Symptom reporting in people with Fibromyalgia

Research on fibromyalgia frequently relies on self-report. A significant problem in interpreting responses to self-report instruments is that the responses might reflect response style, rather than an accurate reflection of physical condition. 2,583 participants responded to a 24-item internet questionnaire that included questions about symptoms (e.g., abdominal pain, rashes). The mean number of symptoms endorsed was 12.83 (SD = 4.36). Participants were divided into extreme groups- “High endorsers”, who reported more than 18 (n = 346), and “Low Endorsers”, who reported fewer than 9 symptoms (n = 394). High endorsers reported lower education (χ2(3) = 71.74, p < .001) and income (F1, 698 = 109.293, p < .001), and had been divorced more frequently (χ2(3) = 12.76, p < .01). High endorsers visited multiple providers prior to diagnosis (χ2(4) = 77.96, p < .001), indicated providers questioned the legitimacy of their illness (χ2(3) = 40.30, p < .001), and visited emergency rooms more in the past year (χ2(4) = 73.15, p < .001). They were also more likely to have filed a disability claim (χ2(1) = 137.38, p < .001) and to report they were not capable of working (χ2(1) = 141.81, p < .001). Additionally, respondents were asked which of 14 factors contributed to the onset of their condition. High endorsers reported more triggers on average (mean = 3.32, SD = 2.49) than Low Endorsers (mean = 1.74, SD = 1.51, F1, 711 = 445.76, p < .001). High endorsement of triggering events and symptoms suggests the possibility that this is a response set. Alternately, High Endorsers may be experiencing abnormal bodily function in multiple domains, or be vigilant to bodily functions. Research is needed to clarify the basis of responses of people with FM to symptom checklists.

Survey supported by Pfizer and research by NIH:AR044724