Women's pursuit of personal goals in daily life with fibromyalgia: A value-expectancy analysis.

Eighty-nine women with fibromyalgia completed the Life Orientation Test, identified health and social goals, and answered questions from the Goal Systems Assessment Battery (P. Karoly & L. Ruehlman, 1995) about their valuation of, and self-efficiency in attaining, each goal. For 30 days, they responded to palm-top computer interviews about their pain and fatigue and rated their goal effort, goal progress, and pain- and fatigue-related goal barriers. Goal barriers increased and goal efforts and progress decreased on days with greater pain and fatigue; goals valued more highly were pursued more effortfully and successfully; more optimistic individuals were less likely to perceive goal barriers and, on days that were more fatiguing than usual, were less likely to reduce their effort and to retreat from progress in achieving their health goal; and more pessimistic individuals perceived greater goal barriers on days that were less painful than usual. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of positive and negative interpersonal events on daily fatigue in women with fibromyalgia, rheumatoid arthritis, and osteoarthritis.

Objective: The current study tested whether daily interpersonal events predicted fatigue from one day to the next among female chronic pain patients. Design: Self-reported fatigue, daily events, pain, sleep quality, depressive symptoms, and functional health across 30 days were assessed in women with rheumatoid arthritis (RA: n = 89), Osteoarthritis (OA: n = 76), and Fibromyalgia syndrome (FM: n = 90). Main Outcome Measures: Self-report fatigue measured on a 0 to 100 scale and fatigue affect from PANAS-X (Watson & Clark, 1994). Results: Multilevel analyses showed that both higher average levels of and daily increases in negative events predicted more fatigue, whereas daily increases in positive events predicted less fatigue. Across all pain conditions, increases in negative events continued to predict higher fatigue on the following day. Moreover, for participants with FM or RA, increases in positive events also predicted increased fatigue the following day. Daily increases in fatigue, in turn, predicted poorer functional health on both the same day and the next day. Conclusion: These results indicate that both on average and on a daily basis, interpersonal events influence levels of fatigue beyond common physical and psychological correlates of chronic pain and highlight differences between chronic pain groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fibromyalgia: The role of sleep in affect and in negative event reactivity and recovery.

Objective: Fibromyalgia (FM) syndrome is a chronic pain condition characterized by diffuse muscle pain, increased negative mood, and sleep disturbance. Until recently, sleep disturbance in persons with FM has been modeled as the result of the disease process or its associated pain. The current study examined sleep disturbance (i.e., sleep duration and sleep quality) as a predictor of daily affect, stress reactivity, and stress recovery. Design and Measures: A hybrid of daily diary and ecological momentary assessment methodology was used to evaluate the psychosocial functioning of 89 women with FM. Participants recorded numeric ratings of pain, fatigue, and positive and negative affect 3 times throughout the day for 30 consecutive days. At the end of each day, participants completed daily diary records of positive and negative life events. In addition, participants reported on their sleep duration and sleep quality each morning. Results: After accounting for the effects of positive events, negative events, and pain on daily affect scores, it was found that sleep duration and quality were prospectively related to affect and fatigue. Furthermore, the effects of inadequate sleep on negative affect were cumulative. In addition, an inadequate amount of sleep prevented affective recovery from days with a high number of negative events. Conclusions: These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rumination, fear, and cortisol: An in vivo study of interpersonal transgressions.

The authors sought to examine whether rumination about psychologically painful, though nontraumatic, interpersonal transgressions is associated with increased salivary cortisol. They measured salivary cortisol, rumination about a transgression, fear and anger regarding the transgressor, perceived painfulness of the transgression, and positive and negative mood in 115 undergraduates who had experienced an interpersonal transgression during the previous 7 days. They obtained measurements on as many as 5 occasions separated by approximately 14 days each. On occasions when participants reported that they had been ruminating to a degree that was greater than was typical for them, they had higher levels of salivary cortisol than was typical for them. The rumination- cortisol association appeared to be mediated by fear of the transgressor. Rumination about even moderately painful but nontraumatic life events and associated emotions are related to biological changes that may subserve social goals such as avoiding social threats. Items from the rumination scale are appended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression history and coping with chronic pain: A daily process analysis.

This study examined how a previous episode of depression is related to daily pain and reactions to pain among individuals with fibromyalgia, a chronic pain syndrome. Seventy-one women with fibromyalgia (including 30 who were previously depressed) rated their pain and mood 3 times daily for 30 days. Each night, participants rated the extent to which they responded to pain by catastrophizing, how much control they had over that day's pain, their ways of coping with pain that day, and the effectiveness of their coping efforts. Multivariate multilevel regression models revealed that after controlling for neuroticism and current depressive symptoms, formerly depressed and never-depressed individuals differed in how they coped with increased pain and in how they appraised the efficacy of their coping efforts. Formerly depressed participants who also reported more current depressive symptoms showed a greater decline in pleasant mood on more painful days than did formerly depressed participants who were experiencing fewer current depressive symptoms. These findings illustrate how a history of depression can be captured in the dynamics of daily life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily Mood and Stress Predict Pain, Health Care Use, and Work Activity in African American Adults With Sickle-Cell Disease.

This study examined the extent to which daily mood and stress were associated with pain, health care use, and work activity in 41 adults (mean age=36 years) with sickle-cell disease. Multilevel model analyses of daily diaries (M=91 days) indicated that increases in stress and negative mood were associated with increases in same-day pain, health care use, and work absences. Lagged models suggested bidirectional relationships, with evidence that pain may be the more powerful initiating variable in pain-mood and pain-stress cycles. Of importance, positive mood was associated with lower same-day and subsequent day pain, as well as fewer health care contacts, suggesting that positive mood may serve to offset negative consequences of pain and other illness symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How goal instrumentality shapes relationship evaluations.

Findings from 6 experiments support the hypothesis that relationship evaluations and behavioral tendencies are goal dependent, reflecting the instrumentality of significant others for the self's progress toward currently active goals. Experiments 1 and 3 found that active goals can automatically bring to mind significant others who are instrumental for the activated goal, heightening their accessibility relative to noninstrumental others. Experiments 2-5 found that active goals cause individuals to evaluate instrumental others more positively, draw closer to them, and approach them more readily, compared with noninstrumental others. Experiment 6 found that people who engage in goal-dependent interpersonal evaluations are more successful, receiving higher grades. Implications for understanding the social nature of self-regulation and the impact of personal goals on interpersonal relationships are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of daily stress on health and mood: Psychological and social resources as mediators.

This study examined daily stress processes among 75 married couples across 20 assessments during a 6-month period. The somatic and psychological effects of common everyday hassles were investigated. Overall, there was a significant relationship between daily stress and the occurrence of both concurrent and subsequent health problems such as flu, sore throat, headaches, and backaches. The relationship of daily stress to mood disturbance was more complex. The negative effects of stress on mood were limited to a single day, with the following day characterized by mood scores that were better than usual. Furthermore, striking individual differences were found in the extent to which daily stress was associated with health and mood across time. Participants with unsupportive social relationships and low self-esteem were more likely to experience an increase in psychological and somatic problems both on and following stressful days than were participants high in self-esteem and social support. These data suggest that persons with low psychosocial resources are vulnerable to illness and mood disturbance when their stress levels increase, even if they generally have little stress in their lives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developing effective helping relationships in health education practice

Health educators who interact directly with the people they serve must be able to establish effective relationships. Helping relationships are effective if they facilitate clients' progress toward health-promoting goals. Health educators are usually well versed in learning activities and spend a significant proportion of their time interacting with clients. However, many health educators have never received explicit training in how to establish effective formal helping relationships. Research on social influence processes has provided a set of empirical findings that suggest interpersonal behaviors that are likely to maximize the effectiveness of formal helping relationships. This literature indicates that formal helping relationships characterized by interpersonal behaviors that enhance client self-esteem and feelings of control are most effective in helping clients achieve specific goals. Interestingly, enhancement of self-esteem and feelings of control are consistent with many definitions of personal empowerment. Since the social influence and empowerment literatures come from very different intellectual roots and have different approaches to power and influence, their convergence is especially notable. These literatures combine to establish the bases for proposing two essential components of effective helping relationships: (1) providing unconditional acceptance and positive regard for clients, and (2) sharing power and control through participatory processes.     

Readiness to adopt a self-management approach to cardiac health: Predicting outcomes from cardiac rehabilitation.

Purpose/Objective: To examine whether initial attitudes toward a self-management approach to cardiac health and early-treatment changes in those attitudes predict outcomes in cardiac rehabilitation. Research Method/Design: One hundred eighteen participants took part in a 12-week Phase II cardiac rehabilitation program. Questionnaires to assess readiness to engage in a self-management approach, mood, activity level, and diet were completed at pretreatment and at Weeks 3, 6, 9, and 12. Results: Repeated-measures regressions showed that participants with higher pretreatment levels of readiness to engage in a self-management approach showed more pronounced improvements in mood, activity level, and diet than did those with lower levels of readiness. Those who reported significant shifts in self-management attitudes during the first 3 weeks of the program finished treatment with greater improvements on measures of mood, cardiorespiratory fitness, activity level, and weight than did participants who reported smaller shifts. Conclusions/Implications: Results suggest that pretreatment acceptance of a self-management orientation, as well as early shifts toward such a stance, predicted treatment gains. This information may be used to improve outcomes from cardiac rehabilitation by intervening to enhance readiness in those that start at low levels or fail to engage in the initial stages of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily interpersonal experiences, context, and alcohol consumption: Crying in your beer and toasting good times.

The authors explored a multidimensional view of drinking, whereby social and solitary drinking represent distinct behaviors associated with positive and negative experiences, respectively. Using daily diary methodology and multilevel analytic strategy, the authors examined, over 30 days, the within-person association of negative and positive experiences and alcohol consumption in different contexts and focused on interpersonal experiences. On days with more negative interpersonal experiences, participants engaged in more solitary drinking (i.e., drinking at home and alone), whereas on days with more positive interpersonal experiences they drank more in social contexts. The authors also demonstrated that individuals high on neuroticism drank more in solitary contexts on days with more negative interpersonal experiences, relative to those with lower neuroticism. These findings lend support to models linking daily drinking motivation and context-dependent drinking behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When do opposites attract? Interpersonal complementarity versus similarity.

Two experiments examined whether interpersonal complementarity or similarity influences people's satisfaction with dyadic interactions. Participants in complementary partnerships (submissive people with dominant partners, dominant people with submissive partners) reported more satisfaction than did those with similar partners. In Study 1 complementarity referred to the match between the participants' self-reported interpersonal style (dominant or submissive) and the role enacted by a confederate (dominant or submissive). In Study 2 participants interacted in pairs, and complementarity referred to the match between one participant's interpersonal goals and the other's overt behavior. Participants whose goals were complemented by their partners' behavior were more satisfied with the interaction than those whose goals were not. In both studies satisfied participants perceived their partners as similar to themselves. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Sleep and the affective response to stress and pain.

Objective: The current study examined sleep disturbance (i.e., sleep duration, sleep quality) as a correlate of stress reactivity and pain reactivity. Design and Outcome Measures: An ecological momentary assessment design was used to evaluate the psychosocial functioning of men and women with fibromyalgia or rheumatoid arthritis (N = 49). Participants recorded numeric ratings of pain, the occurrence of a stressful event, as well as positive and negative affect 7 times throughout the day for 2 consecutive days. In addition, participants reported on their sleep duration and sleep quality each morning. Results: Sleep disruption was not found to be an independent predictor of affect. However, sleep was found to buffer the relationship between stress and negative affect and the relationship between pain and both positive and negative affect. Conclusion: These results are consistent with a model in which good-quality sleep acts as a biobehavioral resource that minimizes allostatic load. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reaching one's personal goals: A motivational perspective focused on autonomy.

The present article reviews recent research on motivational factors that influence the success of personal goals. Although achieving progress on personal goals is made difficult by limitations in self-regulatory strength, it is argued that individuals who feel autonomous regarding their goals will benefit in distinct ways. The issue of autonomy concerns whether a goal reflects an individual's interests and personal values versus whether it is adopted because of social pressures or expectations of what an individual "should do." Recent research indicates that autonomous goal motivation can lead directly to greater goal progress by allowing individuals to exert more effort, experience less conflict, and feel a greater sense of readiness to change their behaviour. It also allows individuals to make better use of implementation plans specifying how, when, and where they will enact goal-directed behaviours. Support from other people (health care providers, etc.) can play a vital role in facilitating goal pursuits, especially when such support enhances feelings of autonomy. Successful goal progress results in enhanced positive affect and reduced negative affect, particularly if the goal pursuits involved satisfaction of intrinsic psychological needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of self-focused rumination on negative thinking and interpersonal problem solving.

Hypotheses about the effects of self-focused rumination on interpretations of events and interpersonal problem solving were tested in 3 studies with dysphoric and nondysphoric participants. Study 1 supported the hypothesis that dysphoric participants induced to ruminatively self-focus on their feelings and personal characteristics would endorse more negative, biased interpretations of hypothetical situations than dysphoric participants induced to distract themselves from their mood, or nondysphoric participants. Study 2 showed that dysphoric participants who ruminated were more pessimistic about positive events in their future than the other 3 groups. Study 3 showed that dysphoric ruminating participants generated less effective solutions to interpersonal problems than the other 3 groups. In Studies 1 and 3, dysphoric ruminating participants also offered the most pessimistic explanations for interpersonal problems and hypothetical negative events. In all 3 studies, dysphoric participants who distracted were as optimistic and effective in solving problems as nondysphoric participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting attendance and expectations for group therapy.

Inconsistent membership is one of the leading problems in groups. Group therapy participants (N=310) from 2 university counseling centers were studied over a period of 7 years to examine interpersonal style, expectations, and attendance in group therapy. The Group Therapy Questionnaire (R. R. MacNair & J. Corazzini, 1994; R. R. MacNair-Semands, 1996, 1997, 2001) assessed client goals, substance use, and interpersonal problems in relation to expectations for group and attendance. A discriminant analysis demonstrated that angry hostility and social inhibition were predictive of low attendance. Additionally, clients with previous therapy reported more positive expectations about group, whereas those reporting greater substance use and more somatic symptoms had fewer positive expectations about group. Implications for treatment decisions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of cocaine on mood and sleep in cocaine-dependent males.

The effects of cocaine use and withdrawal on mood and sleep were examined. Three cocaine-dependent men lived in an inpatient facility for approximately 4 weeks, which included an initial abstinence phase (8–10 days), a cocaine administration phase (5 days), and a 2nd abstinence phase (14–16 days). During the 2nd phase, cocaine was administered intranasally a few hours before bedtime. During the day, mood and daytime sleepiness were measured, and sleep was monitored each night. Cocaine produced typical changes in mood and blood pressure, and sleep was severely disrupted. Following Phase 2, there were no changes in mood that was indicative of an abstinence syndrome, although, initially, daytime sleepiness increased. After 2 weeks, sleep architecture remained different from age-matched controls. This study is the first to measure changes in sleep architecture polysomnographically following a period of controlled cocaine use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multivariate analysis of adolescents' orientations toward physician use.

Interviewed 2,188 early adolescents (aged 12–13 yrs), 1,814 late adolescents (aged 16–28 yrs), their parents, school representatives, and health professionals. Hypotheses regarding direct parent–adolescent links were examined in a multivariate structural equations model relating demographics, adolescents' interpersonal competencies, and parental variables to adolescents' orientations toward physician utilization. Adolescents' orientations toward physician use were associated with those of their parents, and this link was generally stronger and more specific during late adolescence. The model also suggests that these orientations conform to social and cultural variables related to differences in social stratification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fatigue following traumatic brain injury: Frequency, characteristics, and associated factors.

Objectives: To document the frequency, characteristics, and factors associated with fatigue following traumatic brain injury (TBI). Design: Survey methodology and multivariate statistical design. Setting: Rehabilitation center and community. Participants: 452 participants aged 16 years and over with minor to severe TBI who answered a questionnaire measuring diverse aspects of fatigue as well as different dimensions of psychological distress, pain, and sleep quality. Measures: Proportion of participants reporting being significantly fatigued. Validated measures of fatigue, sleep quality, and psychological distress. Results of a logistic regression analysis. Results: Significant fatigue was reported by 68.5% of participants. Mental fatigue was the most prominent type of fatigue, followed by physical fatigue. Fatigue was present even several years following the accident and had many perceived impacts on day-to-day function. Factors associated with fatigue were a shorter time since injury; being on long-term disability leave; and higher levels of sleep problems, cognitive disturbances, and anxiety. Conclusion: Fatigue is a prevalent problem after TBI that requires more clinical and scientific attention because it probably has important repercussions on the quality of rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional selection is biased toward mood-congruent stimuli.

One can exert significant volitional control over the attentional filter so that stimuli that are consistent with one's explicit goals are more likely to receive attention and become part of one's conscious experience. Here we pair a mood induction procedure with an inattentional blindness task to show that one's current mood has a similar influence on attention. A positive, negative, or neutral mood manipulation was followed by an attentionally demanding multiple-object tracking task. During the tracking task, participants were more likely to notice an unexpected face when its emotional expression was congruent with participants' mood. This was particularly true for the frowning face, which was detected almost exclusively by participants in the sad mood induction condition. This attentional bias toward mood-congruent stimuli provides evidence that one's temporary mood can influence the attentional filter, thereby affecting the information that one extracts from, and how one experiences the world. (PsycINFO Database Record (c) 2011 APA, all rights reserved)