| 11. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Fibromyalgia as a Variant of High-performing PTSD: Negative affect, Emotional integrity counter play and functional impairment.
- 2017
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Ingår i: Journal of Neuropsychology & Stress Management. ; 2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present analysis was to examine psychological functioning and functional impairment in fibromyalgia (FM) based on three dimensions of post traumatic stress disorder (PTSD), positive and negative affect adjective scales (PANAS), Health related quality of life (SF-36) scales concerning pain, vitality and impairment from emotional and physical and causes together with the Work Ability Index (WAI) and to compare the results to healthy women. Materials and method: Twenty-two women presenting FM and twenty-six healthy women were education-and age-matched. All the women completed questionnaires regarding background, Impact of Event Scale-Revised (IES-R) and health related quality of life (SF-36), Negative and Positive Affect Scale (PANAS) and the single item Work ability index (WAI). Result: In comparison to healthy women, women presenting FM showed higher IES-R values of intrusion, avoidance and hypertension and lower values regarding PA and higher values regarding NA. Role emotional (RE), role physical (RP) and vitality (VT) showed lower values respectively and bodily pain (BP) showed more pain during 4 weeks in women presenting FM and WAI showed a higher value in healthy women (all these p values p ≤ 0.001). Intrusion, avoidance and hypertension correlated but were inversely related to health relates quality of life in terms of RE in FM. Only intrusion and hypertension were associated with NA while avoidance showed a positive association to WAI in FM where also the PA and the NA values were correlated unlike in healthy women. BP was related to VT but unrelated to all other measurements in FM. Conclusion: The absence of links between BP and the other measurements may imply a somewhat non psychological nature of clinical FM pain. Lower PA values and higher NA values added by high levels of PTSD like symptomatology induces severe psychological strain in FM. Avoidance relates positively to WAI but negatively to RE which suggests a pattern of alarming emergency functioning. The result and other research on relentless activity in FM may term FM a variant of high performance PTSD. An investment in areas of psychological resources that need to be filled in in FM may open up for a more resourceful physiological regulation of pain and global self-regulation of e.g. RE, RP.
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| 12. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Need for recovery in relation to effort from work and health in four occupations
- 2020
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246.
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine three levels of need for recovery (NFR) after work in relation to effort from work demands, demand compensatory strategies, effort-moderating or -reversing resources, and health including health behaviors. A further purpose was to examine occupational characteristics determining NFR. Methods 5000 engineers, carpenters, nurses, and home care nurses were invited to participate. NFR k-means clusters were calculated from 1289 participants. The effect from three levels of NFR regarding demands, compensatory strategies, resources at work, health, and health behaviors was examined using analysis of variance (ANOVA) and post hoc analysis. Prevalence ratios (PRs) of suboptimal health for three levels of NFR were calculated using Poisson regression. Linear stepwise multiple regression predictors explaining NFR were examined also occupation wise. Results NFR centroids at 5.8/33, 13.1/33, and 21.0/33 points were identified. ANOVA showed corresponding effects from NFR levels on work demands and compensatory strategies. The inversed proportion concerned levels of resources at work. Only the low NFR cluster negated regular health effects. The other two cluster groups also repeatedly worked while ill and presented PRs concerning health effects from 1.9 to 3.9 when compared to the low NFR group. Making good quality work, recovery opportunities, and thinking of work when off work were the most important predictors of NFR among 1289 participants with also occupation-wise interpretable profiles. Conclusions Three levels of NFR meant corresponding levels of work demands, work-demand compensatory strategies, and unfavorable health behaviors. An inversed proportion of resources related to the same levels of NFR. Low NFR meant no regular health effects which could guide limit values regarding salutary NFR. Important predictors of NFR were resources making a good quality work, recovery opportunities, and reversely effort from rumination when off work. Occupation-wise predictors could guide interventions.
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| 13. |
- Wentz, Kerstin, 1958, et al.
(författare)
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On parole : The natural history of recovery from fibromyalgia in women: A grounded theory study
- 2012
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Ingår i: Journal of Pain Management. - Hauppauge, NY : Nova Science Publishers, Inc.. - 1939-5914. ; 5:2, s. 177-194
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Tidskriftsartikel (refereegranskat)abstract
- Full remission of fibromyalgia symptoms is unusual and this course is unknown. The aim of this study was to elucidate psychological functioning and psychosocial processes expressed by women originally diagnosed with fibromyalgia and presently recovered. Eight women, earlier diagnosed with fibromyalgia but presently subjectively and objectively recovered, were interviewed in-depth. The interviews were analysed in line with Grounded Theory. Result: The women were as children exposed to high levels of mental load. Adult psychological functioning, prior to the onset of fibromyalgia, was characterised by insufficient definition of self and dissociation; psychological strengths were used to cover up or desert psychological ’weaknesses’ as negative effects. Later in process an increase in mental load was accompanied by development of fibromyalgia symptoms. The phase of fibromyalgia held three dimensions; a maintained high level of load, mastering strategies as seeking alternative treatment and use of support from others. The stage of recovery or remission was reached proceeded by a pronounced decrease in mental load as improved life conditions or cease of overexertion of body and mind. The stage of conditional recovery was mirrored by the core concept ’on parole -strengthened enough to be weak’. At this stage of process, absence of symptoms was secured by personal growth and less dissociative functioning including careful management of health needs as pacing of activity. Conclusions: Recovery from fibromyalgia seems to be a recovery on parole. Recovery appears to rely on improved self-regulation including less dissociative psychological functioning and ways of living allowed by prosperous conditions of life. © Nova Science Publishers, Inc.
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| 14. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Pain and physiological adaptation in women presenting fibromyalgia
- 2016
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Ingår i: Journal of Pain Management and Therapy. ; 1:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present analysis was to examine physiological adaptation to a sub-maximal test by measuring heart rate (HR) and heart rate variability (HRV) from the perspective of the fibromyalgia (FM) pain experience. Method: Twenty-five women presenting FM and healthy women were education- and age-matched. In their homes, all women completed questionnaires regarding health related quality of life and physical activity. All the women performed a stepwise load increment submaximal exercise test on a cycle ergometer to the severe perceived exertion level. HR and HRV were recorded before, during and after the test. Current pain was recorded before and after the test upon the FM women. Result: Correlational analysis over all the pain ratings and adaptation measures of HR and HRV showed that higher HR on two or three levels of workload were linked to greater clinical pain in women presenting FM. Pain at baseline related to clinical everyday pain. Both these pain measures correlated with the intersection between HR and workload and pain after the test. Reactivity through increase in pain from the test did not relate to everyday pain or baseline pain. Pain reactivity instead related to more adaptive HRV from the test, similar to the HRV adaptation of healthy women. In FM, the pain measures were neither related to HR at baseline, maximal workload during the test nor to physical exertion during the test. Conclusion: FM implies everyday clinical pain that is related to the intersection between HR and workload. In contrast to clinical pain, pain reactivity from the test related to a more physiologically adaptive pattern in terms of HRV. Clinical pain and pain reactivity seem to mobilize separate physiological processes via separate mechanisms.
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| 15. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Psychological functioning in women with fibromyalgia: a grounded theory study.
- 2004
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Ingår i: Health care for women international. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 25:8, s. 702-29
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to elucidate psychological functioning and psychological processes in women with fibromyalgia. Twenty-one females with fibromyalgia (aged 26-72 years) were interviewed in-depth. The interviews were analysed in line with grounded theory. A core concept, "unprotected self," mirroring childhood conditions and adult psychological functioning, was identified. Intense activity or hypomanic helpfulness often was used as self-regulation in adult life. Later an increased exposure to mental load is accompanied by reduction of cognitive functioning and generalised pain. The phase of persistence of fibromyalgia is marked by reduction of cognitive functions, unprotected psychological functioning, and increased mental load as from crisis and somatic symptoms.
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| 16. |
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| 17. |
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| 18. |
- Wentz, Kerstin, 1958
(författare)
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Symptom fluctuation in fibromyalgia. Environmental, psychological and psychobiological influences.
- 2013
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Fibromyalgia is a syndrome of widespread pain characterized by symptom fluctuations. Analysing these is a basis for learning the nature of the syndrome itself. The book covers development, quantitative patterns, psychobiology, life with fibromyalgia, biomarkers, gaps in pain, environmental factors, affect and defense measures related to mental load and influences on recovery. A focus is on dissociation and environmental influences on maintenance.
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| 19. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Women Developing and Maintaining Fibromyalgia: Qualitatively and Quantitatively Appearing Dissociative and Self-Loading Psychological Patterns
- 2008
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Ingår i: In F. Hu (Ed). Pain Research Progress:Migraine, Fibromyalgia and related pain. - New York : Nova Publishers. ; , s. 71-111
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The overall aim of this study was to describe psychological functioning in women developing and maintaining fibromyalgia. A further aim was to test if women with fibromyalgia and women with organically explained long-lasting pain differed on selected psychometrical instruments. In this study creation, selection and use of inventories were based on theoretical formulations from in depth interviews with 21 women diagnosed with fibromyalgia. These formulations included difficulties handling affects and stimulation in adult life before onset of fibromyalgia. Psychological vulnerability was compensated for through pronounced helpfulness and dissociation/repression including intense activity. The state of fibromyalgia meant continued high levels of mental load such as difficulties due to the self-structure, impaired cognitive functioning and somatic symptoms. Methods: From previously naturalistically generated theory the I Myself Scale (IMS) was constructed to mirror self-regulation in adult life prior to onset of fibromyalgia symptoms. The IMS was complemented with an instrument on current self-regulation: Structural Analysis of Social Behaviour (SASB). The result of the psychometrical testing was elucidated by a determination of sample characteristics regarding physical functioning, bodily pain and other dimensions of health related quality of life. A standardized instrument, SF-36 was employed. The groups were compared using analysis of variance, principal components analysis paired with discriminant analysis and profile analysis. Results: Psychometrical testing confirmed qualitative data patterns of self-regulation connected to development and maintenance of fibromyalgia. Prior to onset of symptoms women with fibromyalgia showed contrasting self-regulatory measures as a pattern of impaired self-reference/understanding of health needs. Strategies of dissociation or repression including intense activity and self-loading were used to avoid mental pain. Others were urgent objects of help and assistance but were not asked for help and advice. SF-36 indicated that the two groups experienced similar quality of life in the physical dimension but less psychological well being on behalf of the fibromyalgia group. The result from SASB showed that women with fibromyalgia experienced a higher level of mental “load” than the other pain group. Conclusion: Qualitative data indicated that life prior to onset of fibromyalgia and current fibromyalgia held qualities of impaired self-regulation in relation to mental load. Quantitative data patterns confirmed qualitative results on impaired self-protection before onset of fibromyalgia and a specifically high level of mental load during the state of fibromyalgia. Based on the result, relationships between self-regulation, development and maintenance of mental overload and generalized pain are discussed. Aspects of psychological and psychosomatic disregulation are discussed and hypothesized to cause but also later in the process to parallel alterations in somatic homeostatic functions. Consequences for treatment are suggested.
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| 20. |
- Wentz, Kerstin, 1958
(författare)
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Women With Fibromyalgia: Distress Avoidance Interferes with Gaps in Pain
- 2012
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Ingår i: Journal of Pain Management. - 1939-5914. ; 5:3, s. 245-259
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Tidskriftsartikel (refereegranskat)abstract
- The aetiology and the mechanisms involved in fibromyalgia pain are insufficiently understood. Pain intensity varies with stress. The pain itself is continuous during waking hours for the majority affected. For one in three the pain is interrupted by breaks. The lengths of these pain-gaps vary substantially. Aim: The study aim was to explore initiation, maintenance and termination of these breaks. Method: Twenty-four women with fibromyalgia pain-gaps were interviewed in depth. The interviews were analysed inductively using Grounded Theory. Result: A dominating quality of dissociation keeping distress out of sight meant that psychological vulnerability was dealt with through habitual use of avoidance including incoherence, overemphasis on positive affect and an over-active/health jeopardizing approach. A state of permanent crisis and not accepting fibromyalgia was identified. The disease was unmapped and unmanaged. Unplanned gaps in pain ‘happened’ during happiness/absence from stress, physical conditions of warmth or paced exercise or absorption during joyous events. The pain-gaps were lost during reversed conditions as intense activity or emotional stress. A subgroup of informants had ceased to dissociate. The disease became recognized/managed. Pain-gaps were planned, promoted, preserved and lengthened. Discussion: Careful crisis intervention in treatment of fibromyalgia seems to be an important measure. Automatic forms of dissociation could thereby pass. Regarding aetiology and mechanism in fibromyalgia pain the effect of efforts at dissociating unwanted mental content needs to be investigated further. Suppression and recoil relapse that creates permanent suppression and relapse engendering chronic stress might exert an explanatory power regarding both the development and maintenance of fibromyalgia. Keywords: Fibromyalgia dissociation crisis acceptance rehabilitation aetiology
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