title: Relations between adaptive and maladaptive pain cognitions and within-day pain exacerbations in individuals with fibromyalgia.
abstract: The objectives of this study were to assess within-person hypotheses regarding temporal cognition-pain associations: (1) do morning pain flares predict changes in two afternoon adaptive and maladaptive pain-related cognitions, and (2) do these changes in afternoon cognitions predict changes in end-of-day pain reports, which in turn, carry over to predict next morning pain in individuals with fibromyalgia. Two hundred twenty individuals with fibromyalgia completed electronic assessments of pain intensity, pain catastrophizing, and pain coping efficacy three times a day for three weeks. Multilevel structural equation modeling established that afternoon catastrophizing and coping efficacy were parallel mediators linking late morning with end-of-day pain reports (controlling for afternoon pain), in line with prediction. Catastrophizing was a stronger mediator than coping efficacy. Moreover, afternoon cognitions and end-of-day pain reports served as sequential mediators of the relation between same-day and next-day morning pain. These findings align with assertions of cognitive-behavioral theories of pain that pain flares predict changes in pain both adaptive and maladaptive cognitions, which in turn, predict further changes in pain.
authors.affiliation: Health Services Research and Development Service, Durham VA Medical Center, 508 Fulton Street, Durham, NC, 27705, USA. shannon.taylor14@va.gov.
authors.forename: Shannon Stark
authors.identifier: http://orcid.org/0000-0003-4830-2852
authors.initials: SS
authors.lastname: Taylor
authors.affiliation: Department of Psychology, Arizona State University, Tempe, AZ, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Davis
authors.affiliation: Department of Psychology, Arizona State University, Tempe, AZ, USA.|Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Yeung
authors.affiliation: Department of Psychology, Arizona State University, Tempe, AZ, USA.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Zautra
authors.affiliation: Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Tennen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D058443:Catastrophization; D059350:Chronic Pain / Q000150:complications / Q000523:psychology*; D003071:Cognition; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D055815:Young Adult
keywords: Catastrophizing; Chronic pain; Daily process methodology; Fibromyalgia; Multilevel structural equation modeling; Pain cognitions; Pain coping efficacy