EVALUATION OF EARLY MALADAPTIVE SCHEMES IN FEMALE FIBROMYALGIA PATIENTS

Yıl 2022, Cilt: 44 Sayı: 2, 250 - 257, 28.02.2022

Fatih Yığman , Zeynep Aykın Yığman , Damla Cankurtaran

https://doi.org/10.20515/otd.1004142

Cited By: 1

Öz

Aim: Fibromyalgia is a condition characterized by widespread musculoskeletal pain and tenderness without an underlying organic cause. Relationships with psychiatric factors and personality traits have been reported in many studies. In this study, we aimed to examine the relationship between early maladaptive schemes (EMS) and fibromyalgia severity from the perspective of schema theory.
Materials and Methods: For the study, 73 patients with fibromyalgia who applied to the Physical Medicine and Rehabilitation outpatient clinic and were diagnosed with fibromyalgia were included. In addition, 78 healthy control patients (without additional psychiatric disease and chronic pain) were included. A sociodemographic data form, Young Schema Questionnaire – Short Form 3 (YSQ -SF3) and Fibromyalgia Impact Questionnaire (FIQ) self-report scale was administered to the participants.
Results: We found significantly higher scores on emotional deprivation, failure to achieve, dependence/incompetence, vulnerability to harm, enmeshment, subjugation, self-sacrifice, and pessimism/negativity schemes in the patient group. We also found positive correlations with FIQ scores, emotional deprivation, and vulnerability to harm schemes. Finally, we found that age was a positive predictor on FIQ. After controlling for age, we found that emotional deprivation and vulnerability to harm schemes predicted FIQ scores.
Discussion and Conclusion: Fibromyalgia is a disease of unknown etiology. Psychological factors should be considered in the holistic treatment approach. In this sense, schema theory-oriented perspective can contribute to the treatment process.

Anahtar Kelimeler

Fibromyalgia, psychological factors, pain, schema therapy

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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KADIN FİBROMYALJİ HASTALARINDA ERKEN DÖNEM UYUMSUZ ŞEMALARIN DEĞERLENDİRİLMESİ

Öz

Amaç: Fibromyalji, altta yatan organic bir neden olmaksızın, yaygın kas iskelet sistemi ağrısı ve hassasiyeti ile karakterize bir tablodur. Psikiyatrik faktörlerle ve kişilik özellikleri ile ilişkileri birçok çalışmada bildirilmiştir. Bu çalışmada şema teorisi perspektifinden early maladaptive schemes (EMS) ile fibromyalji şiddeti arasındaki ilişkiyi incelemeyi amaçladık.
Gereç ve Yöntemler: Çalışma için Fiziksel Tıp ve Rehabilitasyon polikliniğine başvuran ve fibromyalji tanısı konulan 73 fibromyalji tanılı hasta dahil edilmiştir. Ek olarak 78 sağlıklı control (ek psikiyatrik hastalığı olmayan ve kronik ağrısı olmayan) hasta dahil edilmiştir. Katılımcılara sosyodemografik veri formu, Young Schema Questionnarie – Short Form 3 (YSQ -SF3) ve Fibromyalji Impact Questionnarie (FIQ) özbildirim ölçeği olarak uygulanmıştır.
Bulgular: Hasta grubunda emotional deprivation, failure to achieve, dependence /ıncompetence, vulnerability to harm, enmeshment, subjugation, self-sacrifice ve pessimisim /negativity şemalarında anlamlı yüksek puanlar saptadık. Ayrıca FIQ puanları ile, emotional deprivation ve vulnerability to harm şemaları ile pozitif korelasyonlar saptadık. Son olarak FIQ üzerinde yaşın pozitif yordayıcılığını saptadık. Yaş kontrol edildikten sonra ise FIQ skorlarını emotional deprivation ve vulnerability to harm şemalarının öngördüğünü saptadık.
Sonuç: Fibromyalji, etiyolojisi net olarak belirlenemeyen bir hastalıktır. Bütüncül tedavi yaklaşımında psikolojik faktörler ele alınmalıdır. Bu anlamda şema teorisi yönelimli bakış açısı, tedavi sürecine katkı sağlayabilir.

Anahtar Kelimeler

fibromyalji, psikolojik faktörler, ağrı, şema terapi

Proje Numarası

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Kaynakça

• 1. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheumatol. 1990;33(2):160-72.
• 2. Bucourt E, Martaillé V, Mulleman D, et al. Comparison of the Big Five personality traits in fibromyalgia and other rheumatic diseases. Joint Bone Spine. 2017;84(2):203-7.
• 3. Kool MB, van de Schoot R, García IL-C, et al. Measurement invariance of the Illness Invalidation Inventory (3* I) across language, rheumatic disease and gender. Ann Rheum Dis. 2014;73(3):551-6.
• 4. Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76(2):318-28.
• 5. Imbierowicz K, Egle UT. Childhood adversities in patients with fibromyalgia and somatoform pain disorder. Eur J Pain. 2003;7(2):113-9.
• 6. Walker E, Keegan D, Gardner G, et al. Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: II. Sexual, physical, and emotional abuse and neglect. Psychosom Med. 1997;59(6):572-7.
• 7. Schofferman J, Anderson D, Hines R, et al. Childhood psychological trauma and chronic refractory low-back pain. Clin J Pain. 1993;9(4):260-5.
• 8. Saariaho TH, Saariaho AS, Karila IA, et al. Early maladaptive schemas in Finnish adult chronic male and female pain patients. Scand J Pain. 2010;1(4):196-202.
• 9. Sansone RA, Pole M, Dakroub H, et al. Childhood trauma, borderline personality symptomatology, and psychophysiological and pain disorders in adulthood. Psychosomatics. 2006;47(2):158-62.
• 10. Davis DA, Luecken LJ, Zautra AJ. Are reports of childhood abuse related to the experience of chronic pain in adulthood?: a meta-analytic review of the literature. Clin J Pain. 2005;21(5):398-405.
• 11. Young JE. Cognitive therapy for personality disorders: A schema-focused approach: Professional Resource Press/Professional Resource Exchange; 1999.
• 12. Bach B, Bernstein DP. Schema therapy conceptualization of personality functioning and traits in ICD-11 and DSM-5. Curr Opin Psychiatry. 2019;32(1):38-49.
• 13. Arntz A, Van Genderen H, Drost J. Schema therapy for borderline personality disorder: Wiley Online Library; 2009.
• 14. Saariaho TH, Saariaho AS, Karila IA, et al. Early maladaptive schemas in Finnish adult chronic pain patients and a control sample. Scand J Psychol. 2011;52(2):146-53.
• 15. Saariaho T, Saariaho A, Karila I, et al. Early maladaptive schema factors, pain intensity, depressiveness and pain disability: An analysis of biopsychosocial models of pain. Disabil Rehabil. 2012;34(14):1192-201.
• 16. Henker J, Keller A, Reiss N, et al. Early maladaptive schemas in patients with somatoform disorders and somatization. Clin Psychol Psychother. 2019;26(4):418-29.
• 17. Ribas KHdS, Ribas VR, Barros SSM, et al. The participation of Early Maladaptive Schemas (EMSs) in the perception of pain in patients with migraine: A psychological profile. Dement Neuropsychol. 2018;12:68-74.
• 18. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J rheumatol. 1991;18(5):728-33.
• 19. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000;20(1):9-12.
• 20. Young JE, Brown G. Young Schema Questionnaire-Short Form; Version 3. Psychol Assess. 2005.
• 21. Soygüt G, Karaosmanoğlu A, Çakir Z. Erken Dönem Uyumsuz Şemaların Değerlendirilmesi: Young Şema Ölçeği Kısa Form-3'ün Psikometrik Özelliklerine İlişkin Bir İnceleme. Turk Psikiyatri Derg. 2009;20(1).
• 22. Pulido-Martos M, Luque-Reca O, Segura-Jiménez V, et al. Physical and psychological paths toward less severe fibromyalgia: A structural equation model. Ann Phys Rehabil Med. 2020;63(1):46-52.
• 23. Bucourt E, Martaillé V, Goupille P, et al. A comparative study of fibromyalgia, rheumatoid arthritis, spondyloarthritis, and Sjögren’s syndrome; Impact of the disease on quality of life, psychological adjustment, and use of coping strategies. Pain Med. 2021;22(2):372-81.
• 24. Galvez-Sánchez CM, Duschek S, Del Paso GAR. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag. 2019;12:117.
• 25. Bach B, Lockwood G, Young JE. A new look at the schema therapy model: organization and role of early maladaptive schemas. Cogn Behav Ther. 2018;47(4):328-49.
• 26. Beck JS, Beck AT. Cognitive therapy: Basics and beyond: Guilford press New York; 1995.
• 27. Young JE, Klosko JS, Weishaar ME. Schema therapy: A practitioner's guide: Guilford Press; 2003.
• 28. Arntz A, Jacob G. Schema therapy in practice: An introductory guide to the schema mode approach: John Wiley & Sons; 2017.
• 29. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317-32.