title: The role of generalized pain and pain behavior in tender point scores in fibromyalgia.
abstract: OBJECTIVE
  To determine and assess the significance of the independent role of pain, pain behavior, depression, and weekly stress in tender point scores in objectively diagnosed fibromyalgia (FM) patients.
  
  
  METHODS
  One hundred eleven patients with FM recruited from the community and private and university based clinics participated in a comprehensive evaluation of their pain, psychological distress, and pain behavior. Tender point assessment was carried out across 18 discrete sites according to American College of Rheumatology criteria. Pain was assessed with a composite index of 4 pain measures; psychological distress consisted of measures of stress and depression, and pain behavior was measured by an objective index derived from a 10 minute videotaped sequence in which 5 pain behaviors were recorded.
  
  
  RESULTS
  Multiple regression analyses revealed that high pain, high pain behavior, and shorter illness duration were related independently to tender point scores. Measures of depression and weekly stress were not independently related to tender point scores.
  
  
  CONCLUSIONS
  Tender point scores are related to generalized pain and pain behavior tendencies in patients with FM, and do not independently reflect generalized psychological distress.
authors.affiliation: California School of Professional Psychology, Department of Psychiatry, University of California, San Diego, USA. pnicassio@mail.cspp.edu
authors.forename: P M
authors.initials: PM
authors.lastname: Nicassio
authors.forename: M H
authors.initials: MH
authors.lastname: Weisman
authors.forename: C
authors.initials: C
authors.lastname: Schuman
authors.forename: C W
authors.initials: CW
authors.lastname: Young
mesh_terms: D000328:Adult; D000368:Aged; D004644:Emotions; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012803:Sick Role; D013312:Stress, Physiological / Q000503:physiopathology / Q000523:psychology; D014743:Videotape Recording