersonal enjoyment and fatigue in 102 partnered and 74 unpartnered women with FM. Participants provided three daily ratings for 21 days. They rated their fatigue in late morning and at the end of the day. Both partnered and unpartnered participants reported their interpersonal enjoyment in the combined familial, friendship, and work domains (COMBINED domain) in the afternoon. Additionally, partnered participants reported their interpersonal enjoyment in the spousal domain. The study was guided by three hypotheses at the within-person level, based on daily diaries: (1) elevated late morning fatigue would predict diminished afternoon interpersonal enjoyment; (2) diminished interpersonal enjoyment would predict elevated end-of-day fatigue; (3) interpersonal enjoyment would mediate the late morning to end-of-day fatigue relationship. In cross-level models, the study explored whether individual differences (between-person) in late morning fatigue and afternoon interpersonal enjoyment would moderate within-person relations from late morning fatigue to afternoon interpersonal enjoyment, and from afternoon interpersonal enjoyment to end-of-day fatigue. Furthermore, it explored whether the hypothesized relationships at the within-person level would also emerge at the between-person level (between-person mediation models). Multilevel structural equation modeling and multilevel modeling were employed for model testing, separately for partnered and unpartnered participants. Within-person mediation models supported that on high fatigue mornings, afternoon interpersonal enjoyment was dampened in the spousal and combined domains in partnered and unpartnered samples. Moreover, low afternoon interpersonal enjoyment in both the spousal and combined domains predicted elevated end-of-day fatigue. Afternoon interpersonal enjoyment mediated the relationship of late morning to end-of-day fatigue in the combined domain but in not the spousal domain. Cross-level moderation analyses showed that individual differences in afternoon spousal enjoyment moderated the day-to-day relation between afternoon spousal enjoyment and end-of-day fatigue. Finally, the mediational chain was not observed at the between-person level. These findings suggest that preserving interpersonal enjoyment in non-spousal relations limits within-day increases in FM fatigue. They highlight the importance of examining domain-specificity in interpersonal enjoyment when studying fatigue, and suggest that targeting enjoyment in social relations may improve the efficacy of existing treatments.
ContributorsYeung, Wan (Author) / Aiken, Leona S. (Thesis advisor) / Davis, Mary C. (Thesis advisor) / Mackinnon, David P (Committee member) / Zautra, Alex J (Committee member) / Arizona State University (Publisher)
Created2013
Description
Childhood trauma has been linked to an increased risk of chronic pain in adulthood. One potential mechanism is via childhood trauma's impact on the hypothalamic-pituitary-adrenal axis (HPA) response to stress, reflected in changes in salivary cortisol levels (Nicolson et al., 2010). This study sought to determine the relations between childhood trauma, increases in cortisol levels following induced pain, and pain perceptions in adults with fibromyalgia, a chronic pain condition. It drew on data collected from participants enrolled in an investigation comparing the effectiveness of behavioral treatments for chronic pain. Before receiving treatment, participants attended a laboratory session during which they first rested, and then were exposed to heat stimuli to assess pain threshold and tolerance. Saliva samples were collected from each participant immediately following the rest, and twice during pain induction. Fibromyalgia participants with a history of childhood trauma were expected: 1) to report lower pain threshold and tolerance levels (i.e., have higher pain sensitivity), 2) to exhibit a higher resting cortisol level, and 3) to have greater increases in cortisol in response to acute pain induction than fibromyalgia participants without a history of childhood trauma. Findings showed that childhood trauma scores were: 1) related to lower pain tolerance (but not pain threshold), 2) unrelated to resting cortisol levels, and 3) unrelated to changes in cortisol in response to pain induction and pain tolerance, contrary to prediction. However, a subtype of childhood trauma, i.e., emotional maltreatment: 1) predicted lower pain tolerance, and 2) moderated the cortisol changes over time in response to pain induction during the laboratory session in the expected direction. That is, individuals who reported higher levels of childhood emotional maltreatment showed greater cortisol responses to the pain induction than individuals who reported lower levels of exposure to emotional maltreatment. Cortisol responses did not relate to pain perception. Thus, childhood emotional trauma predicted greater pain sensitivity and cortisol reactivity, but cortisol did not relate to pain perception. The findings suggest that early childhood trauma predicts cortisol reactivity and pain sensitivity, but that cortisol reactivity is not a mediator in the trauma-pain relation.
ContributorsCiaramitaro, Marissa Catherine (Author) / Davis, Mary (Thesis director) / Glenberg, Arthur (Committee member) / Doane, Leah (Committee member) / Yeung, Wan (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor)
Created2013-12