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)     

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)     

Fibromyalgia and women's pursuit of personal goals: A daily process analysis.

For 30 days, 50 women with primary fibromyalgia syndrome reported daily progress and effort toward a health–fitness and a social–interpersonal goal and the extent to which their pain and fatigue hindered their accomplishment. They also carried palmtop computers to assess their sleep and their pain, fatigue, and positive and negative mood throughout the day. Analyses of the person–day data set showed than on days during which pain or fatigue increased from morning to evening, participants perceived their goal progress to be more attenuated by pain and fatigue. Unrestorative sleep the night before predicted the following day's effort and progress toward accomplishing health–fitness goals, but not social–interpersonal goals. Finally, participants who reported more progress toward social–interpersonal goals on a given day were more likely to evidence improvements in positive mood across the day, regardless of any changes in pain or fatigue that day. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic influences on the dynamics of pain and affect in fibromyalgia.

[Correction Notice: An erratum for this article was reported in Vol 29(3) of Health Psychology (see record 2010-09923-002). In the article, grant information was omitted from the author note. The authors wish to acknowledge grant support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR046034: Alex J. Zautra, PI).] Objective: The purpose of the present investigation was to determine if variation in the catechol- O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes is associated with pain-related positive affective regulation in fibromyalgia (FM). Design: Forty-six female patients with FM completed an electronic diary that included daily assessments of positive affect and pain. Between- and within-person analyses were conducted with multilevel modeling. Main Outcome Measure: Daily positive affect was the primary outcome measure. Results: Analyses revealed a significant gene × experience interaction for COMT, such that individuals with met/met genotype experienced a greater decline in positive affect on days when pain was elevated than did either val/met or val/val individuals. This finding supports a role for catecholamines in positive affective reactivity to FM pain. A gene × experience interaction for OPRM1 also emerged, indicating that individuals with at least one asp?? allele maintained greater positive affect despite elevations in daily pain than those homozygous for the asn?? allele. This finding may be explained by the asp?? allele’s role in reward processing. Conclusions: Together, the findings offer researchers ample reason to further investigate the contribution of the catecholamine and opioid systems, and their associated genomic variants, to the still poorly understood experience of FM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of positive events at work on after-work fatigue: They matter most in face of adversity.

There is evidence that daily negative events at work enhance fatigue. In contrast, positive events may trigger processes that increase, but also processes that decrease, energetic resources. Accordingly, results regarding a main effect of positive events on fatigue have been mixed. However, a clearer pattern between positive events and fatigue can be expected under adverse circumstances (i.e., accumulation of negative events, high chronic stressors). Positive events may facilitate coping and accelerate recovery processes and, thus, reduce resource drain due to daily negative events and chronic stressors. Predicting fatigue in a diary study with 76 employees, we investigated interactions between daily positive events and (a) daily negative events and (b) chronic social stressors. Multilevel modeling revealed that negative but not positive events were associated with increased end-of-work fatigue. However, positive events interacted with negative events and with chronic social stressors. As expected, positive events were negatively associated with fatigue only on days with many negative events, but not so on days with few negative events. Analogously, positive events were negatively associated with fatigue only among employees with high, compared with low, chronic social stressors. We conclude that the beneficial short-term effects of positive events on energetic resources are largely confined to adverse circumstances. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

"Genetic influences on the dynamics of pain and affect in fibromyalgia": Correction to Finan et al. (2010).

Reports an error in "Genetic influences on the dynamics of pain and affect in fibromyalgia" by Patrick H. Finan, Alex J. Zautra, Mary C. Davis, Kathryn Lemery–Chalfant, Jonathan Covault and Howard Tennen (Health Psychology, 2010[Mar], Vol 29[2], 134-142). In the article, grant information was omitted from the author note. The authors wish to acknowledge grant support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR046034: Alex J. Zautra, PI). (The following abstract of the original article appeared in record 2010-04888-006.) Objective: The purpose of the present investigation was to determine if variation in the catechol- O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes is associated with pain-related positive affective regulation in fibromyalgia (FM). Design: Forty-six female patients with FM completed an electronic diary that included daily assessments of positive affect and pain. Between- and within-person analyses were conducted with multilevel modeling. Main Outcome Measure: Daily positive affect was the primary outcome measure. Results: Analyses revealed a significant gene × experience interaction for COMT, such that individuals with met/met genotype experienced a greater decline in positive affect on days when pain was elevated than did either val/met or val/val individuals. This finding supports a role for catecholamines in positive affective reactivity to FM pain. A gene × experience interaction for OPRM1 also emerged, indicating that individuals with at least one asp?? allele maintained greater positive affect despite elevations in daily pain than those homozygous for the asn?? allele. This finding may be explained by the asp?? allele’s role in reward processing. Conclusions: Together, the findings offer researchers ample reason to further investigate the contribution of the catecholamine and opioid systems, and their associated genomic variants, to the still poorly understood experience of FM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily negative mood affects fasting glucose in Type 2 diabetes.

Objective: To examine the relationship between mood and blood glucose in a 21-day daily diary study. Design: During a home visit, information was gathered from 206 persons with Type 2 diabetes regarding demographics, disease characteristics and treatment, and depressive symptoms. They had blood drawn at a laboratory, yielding HbA1C. The participants were then telephoned each evening for 21 days and were asked about their positive and negative mood during the past 24 hours. They also tested their blood glucose upon rising in the morning. Main Outcome Measures: The main outcomes measures were positive and negative affect and fasting glucose. Results: Multilevel analyses revealed a relationship between negative affect on one day and morning glucose on the next day. There was no such relationship between positive affect and glucose, nor was there a comparable effect of glucose on one day and either positive or negative affect on the next day. Conclusion: The observed relationship between mood and blood glucose appears to be because of negative affect, not positive, with no evidence of a lagged effect of glucose on mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of sleep quality on symptoms of irritable bowel syndrome

A prospective, one-month diary study was conducted with 23 adult irritable bowel syndrome (IBS) patients in order to determine the relationship between IBS and the quality of sleep. Subjects were screened through history and diagnostic studies. Accepted patients then completed a daily diary of IBS symptoms and sleep quality. At baseline, most subjects (74%) characterized themselves as "poor sleepers." Using pooled time series analysis, the study found a significant correlation between morning IBS symptoms and the quality of the prior night's sleep (P < 0.001), a finding not previously reported in the literature. A less strong but still significant correlation (P < 0.05) was found between end of day IBS symptoms and the quality of sleep during the prior evening. Morning IBS symptoms seem to rise or fall in close association with the prior night's quality of sleep. The study supports the hypothesis that IBS symptoms are related to a disturbance in sleep.     

Examinations of chronic pain and affect relationships: Applications of a dynamic model of affect.

Two studies of the relationship between pain and negative affect are presented in this article: a study of weekly fluctuations in pain and negative affect among those with arthritis and a study of daily fluctuations in pain and negative affect for participants with fibromyalgia. The roles of positive affect and mood clarity (or the ability to distinguish between different emotions) in modifying the size of the relationship between pain and negative affect were examined in both studies as a means of testing the predictions of a dynamic model of affect regulation. In both studies, the presence of positive affect reduced the size of the relationship between pain and negative affect. Also, for arthritis participants with greater mood clarity, there was less overlap in ratings of negative and positive affective states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interplay of concurrent positive and negative interpersonal events in the prediction of daily negative affect and fatigue for rheumatoid arthritis patients.

Objective: The purpose of this study was to examine the interaction of daily concurrent positive interpersonal events (PIE) and negative interpersonal events (NIE) on the daily experience of negative affect and fatigue in a sample of men and women with rheumatoid arthritis. Two hypotheses were made. The blunting hypothesis predicted that NIE would nullify the beneficial influence of PIE on outcome measures, and the buffering hypothesis predicted that PIE would offset the adverse influence of NIE. Design: Participants completed up to 30 consecutive daily diaries. Multilevel modeling was used to examine the day-to-day dependencies among study variables. Main Outcome Measures: The primary outcomes were daily negative affect and fatigue. Results: In support of the blunting hypothesis, on days when NIE were diminished, PIE were associated with a greater reduction in fatigue. In contrast, consistent with the buffering hypothesis, on days when PIE were elevated, NIE were associated with a lesser increase in negative affect. Conclusion: The examination of concurrent PIE and NIE provides a unique perspective on the role of interpersonal events in affective and physiological outcomes, beyond that which can be gained from the examination of either type of event in isolation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness impairs daytime functioning but not sleep duration.

Objective: To assess the prospective association between daily feelings of loneliness and subsequent feelings of daytime dysfunction indicative of poor sleep quality. Design: Three consecutive end-of-day diaries were completed by a population-based sample of 215 adults (mean age = 57.5 years, SD = 4.4). Diary questions probed sleep duration, daytime dysfunction (i.e., fatigue, low energy, sleepiness), loneliness, physical symptoms, and depressed affect experienced that day. Chronic health condition data and body mass index were also obtained. Autoregressive cross-lagged panel models were used to examine the magnitude of reciprocal prospective associations between loneliness and daytime dysfunction. Main Outcome Measures: Unstandardized path coefficients adjusted for race/ethnicity, sleep duration, marital status, household income, chronic health conditions, and health symptom severity. Results: Daily variations in loneliness predicted subsequent feelings of daytime dysfunction (B = 0.16, p     

Effects of daily events on mood states in major depressive disorder.

Major depressive disorder (MDD) is characterized by high negative affect (NA) and low positive affect (PA), but little is known about emotional reactivity in daily life. The authors used experience sampling methodology to investigate changes in NA and PA following minor daily events in MDD compared with healthy participants. Contrary to expectation, MDD participants did not report more frequent negative events, although they did report fewer positive events. Multilevel regression showed that both NA and PA responses to negative events were blunted in the MDD group, whereas responses to positive events were enhanced. NA responses to negative events persisted longer in MDD participants. Depressed participants with a positive family history or longer current episodes showed relatively greater NA responses to negative events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral activation and inhibition in everyday life.

Joint effects of daily events and dispositional sensitivities to cues of reward and punishment on daily positive affect (PA) and negative affect (NA) were examined in 3 diary studies. Study 1 showed that positive events were strongly related to PA but not NA, whereas negative events were strongly related to NA but not PA. Studies 2 and 3 examined how the dispositional sensitivities of independent appetitive and aversive motivational systems, the Behavioral Activation System (BAS) and the Behavioral Inhibition System (BIS), moderated these relationships. Participants in Study 2 with higher BAS sensitivity reported more PA on average; those with more sensitive BIS reported more NA. Also, BIS moderated reactions to negative events, such that higher BIS sensitivity magnified reactions to negative events. Study 3 replicated these findings and showed that BAS predisposed people to experience more positive events. Results demonstrate the value of distinguishing within-person and between-person effects to clarify the functionally independent processes by which dispositional sensitivities influence affect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ambulatory cardiovascular activity in Vietnam combat veterans with and without posttraumatic stress disorder.

The present study investigated the relationship between daily diary affect ratings and ambulatory cardiovascular activity in 117 male Vietnam combat veterans (61 with posttraumatic stress disorder [PTSD] and 56 without PTSD). Participants completed 12–14 hr of ambulatory monitoring and daily diary affect ratings. Compared with veterans without PTSD, veterans with PTSD reported higher negative affect and lower positive affect in daily diary ratings. No differences were detected for mean laboratory initial recordings or mean ambulatory heart rate (HR), systolic blood pressure (SBP), or diastolic blood pressure (DBP). However, compared with veterans without PTSD, veterans with PTSD demonstrated higher SBP and DBP variability and a higher proportion of HR activity (compared with initial recording values) during daily activity. There was a significant Time of Day × Group interaction for mean HR, with a trend for PTSD participants to maintain HR levels during evening hours. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Did you have a nice evening?" A day-level study on recovery experiences, sleep, and affect.

In this study, the authors used a within-person design to examine the relation between recovery experiences (psychological detachment, relaxation, mastery experiences) during leisure time, sleep, and affect in the next morning. Daily survey data gathered over the course of 1 work week from 166 public administration employees analyzed with a hierarchical linear modeling approach showed that low psychological detachment from work during the evening predicted negative activation and fatigue, whereas mastery experiences during the evening predicted positive activation and relaxation predicted serenity. Sleep quality showed relations with all affective states variables. This study adds to research on job-stress recovery and affect regulation by showing which specific experiences from the nonwork domain may improve affect before the start of the next working day. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized, double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia

OBJECTIVE: To study the effect of fluoxetine (FL) and amitriptyline (AM), alone and in combination, in patients with fibromyalgia (FM). METHODS: Nineteen patients with FM completed a randomized, double-blind crossover study, which consisted of 4 6-week trials of FL (20 mg), AM (25 mg), a combination of FL and AM, or placebo. Patients were evaluated on the first and last day of each trial period. Outcome measures included a tender point score, the Fibromyalgia Impact Questionnaire (FIQ), the Beck Depression Inventory (BDI) scale, and visual analog scales (VAS) for global well-being (1 completed by the physician and 1 by the patient), pain, sleep trouble, fatigue, and feeling refreshed upon awakening. RESULTS: Both FL and AM were associated with significantly improved scores on the FIQ and on the VAS for pain, global well-being, and sleep disturbances. When combined, the 2 treatments worked better than either medication alone. Similar, but nonsignificant, improvement occurred in the BDI scale, the physician global VAS, and the VAS for fatigue and feeling refreshed upon awakening. Trends were less clear for the tender point score. CONCLUSION: Both FL and AM are effective treatments for FM, and they work better in combination than either medication alone.     

Cardiovascular Intraindividual Variability in Later Life: The Influence of Social Connectedness and Positive Emotions.

Healthy normotensive men and women (N = 33) underwent a 60-day diary assessment of emotions and cardiovascular functioning. Individual differences in social connectedness and mood were measured in questionnaires, and positive emotions, negative emotions, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed daily for 60 consecutive days. Results confirmed that the cardiovascular undoing effect of positive emotions is evident primarily in the context of negative emotional arousal. The daily associations between positive emotions and cardiovascular outcomes were linked to individual differences in social connectedness. Controlling for individual differences in mood levels, multilevel regression analyses showed that social connectedness predicted extended positive emotion, diminished SBP and DBP reactivity, and more rapid SBP recovery from daily negative emotional states. (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)     

Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastic breast cancer.

This study investigated the efficacy of a multimodal cognitive-behavioral intervention for women who had been treated for nonmetastatic breast cancer. Ten participants were enrolled in the treatment protocol in a multiple-baseline design. Intervention time series analyses of daily sleep diary data revealed significant improvements of sleep efficiency and total wake time. These results were corroborated by polysomnographic data. In addition, insomnia treatment was associated with significant improvements of mood, general and physical fatigue, and global and cognitive dimensions of quality of life. These findings suggest that cognitive-behavioral therapy, previously found effective for primary insomnia, is also of clinical benefit for insomnia secondary to cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trust, variability in relationship evaluations, and relationship processes.

Little is known about why some people experience greater temporal fluctuations of relationship perceptions over short periods of time, or how these fluctuations within individuals are associated with relational processes that can destabilize relationships. Two studies were conducted to address these questions. In Study 1, long-term dating partners completed a 14-day diary study that assessed each partner's daily partner and relationship perceptions. Following the diary phase, each couple was videotaped trying to resolve the most important unresolved problem from the diary period. As predicted, (a) individuals who trusted their partners less reported greater variability in perceptions of relationship quality across the diary period; (b) they also perceived daily relationship-based conflict as a relatively more negative experience; and (c) greater variability in relationship perceptions predicted greater self-reported distress, more negative behavior, and less positive behavior during a postdiary conflict resolution task (rated by observers). The diary results were conceptually replicated in Study 2a, in which older cohabiting couples completed a 21-day diary. These same participants also took part in a reaction-time decision-making study (Study 2b), which revealed that individuals tend to compartmentalize positive and negative features of their partners if they (individuals) experienced greater variability in relationship quality during the 21-day diary period and were involved in higher quality relationships. These findings advance researchers' understanding of trust in intimate relationships and provide some insight into how temporal fluctuations in relationship quality may undermine relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)