The Effects of Self-Efficacy on Depression and Pain in Fibromyalgia Syndrome: Does Initial Depression Matter?

Abstract Objective: Fibromyalgia syndrome [FMS] is a chronic pain condition of unknown etiology. Non-myalgic aspects of the disorder have become increasingly focal in its evaluation. Research has suggested that subgrouping FMS patients based on factors other than pain may abet diagnostic and interventional processes. Self-efficacy and depression are two such constructs that appear to be important in FMS. However, it is not known whether the consequentiality of self-efficacy in FMS is dependent on depression. The present study examined the pathways among depression, self-efficacy and pain, in a large sample of depressed and non-depressed FMS patients over a one-year timeframe to determine whether differential relationships existed. Method: Participants completed assessments of pain intensity, depression and self-efficacy at baseline, 6 months and 1 year as part of an intervention study. Approximately half of the participants met the cutoff for depression in chronic pain populations on the Centers for Epidemiologic Studies Depression Scale. Results: Participants who were depressed at baseline experienced a general decline in pain intensity and depression, whereas depression and pain for non-depressed participants appeared to be far more stable across time. Though self-efficacy was a significant predictor of changes in both pain and depression for depressed participants, self-efficacy did not predict changes in pain for non-depressed participants. Conclusion: Our findings support subgrouping FMS patients based on psychological factors. The results indicated that relationships between pain, depression and self-efficacy differed between depressed and non-depressed participants, implying that individuals with FMS and depression may benefit most from interventions that aim to decrease lability and increase self-efficacy for the most challenging times.