Masters Theses & Projects
- Kircher, J. (Thesis, Psychology, 2016). Social support as a moderator between stress and chronic pain in fibromyalgia
ABSTRACT: The etiology of fibromyalgia is unknown; thus, research on the psychosocial factors contributing to the symptomatology of fibromyalgia is an important area of study. Research indicates that perceived stress and perceived social support affect the experience of chronic pain, but the relationship between the two has been under-studied. The purpose of this study is to explore the association between perceived stress, perceived social support and chronic pain among older adults with and without fibromyalgia. Social support was tested as a moderator of the relationship between stress and pain. Results revealed that social support did not significantly moderate the relationship between stress and pain in either the fibromyalgia or control group. However, stress was found to be strongly associated with pain among people with fibromyalgia. In contrast, among those without fibromyalgia, social support was related to chronic pain but stress was not. These findings demonstrate that perceived stress and perceived social support may play an important role in the expression of chronic pain among older adults. Future research should further investigate the impact psychosocial factors have on chronic pain disorders, more specifically fibromyalgia.
- Lynch, K. (Thesis, Psychology, 2016). Examining negative mood regulation expectancies, fibromyalgia, childhood trauma, and depression.
ABSTRACT: Fibromyalgia (FM) is a chronic pain condition that affects 2% to 4% of the population. Many patients with FM report a history of depression and child abuse. Childhood abuse affects both physical and mental health in adulthood. Negative mood regulation expectancies (NMRE) are one’s belief that one can alleviate his or her negative moods (Catanzaro & Mearns, 1990). People with higher NMRE experience fewer mental and physical symptoms in adulthood following childhood maltreatment. My study investigated how NMRE, depression, childhood trauma, and FM were related. The study expected to find that more severe child abuse would be associated with lower NMR Scale scores, more depression, and more FM symptoms. NMRE was also expected to mediate the relationships of child abuse with both depression and FM symptoms. Questionnaires were completed by 164 participants with an FM diagnosis (n = 34) or a history of child abuse (n = 130). Participants were sampled from online support groups for FM and child abuse. More severe child abuse was associated with greater depression, but it was unrelated to NMRE and FM symptoms. Higher NMRE were associated with lower depression, but they had no association with FM symptoms. This study did not support past research suggesting that NMRE may influence health symptoms. Limitations include that the current study had few participants and many incomplete responses to the questionnaires. Future research should include non-self-report measures and should collect questionnaire data at multiple sessions to better understand causality among the variables.
- Quinn, T. (2015). Associated benefits of positive affect on cognitive and physical health among adults 50+ with and without fibromyalgia. Department of Psychology. Proquest: 1605287
ABSTRACT: Fibromyalgia (FM) is a chronic pain condition most prevalent in women, particularly over the age of 50. Chronic conditions, including pain, affect more than half of adults over 65. Such conditions can contribute to functional limitations that lead to disability, illness, and death. Currently, the U.S. faces a national healthcare crisis that can be attributed to the deteriorating cognitive and physical health of older adults. Exploring ways to promote healthy behaviors that may prevent or delay such conditions should be of paramount importance. Past literature exploring the benefits of positive mood has linked elevated positive affect (PA) with improved memory, physical recovery, and habitual activity engagement. The focus of this study was to identify potential benefits of heightened levels of PA on various domains of cognition, physical performance, and perceived cognitive and physical health. A total of 94 individuals 50+ years of age with and without FM participated in the current investigation. A series of objective and subjective cognitive and physical assessments were administered. Results from the study indicate associated benefits of heightened PA for FM and non-FM individuals. For FM individuals, higher PA was associated with fewer reported problems with concentration and improved working memory performance. For non-FM individuals, higher PA was associated with fewer functional limitations, superior lower extremity strength, and fewer reported troubles with memory and concentration.
- Gutierrez, A. (2015). Effects of Tomando Control de su Salud on health status, symptoms, and self-efficacy among Spanish-speaking Latino adults with chronic widespread pain. Department of Health Science.
- Creek, J. (Thesis, Psychology, 2015). Social engagement and episodic memory in older adults.
ABSTRACT: Cognitive aging in older adults ranges from mild to severe and typically results in attention and memory impairments, especially for episodic memory. Because there is currently no effective treatment or cure for cognitive decline, preventative measures have gained increasing attention. In this field of research, social engagement shows a positive association with cognitive performance; however, the link between social engagement and episodic memory has yet to be thoroughly investigated. Data from the six-year Fibromyalgia (FM) study at California State University, Fullerton were used to determine the association between social engagement and episodic memory. A 10-item questionnaire was used to measure social engagement level and the 10-item word list from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) was used to assess immediate recall, delayed recall, and delayed recognition. The sample (n = 50) consisted of 13 males and 37 females, ages ranging from 50 to 87 years (M= 66.04, SD = 8.58). Bivariate correlation analyses revealed that there was no significant relationship between CERAD scores and level of social activity, although the relationship between social activity and delayed recall approached significance in 2008 (r = -.27, p = .065). Moreover, a hierarchical regression analysis indicated that social activity in 2014 did not significantly predict CERAD six-year change scores while controlling for baseline social activity level in 2008. The results suggest that the expected positive relationship between social engagement and episodic memory in older adults does not exist
- Fuimara, M. (2014). Cognitive performance subgroups in fibromyalgia. IBSN:
ABSTRACT: Fibromyalgia (FM) is a chronic condition described as widespread pain and tenderness in at least 11 of the 18 specified tender points in the body (Wolfe, Ross, Anderson, Russell, & Herbert, 1995). Fibromyalgia is believed to be prevalent in approximately 2% to 7% of the population, with a female-to-male diagnosis ratio of approximately 9:1 (Lawrence et al., 2008; Wolfe et al., 1995). Individuals with FM often present an array of physical, cognitive, and emotional symptoms. While such symptoms are discussed, the study focused on the cognitive component of the condition. This study was modeled after the procedures of the Libon and colleagues experiment (2010) on Complex Regional Pain Syndrome but instead examined cognitive performance deficits associated with FM, and the possibility of subgroups existing within this domain. This research used secondary data from a previous study (Jones, Rutledge, & Aquino, 2008) where participants were given a battery of neuropsychological and physical measures. From this secondary data, 68 individuals with FM (M age = 59.5 years; 92.6% women) were included in the analysis. A two-step cluster analysis was conducted to determine if subgroups were found within FM based on participants' cognitive test scores. A multivariate analysis of variance was used to determine if there were any significant differences between the potential subgroups. The results suggested that the treatment of FM is more complex than currently believed because of the varying degrees of cognitive test performance and severities of FM symptomology that exist within the disorder.
- Nasir, M. (2014). Effects of continuous wave ultrasound therapy on muscular pain intensity and functionality in people of southern california with fibromyalgia. ISBN:
ABSTRACT: Fibromyalgia syndrome (FMS) is a chronic disease that typically presents with musculoskeletal pain, fatigue, sleep problems, and cognitive problems, often with many associated overlapping conditions. This difficult-to-treat condition often requires multiple modalities to control pain symptoms; one such modality is ultrasound therapy. No study has been conducted to investigate the effects of continuous wave ultrasound therapy on FMS. Thus, the purpose of this randomized controlled pilot study was to investigate the effect of six weekly sessions of continuous wave ultrasound therapy on muscle pain and functionality among participants living with FMS. Twelve participants (1 male; 11 females) comprised the intervention group ( n = 8) and placebo group (n = 4). Scores for selected muscle area pain and functionality were compared at baseline and four weeks after the final session. Results revealed that continuous wave ultrasound therapy is effective in reducing muscle pain intensity (p < 0.01) and improving functionality (p < 0.01) among people with FMS. Further studies with larger samples are required to assess long-tenn outcomes of this treatment modality.
- Reuben, P. (2014) Hypersensitivity in fibromyalgia. School of Nursing.
- Cortez, F. A. (2014). Cognitive and physical functioning in older adults with and without fibromyalgia over time. ISBN: 9781303668166
ABSTRACT: Fibromyalgia (FM) is a chronic pain disorder that affects both cognitive and physical functioning. It is a salient issue for older adults, as larger proportions of them will be diagnosed as they age. Cognitive and physical performance as well as a symptom battery in older adults with and without FM were assessed over a four year period using three time points (T1, T2, T3), measured every two years. Measures of cognitive function included tests for the following abilities: orientation, concentration, attention/executive function performance, working memory, psychomotor speed, set-shifting/complex sequencing, verbal fluency, problem solving and cognitive competence. Physical performance tests measured balance, agility, and functional mobility. A repeated measures analysis of variance (ANOVA) with Kenward-Rogers (1997) adjustment of the degrees of freedom and a stringent p- value of 0.01 was used to assess mean changes over time. It was expected that FM older adults would perform worse on all measures than their healthy counterparts, controlling for age, education, and body mass index (BMI). There were distinct group differences in physical performance and symptoms; however, the cognitive assessments showed sporadic evidence of group differences. While both groups were anticipated to decline T1 to T2, T2 to T3, and T1 to T3 on the cognitive and physical measures with FM older adults declining at a faster rate, there was inconclusive evidence of change over time for either group.
- Aquino, J. K. (2013). Effect of group empowerment drumming on cognitive performance and mood in women with fibromyalgia. ISBN:
ABSTRACT: Fibromyalgia (FM) is characterized by chronic, widespread pain usually accompanied with mood and cognitive dysfunction. No studies have investigated the effects of group empowerment drumming on cognition, mood, and symptom severity in women with FM. Thus, the purpose of this randomized controlled trial was to determine the effects of a 6-week group empowerment drumming protocol compared to an educational program on cognitive performance and mood states in women with fibromyalgia. A secondary purpose was to determine the effects of the intervention on common symptoms of FM. Twelve women with FM were matched on age, education, and physical activity level and randomly assigned to the drumming intervention group ( Mage = 48.0 years) or the educational control group (Mage = 54.2 years). Baseline measures consisted of cognitive performance measures, the Profile of Mood States - Brief, the Pain Catastrophizing Scale, and the Revised Fibromyalgia Impact Questionnaire (FIQR). After six weeks of drumming, Wilcoxon signed-rank tests revealed significant improvements in working memory and attention. Other domains of cognitive performance, mood states, and symptom severity did not significantly improve over time; however, trends suggest positive outcomes after participating in the intervention. Depression/dejection and vigor/activity were found to differ significantly between groups such that those in the drumming group reported better mood states after six weeks. Overall impact, symptom severity, and total FIQR scores were found to be significantly lower for the drumming group than for the educational group. Unexpectedly, the educational group improved significantly more than the drumming group on processing speed, complex scanning, and visual tracking and on magnification of pain. This pilot study demonstrated preliminary results that group empowerment drumming may be better than an educational program at improving certain aspects of cognitive performance, mood states, and overall impact of FM. Mixed results suggest that education and drumming may improve overall quality of life of women with FM. Future studies should attempt to enroll larger samples and assess long-term outcomes following a group empowerment drumming intervention.
- Ko, Y. (2013). A comparison of central sensory reception and integration abilities between older adults with and without fibromyalgia. ISBN:
ABSTRACT: This study aimed to investigate differences in central sensory reception and integration abilities between older adults with and without Fibromyalgia (FMS), and to investigate influence of a secondary cognitive task on postural control in altered sensory environments. The performances of 10 community-residing older adults with FMS ( Mage = 65.49 ± 4.72) were compared with eight age-matched adults without FMS (HC; Mage = 66.08 ± 4.83) across two task conditions (single, dual) using the Sensory Organization Test® (SOT). In the dual-task condition, a word generation task was performed with the SOT. Although between-group difference for Composite Equilibrium Score in the single task condition was not statistically significant, a large effect size (Cohen's d = .96) suggested a practical difference between groups in sensory reception and integration abilities. Due to multiple falls occurred in the FMS group in sensory conditions 5 and 6 across both task conditions, single trial Equilibrium Scores (ESs) for sensory conditions 1 through 4 were compared between groups across task conditions. The results revealed a significant three-way interaction for Task, Sensory Condition, and Group ( p = .04), a two-way interaction between Task and Group (p = .03), and a main effect for Sensory Condition (p < .01). Single trial ESs for both groups declined significantly in complex sensory conditions across both task conditions; a greater decline was evident for the FMS group in sensory condition 4 with dual-task. A significantly higher percentages of falls was evident for the FMS group in condition 6 in both task conditions. The FMS group also reported significantly higher levels of fibromyalgia-related symptoms when compared to the HC group ( p < .01). Significant correlations were found between the single trial ESs for sensory conditions 4 through 6 and different symptoms (r s = -0.76 to -0.48). In conclusion, postural stability in the FMS group were most adversely affected when vestibular inputs were the primary source for maintaining postural stability. In addition, the increased intensity of symptoms may be related to reduce postural stability in older adults with FMS, particularly when performed with a cognitive task in complex sensory environments.
- Bruk, L. (2012). Leisure activities and depression in people with and without fibromyalgia. Department of Psychology.
ABSTRACT: The objective of the present study was to analyze the association between the symptoms of fibromyalgia (FM, chronic pain symptoms in particular) leisure activities (as measured by a Social/Leisure Activity questionnaire), and depressive symptoms (as measured by the Beck Depression Inventory II). The current study used both cross-sectional and longitudinal data from two waves of a parent study (Jones, Rutledge, & Aquino, 2010; Rutledge, Cherry, Rose, Rakovski, & Jones, 2010). Secondary analyses of data were performed using a sample of 70 participants with FM (93% female, mean age 60 years) and 76 participants without FM (67% female, mean age 68 years). To get a longitudinal perspective, we used data from participants with FM who participated in both the first and second waves of data collection (N = 78). Participants diagnosed with FM had higher levels of depression and participated less in leisure activities than those without FM. An association was found between leisure activities (specifically, overall and active leisure) and depressive symptoms. However, logistic regression analyses displayed no significant association between participation in leisure activities in Wave 1 (overall, active, or passive) and later depressive symptoms in Wave 2. The present findings encourage the integration of active leisure activities in the daily routines of individuals with FM.
- Mbiam, M. (2012). Differences in medication use between older adults aged 50+ with and without fibromyalgia. [MPH Project]. Department of Health Science.
- Follick, B. (2012). Patterns of performance within fibromyalgia: Identifying subgroups. ISBN:9781267348869
ABSTRACT: Fibromyalgia (FM) is a multisystem disorder characterized by widespread musculoskeletal pain and a host of other symptoms. Although FM was originally conceptualized as a musculoskeletal disorder consisting primarily of physical symptoms, it is now understood that individuals with FM experience a host of concordant symptoms including a decline in cognitive functioning, and difficulty with psychological health (Bennett, Jones, Turk, Russell, & Matallana, 2007). This study sought to investigate the possible existence of subgroups within an FM sample based on performance data gathered through the administration of physical and cognitive performance measures, as well as self report psychological measures. Participants (n=57) were recruited from the general community and were required to provide documentation of having met the criteria for diagnosis of FM. Analysis was completed using Ward's method of hierarchical cluster analysis (Ward, 1963). A four cluster solution was chosen for its level of interpretability. Cluster I participants exhibited high physical and cognitive performance and low psychological symptoms. Cluster II participants exhibited low physical and cognitive performance and high psychological symptoms. Cluster III participants exhibited moderate physical and cognitive performance and low psychological symptoms. Cluster IV participants exhibited moderate physical and cognitive performance and high psychological symptoms. The results of this study support the existence of subgroups amongst the fibromyalgia population based on psychological symptoms and levels of cognitive and physical performance. These results provide a better understanding of the variability of symptoms experienced by individuals with fibromyalgia.
- Mc, L. H. (2012). The effects of fibromyalgia on social support: A group interview analysis. ISBN:
ABSTRACT: This study explored the experience of social support in a small group of individuals with fibromyalgia (FM). Ten females over age 50 and diagnosed with FM were recruited for participation in a group interview on the topic of social support. This study utilized qualitative methodology inspired by the empirical phenomenological model to analyze data obtained from the group interview.
Three central themes related to social support emerged from participants' experiences: barriers and gateways to support, responses to adequate and inadequate support, and characteristics of support networks. The first theme described circumstances that prevented participants from or enabled them in getting high quality support. The second theme described participants' responses to getting adequate and inadequate support from social network members. The third theme described who and under what circumstances network members were sought for support, and network member behaviors experienced by participants as either supportive or unsupportive.
Results demonstrate how aspects of having FM can interfere with the mental and physical benefits of social support. Social network factors contributing most appear to be rooted in lack of disease acceptance and failure to provide flexible support to persons with FM. Individual factors interfering with social support include shutting down communication, downplaying symptom severity, and not communicating needs to others.
- Levine, B. J. (2012). A case sudy examining coping strategies, family environment, functioning, and quality of life in adolescents with juvenile primary fibromyalgia syndrome. ISBN:
ABSTRACT:Juvenile primary fibromyalgia syndrome (JPFMS) is characterized by widespread persistent musculoskeletal pain, fatigue, cognitive impairment, stiffness, and sleep disturbance. Adolescence is a crucial developmental stage when children make decisions about their future and prepare for adulthood, such as educational and career goals, social roles, and relationships. Living with constant pain and fatigue can have a significant impact on a child's development and future. The focus of this study was on coping strategies and family environment, and how these important factors in an adolescents' life may be associated with multiple areas of functioning and well-being.
Two female adolescents and their mothers completed questionnaires assessing quality of life, functioning, coping, pain, fatigue, and family environment. Results are reported in a case study format. Both adolescents reported very poor physical functioning, substantial problems with fatigue, keeping up with teens their own age, cognitive functioning, and school functioning. Each adolescent had a very different coping profile and family environment profile.
- Taulbee, C. M. (2011). The association between fibromyalgia symptoms and irritable bowel syndrome subtypes. ISBN:
ABSTRACT: The objective of the thesis is to evaluate the differences in FM symptom intensity levels by IBS subtypes, and increase knowledge of medication discontinuation for common FM and IBS medication types. A 2011, internet survey sponsored by the National Fibromyalgia Association in which data on 620 persons with FM and IBS was analyzed. Kruskal-Wallis tests and follow-up comparison of means were employed for analysis of FM symptom differences. Chi-Square analyses and descriptive statistics were employed for analysis of medication discontinuation.
The results of this sample of women who had been diagnosed with IBS and FM for one year or more represented mainly Caucasian, middle-aged, married adults from all 50 states in the U.S. IBS-A was the most prevalent subtype. Three symptoms that significantly differed among IBS subtypes were: not feeling rested after sleep , depression , and dizziness/fear of falling. Medication discontinuation was not significantly associated with IBS subtypes. Analysis of SSRIs and tricyclics, both medications used to treat depression, show higher frequencies of discontinued use than other common FM and IBS medications; reasons for discontinued were negative side effects. Study results demonstrate that persons with IRS-A experience depression and non-restorative sleep symptoms more severely than persons with IBS-D or IBS-C. Further research for symptom management among persons with FM and IBS should focus on depression and non-restorative sleep and acknowledge the higher prevalence of IBS-A.
- Vuchetich, L. (2012). Change in physical performance as a predictor of cognitive changes in fibromyalgia. ISBN:
ABSTRACT: Fibromyalgia (FM) is a chronic pain condition affecting primarily females (90%). The present study is one of the first to explore change in physical and cognitive performance in individuals with FM over time. In particular, how change in physical performance predicts change in cognitive performance over time. Secondary analyses were conducted using data collected in 2008 and 2010. Change scores, correlations and hierarchical regressions were used. Physical measures in the analyses include: Fullerton Advanced Balance Scale, Senior Fitness Test 6-Minute Walk (aerobic endurance), and the 30-Foot Walk (fast walk velocity). Cognitive measures include: Digit Span Forward/Backward, Trail Making Test, Stroop Color-Word Test (attention/executive function) and Digit Symbol Substitution Test (processing speed). The present study found that change in physical performance was not predictive of change in cognitive performance over time. In fact, most of the predictability of change in cognition came from age; not from FM status, physical activity level, or change in physical performance on measures of balance, endurance, or fast walk velocity.
- Bateham, A. (2011). Functional social support and well-being in adults with and without fibromyalgia. ISBN: 9781124698137
ABSTRACT: Fibromyalgia syndrome (FM) is a chronic pain condition that has been found to impact a person's emotional, cognitive, and perceived physical functioning. Social support has been linked to improved functioning for a variety of health conditions. This study investigated whether specific types of social support (emotional, tangible, affectionate, and positive social interaction) had a relationship with depression, executive functioning, and perceived physical functioning in a sample of 70 people with FM (age M = 67.9, SD = 8.74) and 76 people without FM (age M = 59.6, SD = 7.58). Demographic information was collected and participants were assessed on multiple measures including the MOS-SSS, BDI-II, a verbal fluency task, and the CPF. Controlling for demographic covariates, multiple regression analysis revealed overall social support and emotional social support were significant moderators of depression for the FM group. Tangible social support was not found to be a moderator of any of the outcome measures. Affectionate social support was found to he a marginally significant moderator ( p = .091) of perceived physical functioning. Positive social interaction was found to be a significant moderator of executive functioning and a marginally significant moderator of perceived physical functioning (p = .067). The results of this study suggest that having a variety of types of social support may he more beneficial for people with FM than having abundance of any single type of support.
- Medication and cognition among persons with FM, Erika Callahan, Master of Arts in Psychology
- Fox, C. (2011). Impact of fibromyalgia and hypertension status on cognitive decline in people aged 50+. ISBN:
ABSTRACT: Fibromyalgia (FM) is a syndrome characterized by widespread pain that has also been associated with concentration and accelerated cognitive decline. Many patients suffering from FM also have co-morbid conditions such as hypertension which has been shown to have an effect on the normal process of cognitive decline associated with aging. The purpose of this study was to evaluate whether or not there is an interaction effect in the cognitive decline in adults aged fifty and older with both conditions. The volunteers in this study were from a larger study that measured cognitive function in adults aged 50 and older to evaluate improvement with regular physical activity in groups with and without FM. The dependent variables were cognitive measures of executive function (Stroop Color Word Test; Trials A/B; Digit Span F/B) and processing speed (Stroop C; Digit Span Digit Symbol Substitution Test). There were three hypotheses: (a) hypothesis 1--Participants with hypertension will have lower executive function and processing speed than participants without hypertension; (b) hypothesis 2--Participants with FM will have lower executive function and processing speed than participants without FM; and (c) hypothesis 3--the combination of FM and hypertension will have an interactive effect on executive function and processing speed. The first and third hypotheses were not supported by this study. The second hypothesis, however, was supported and after adjusting for age, FM participants, scores reported lower executive function and processing speed on TRAILS A and the digit symbol substitution test.
- Cognitive impairments in persons with fibromyalgia, M. Fuimara, Master of Arts in Psychology
- Marsh, K. (2011). Reliability of the sensory organization test(RTM) as a measure of sensory reception in older adults with fibromyalgia. ISBN: 9781124895406
ABSTRACT: Although balance problems have been widely reported among individuals with fibromyalgia (FM) (Bennett et al., 2007), no test has presently been established as a reliable tool to identify impairments in central sensory reception and integration as a possible source of the perceived imbalance. Therefore, the purpose of this study was to establish test-retest reliability of the Sensory Organization Test ® (SOT) as a measure of central sensory impairment in a sample of 35 adults (33 women and 2 men) with a confirmed diagnosis of FM ranging in age from 28 to 73 years. The mean intraclass correlation coefficient (ICC) for the mean SOT equilibrium composite score demonstrated good reliability (ICC = .85). However, the ICC values for mean equilibrium scores in each of the six conditions ranged from poor (ICC = .42 in condition 1) to good agreement (ICC = .86 in condition four). The presence of FM-related symptoms may have influenced the magnitude of reliability, suggesting the need of additional study to isolate whether the presence of fatigue, stiffness, pain, and stress varies significantly between the first test and the second test of the SOT®. Comparisons made between participant data and age-matched control groups of individuals without FM suggested that the overall sensory reception and integration abilities of both groups were comparable in the younger age classification (28 to 59 years). However, significant group differences in mean equilibrium scores were found for conditions three and six, as well as the mean equilibrium composite score in the older age classification (61 to 69 years).
- Relationships among depression, BMI, pain, and quality of life in overweight Hispanics with chronic pain, Katelyn Reynolds, Master of Science in Nursing
- Use of conscious and unconscious distraction as a means of self-management in women with FM, Fernando Serrano, Master of Science in Nursing