Fibromyalgia and Posttraumatic Growth in Women

Research Topic

The given research aims to investigate the dynamic relationships between fibromyalgia syndrome (FS) symptoms and posttraumatic growth (PTG) in mothers diagnosed with this disorder. FS is often described as a functional syndrome that affects soft tissues and is characterized by chronic, diffused musculoskeletal pain, presence of specific tender points that can be identified through palpation, physical weakness, fatigue, sleep disturbances, and a variety of psychological symptoms which are associated with the absence of an apparent physiologic pathology that could provide an apparent explanation for the disorder’s symptomology (Smith et al., 2010). The disease impacts both physical and psychological states of the diagnosed patients and is associated with subjective sensations and complaints which do not have significant objective indicators but substantially influence the individual performance of daily activities and the overall life quality. It is observed that the cases of disorder development are more frequent among the female population (Tulay, Emrullah, Aydin, & Ciledag, 2016). And since women’s social roles are usually interrelated with parenting and development of family bonds, the research of FS’s impacts and evaluation of multiple coping mechanisms in relation to PTG has multiple psychological and social implications.

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The given research argues that there is a significant correlation between FS and posttraumatic stress development while the process of PTG in women has a positive impact on their life performance and family bonds. Nowadays, the etiological factors of fibromyalgia remain unknown, and the disorder is thus of great interest for researchers in a variety of medical disciplines. Along with potential physiological pathogenesis of this disease, such as an endocrine system impairment or a reaction to motor system dysfunction, the psychosomatic mechanism of fibromyalgia occurrence are identified in a number of studies (Chinn, Caldwell, & Gritsenko, 2016; Smith et al., 2010). The presence of depression or social psychological distress in the diagnosed population is frequently observed (Smith et al., 2010). Therefore, the analysis of psychological factors of FS, as well as the disorder-related PTG as a positive psychological change, can help to reveal the nature of fibromyalgia and contribute to the development of an adequate intervention plan for this invisible disorder.

Research Problem

The review of recent research studies devoted to psychological, physiological, and social issues related to FS in women reveals that this multifactorial disease may affect individual life to a large extent and cause low self-esteem and result in relationship problems (Blazquez et al., 2015). The disorder can lead to low relationship satisfaction and aggravation of depressive symptoms. Although many researchers observe the correlation between FS and various severe psychological conditions, such as post-traumatic stress disorder (PTSD), developed due to chronic pain, fatigue, and insufficient sleep (McFarlane, 2010), the gaps in the research of FS-associated PTG and its factors is identified. Moreover, although the studies devoted to FS in women find links between its symptoms severity and duration on multiple maternity aspects including breastfeeding or pregnancy status (Tulay et al., 2016), the body of literature focused on the investigation of FS impacts on families is currently of a limited scope.

Literature Review

Along with pain, FS is characterized by a complex of somatic and psychological impairments while personal identity disorders are observed in over 60% of the diagnosed population (Smith et al., 2010). An average personality profile includes anxiety, depression, and other adverse emotional-behavioral reactions such as the feeling of helplessness, and development of psycho-emotional restrictions (Chinn et al., 2016). Depression and chronic stress can be considered the main factors of FS patients’ life quality decrease. The symptoms and disorder-related psychological distress may provoke melancholic moods, narrowing of the range of interests, and loss of sense of enjoyment and satisfaction. In this way, it is possible to say that FS is associated with post-traumatic symptoms of different gravity type and is deeply and dynamically related to PTSD symptomology.

According to McFarlane (2010), among all psychiatric impairments, PTSD has the strongest link to somatization and medically unexplained pain. Chronically perceived stress increases the risk of severe mental and physical health disruption. And it is possible to say that in women with FS, chronic distress provoked by the continuous perception of somatic symptoms has especially significant implications in the context of the family environment. As stated by Collado et al. (2014), FS entails the increase in job change and job loss, family burdens and economic losses which serve as additional stress factors and may result in the aggravation of psychological condition of a patient. The stress-related depressive moods may cause discord in the relationships and may also affect the psychological state of relatives in a negative way (Collado et al., 2014). In this way, the emotional problems of one family member influence his/her close ones and increase their stress level as well. Moreover, a caregiver’s inability to cope with psychosocial and physiological stressors may result in emotional, physical, and psychological neglect and maltreatment of children and serious problems in family relationships (Steeger, Cook, & Connell, 2016). As a result, the excess perception of FS-related stress be women can provoke adverse child developmental outcomes which may lead to the social-emotional impairments and behavioral problems affecting the maltreated individuals throughout their lifespan (Steeger et al., 2016).

Based on the review of potential FS adverse impacts on individuals and family, the investigation of psychological coping mechanisms stimulated by cognitive behavioral intervention and evaluation of PTG factors have great significance. PTG is associated with significant positive changes and stabilization of ability to perform routine daily activities triggered by particular subjective factors. PTG is not usually perceived as the goal in itself but is primarily regarded as an unexpected result manifested in the transformation of personal values, the increase of sensitivity to family members and other social actors, the development of self-belief, and the confidence building (Tedeschi & Blevins, 2015). The researchers identify several potential coping mechanisms that may lead to psychological sustainability: decrease in exposure to risk factors, reduction of negative reactions, maintenance of the sense of personal dignity and effectiveness, and perception of new opportunities (Tedeschi & Blevins, 2015). It is observed that PTG may have a positive systematic impact on a patient’s health condition, and various PTG-related techniques, such as the development of mindfulness (Tedeschi & Blevins, 2015), can lead to the achievement of psycho-emotional sustainability, family relationship improvement, and overall life quality increase.

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Theoretical Framework

The major conceptual frameworks of the study are the attachment theory and the theory of PTG. The attachment theory suggests that through the early interrelations with caregivers, children learn to predict and understand the emotions of others (Muller, Thornback, & Bedi, 2012). Children whose figures of attachment are responsive form a positive image of their caregivers, and the sense of secure attachment helps children to commence developing a sound self- and social identity (Muller et al., 2012). In this way, the early relationship experiences define the patterns of individuals’ attachment organization that largely affect their social-emotional abilities in adolescence and adulthood.

Since early experiences of socialization and family bonding largely affect individual development throughout the lifespan, the negative effects of FS on mothers’ ability to build meaningful relationships with their children may have an adverse impact on child development. It is observed that early exposure to the attachment-related traumas caused by neglect or psychological maltreatment creates a predisposition to individual social malfunctioning (Muller et al., 2012).

According to the theory of PTG, the psychological growth of an individual exposed to a traumatic experience is based on the activation of internal resources, strengthening of social connection and work on their quality, and in-depth restructuring of personal values, beliefs, and philosophy (Tedeschi & Blevins, 2015). The process of PTG is a conscious cognitive-emotional evaluation of life events and situations. To facilitate PTG, it is important to provide a person with favorable external factors such as high-quality social support and opportunity for self-expression. Therefore, psychological counseling of FS patient is an essential part of the disorder’s symptoms alleviation. Moreover, the detailed investigation of PTG factors in FS may help to develop an adequate treatment strategy and achieve greater patient outcomes.

Contributions to Theory

Literature Review

The articles selected for the literature review are the quantitative and qualitative studies devoted to the analysis of FS experience in women and FS impacts on families of the diagnosed patients.

Wuytack and Miller (2011) describe the subjective perceptions of FS impacts on life performance and effects of manual therapy on symptoms manifestation experienced by the female patients. In the qualitative research, the study participants reported the negative effects of FS on their personal life and occupation, the ability to build social relationships, and perceptions of future opportunities (Wuytack & Miller, 2011). The disorder is substantially interrelated with the loss of own social and personal identity that leads to the perpetual psychological discontent and emotional depression. It is observed that while in some cases FS may provoke consolidation of family bonds caused by relatives’ support and involvement, the disorder has a great potential to alter family relationships in a negative way and induce separation of family members (Wuytack & Miller, 2011).

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Through the evaluation of health indicators of patients with FS and their spouses, Dogan, Aytur, and Atbasoglu (2010) found out that the disorder largely affects not only patients’ health conditions but the physiological and psychological state of their relatives as well. It is observed that the husbands of chronically ill female patients have poorer health status than the husbands of healthy women (Dogna et al., 2010). Moreover, chronic disease is regarded as a premise for the loss of communication in the family and the consequent deterioration of relationships’ quality provoked by emotional distress.

Theoretical Implications

The analyzed articles are significant for the research of FS among female population and evaluation of the disorder’s immediate and long-term impacts on family relationships. While quantitative methodology allows the attainment of accurate and objective data that may be generalized, qualitative analysis of subjective phenomena helps to obtain in-depth understanding of FS perceptions based on the personal experience of patients. Therefore, the evaluation of different types of research studies can help to expand the comprehension of psychological and social FS-related issues and correlate them with PTG concepts.

Ethical Considerations

The assessment of FS impacts on individual and family life has many ethical implications. Since FS diagnosis may create a significant distress in women and their families, the data accumulated through multiple data collection and data analysis tools is associated with a high level of study participants’ vulnerability and contains confidential information. Therefore, a careful use of the obtained research information is a necessary requirement.

The assessment of a sample’s psychological indicators should comply with the principles of informed consent and confidentiality. The disclosure of data obtained through examination of psychosocial variables may have a significant impact on the social and psychological identity of the participants. Therefore, by following the principle of confidentiality, it is possible to reduce the opportunity of damaging the participants’ well-being.

At the same time, when the qualitative method of the literature review is implemented, the major ethical consideration is the compliance with the APA standards of referencing and formatting the retrieved information. When a study implied no direct contact with study participants, the authors thus cannot go against the ethical principles of psychological assessment, including informed consent and private information abuse, but they need to pay respect to work of their colleague-researchers and mention their authorship when citing a statement or an idea.

References

Blazquez, A., Ruiz, E., Aliste, L., García-Quintana, A., & Alegre, J. (2015). The effect of fatigue and fibromyalgia on sexual dysfunction in women with chronic fatigue syndrome. Journal Of Sex & Marital Therapy, 41(1), 1-10. Web.

Chinn, S., Caldwell, W. & Gritsenko, K. (2016). Fibromyalgia pathogenesis and treatment options update. Current Pain and Headache Reports, 20(25), 1-10. Web.

Collado, A., Gomez, E., Coscolla, R., Sunyol, R., Solé, E., Rivera, J.,… Castells, X. (2014). Work, family and social environment in patients with Fibromyalgia in Spain: An epidemiological study: EPIFFAC study. BMC Health Services Research, 14(1). Web.

Dogan, S. K., Aytur, Y. K., & Atbasoglu, C. (2010). Assessment of the relatives or spouses cohabiting with the fibromyalgia patients: Is there a link regarding fibromyalgia symptoms, quality of life, general health and psychologic status? Rheumatology International, 31(9), 1137-1142. Web.

McFarlane, A. C. (2010). The long-term costs of traumatic stress: Intertwined physical and psychological consequences. World Psychiatry, 9(1), 3-10. Web.

Muller, R. T., Thornback, K., & Bedi, R. (2012). Attachment as a mediator between childhood maltreatment and adult symptomatology. Journal of Family Violence, 27(3), 243-255. Web.

Smith, B. W., Papp, Z. Z., Tooley, E. M., Montague, E. Q., Robinson, A. E., & Cosper, C. J. (2010). Traumatic events, perceived stress and health in women with fibromyalgia and healthy controls. Stress and Health, 26(1), 83-93. Web.

Steeger, C. M., Cook, E. C., & Connell, C. M. (2016). The interactive effects of stressful family life events and cortisol reactivity on adolescent externalizing and internalizing behaviors. Child Psychiatry & Human Development, 1-10. Web.

Tedeschi, R. G., & Blevins, C. L. (2015). From Mindfulness to Meaning: Implications for the Theory of Posttraumatic Growth. Psychological Inquiry, 26(4), 373-376. Web.

Tedeschi, R. G., & Blevins, C. L. (2015). From mindfulness to meaning: Implications for the theory of posttraumatic growth. Psychological Inquiry, 26(4), 373-376. Web.

Tulay, K. T., Emrullah, T., Aydin, A., & Ciledag, O. F. (2016). The effect of fibromyalgia syndrome to gravidity, parity and duration of breastfeeding; A prospective study from Turkey. Pakistan Journal Of Medical Sciences, 32(3), 545-549. Web.

Wuytack, F., & Miller, P. (2011). The lived experience of fibromyalgia in female patients, a phenomenological study. Chiropractic & Manual Therapies, 19(1), 22. Web.

Fibromyalgia and Posttraumatic Growth in Women
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