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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

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
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Description
Female infertility can present a significant challenge to quality of life. To date, few, if any investigations have explored the process by which women adapt to premature ovarian insufficiency (POI), a specific type of infertility, over time. The current investigation proposed a bi-dimensional, multi-factor, model of adjustment characterized by the

Female infertility can present a significant challenge to quality of life. To date, few, if any investigations have explored the process by which women adapt to premature ovarian insufficiency (POI), a specific type of infertility, over time. The current investigation proposed a bi-dimensional, multi-factor, model of adjustment characterized by the identification of six latent factors representing personal attributes (resilience resources and vulnerability), coping (adaptive and maladaptive) and outcomes (distress and wellbeing). Measures were collected over the period of one year; personal attributes were assessed at Time 1, coping at Time 2 and outcomes at Time 3. It was hypothesized that coping factors would mediate associations between personal attributes and outcomes. Confirmatory Factor Analysis (CFA), simple regressions and single mediator models were utilized to test study hypotheses. Overall, with the exception of coping, the factor structure was consistent with predictions. Two empirically derived coping factors, and a single standalone strategy, avoidance, emerged. The first factor, labeled "approach coping" was comprised of strategies directly addressing the experience of infertility. The second was comprised of strategies indicative of "letting go /moving on." Only avoidance significantly mediated the association between vulnerability and distress.
ContributorsDriscoll, Mary (Author) / Davis, Mary C. (Thesis advisor) / Aiken, Leona S. (Committee member) / Luecken, Linda J. (Committee member) / Zautra, Alex J. (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Current models of pain coping typically focus on how pain contributes to poor physical and psychological functioning. Researchers have argued that this focus on the negative consequences is too narrow and does not account for times when individuals are able to maintain meaningful functioning despite their pain. Thus, the current

Current models of pain coping typically focus on how pain contributes to poor physical and psychological functioning. Researchers have argued that this focus on the negative consequences is too narrow and does not account for times when individuals are able to maintain meaningful functioning despite their pain. Thus, the current study sought to investigate the day-to-day processes that both help and hinder recovery from pain and persistence towards daily goals. Specifically, the present study tested: a) a two-factor model of risk and resilience “factors” that capture key processes across affective, cognitive and social dimensions of functioning, and b) whether the relation between morning pain and end-of-day physical disability is mediated by increases in these afternoon risk and resilience factors. Within-day study measures were collected for 21 days via an automated phone system from 220 participants with Fibromyalgia. The results of multi-level confirmatory factor analysis indicated that, consistent with prediction, risk and resilience do constitute two factors. Findings from multilevel structural equation models also showed resilience factor mediated the link between late morning increases in pain and end-of-day disability, in line with hypotheses. Although the vulnerability factor as a whole did not mediate the within-day link between pain and disability, pain-catastrophizing individually did serve as a significant mediator of this relation. This study was the first to empirically test a within-day latent factor model of resilience and vulnerability and the first to capture the multidimensional nature of the pain experience by examining mechanisms across affective, cognitive and social domains of functioning. The findings of the current study suggest that in addition to studying the processes by which pain has a negative influence on the lives of pain sufferers, our understanding of the pain adaptation process can be further improved by concurrently examining mechanisms that motivate individuals to overcome the urge to avoid pain and to function meaningfully despite it.
ContributorsThummala, Kirti (Author) / Davis, Mary C. (Thesis advisor) / Doane, Leah (Committee member) / Karoly, Paul (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Socioeconomic status (SES) is linked with poorer health outcomes across the range of SES. The Reserve Capacity Model (RCM) proposes that low SES fuels repeated and/or chronic exposure to elevated levels of stress, producing deleterious emotional, psychological, social, and physiological changes that result in development of disease over time. The

Socioeconomic status (SES) is linked with poorer health outcomes across the range of SES. The Reserve Capacity Model (RCM) proposes that low SES fuels repeated and/or chronic exposure to elevated levels of stress, producing deleterious emotional, psychological, social, and physiological changes that result in development of disease over time. The RCM further asserts that a relative lack of social and psychological resources, including efficacy and social support, among low SES individuals accounts for their greater vulnerability to the effects of stress. Although the links between stress, reserve capacity, and health outcomes are framed in the RCM as an ongoing process that produces disease, the majority of investigations testing the model have not examined its utility in explaining 1) coping with daily stressors or 2) symptom flares among individuals managing a chronic illness. This study investigated the effects of SES, reflected in income level, on the: 1) levels of daily financial events and financial worry; 2) relations between daily financial worry and symptoms of pain and fatigue; and 3) extent to which daily coping efficacy and social support mediated the daily financial worry-symptom relation across 21 daily diary reports collected from 220 individuals with fibromyalgia (FM). Simple correlations showed that income was inversely related to frequency of financial events and level of financial worry across 21 days. Results from multilevel models indicated that daily increases in financial worry were unrelated to pain regardless of income level, but were related to increased fatigue among individuals with lower relative to higher income. Daily efficacy and support mediated the relations between financial worry and pain and fatigue, but the extent of mediation did not differ based on high versus low income level. Taken together, the findings suggest that individuals of low versus high income encounter more frequent financial stress and experience greater daily fatigue exacerbation related to that stress, in line with the RCM. Over time, the greater exposure and reactivity to financial strain may account for the inverse relation between income and disability among those with chronic pain.
ContributorsMoore, Shannon Victoria (Author) / Davis, Mary C. (Thesis advisor) / Luecken, Linda J. (Committee member) / Suk, Hye Won (Committee member) / Arizona State University (Publisher)
Created2017