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Cited by 428Fibromyalgia and Chronic Fatigue Syndrome ResearchPsychosomatic Disorders and Their TreatmentsMyofascial pain diagnosis and treatment

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Subgrouping of fibromyalgia patients on the basis of pressure‐pain thresholds and psychological factors

Giesecke, Thorsten, Williams, David A., Harris, Richard E., Cupps, Thomas R., Tian, Xiaoming, Tian, Thomas X., Gracely, Richard H., Clauw, Daniel J.·2003·Arthritis & Rheumatism
DOI 10.1002/art.11272
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Abstract

Objective: Although the American College of Rheumatology (ACR) criteria for fibromyalgia are used to identify individuals with both widespread pain and tenderness, individuals who meet these criteria are not a homogeneous group. Patients differ in their accompanying clinical symptoms, as well as in the relative contributions of biologic, psychological, and cognitive factors to their symptom expression. Therefore, it seems useful to identify subsets of fibromyalgia patients on the basis of which of these factors are present. Previous attempts at identifying subsets have been based solely on psychological and cognitive features. In this study, we attempt to identify patient subsets by incorporating these features as well as the degree of hyperalgesia/tenderness, which is a key neurobiologic feature of this illness. Methods: Ninety‐seven individuals meeting the ACR criteria for fibromyalgia finished the same battery of self‐report and evoked‐pain testing. Analyzed variables were obtained from several domains, consisting of 1) mood (evaluated by the Center for Epidemiologic Studies Depression Scale [for depression] and the State‐Trait Personality Inventory [for symptoms of trait‐related anxiety]), 2) cognition (by the catastrophizing and control of pain subscales of the Coping Strategies Questionnaire), and 3) hyperalgesia/tenderness (by dolorimetry and random pressure‐pain applied at suprathreshold values). Cluster analytic procedures were used to distinguish subgroups of fibromyalgia patients based on these domains. Results: Three clusters best fit the data. Multivariate analysis of variance (ANOVA) confirmed that each variable was differentiated by the cluster solution (Wilks' λ [degrees of freedom 6,89] = 0.123, P < 0.0001), with univariate ANOVAs also indicating significant differences (all P < 0.05). One subgroup of patients (n = 50) was characterized by moderate mood ratings, moderate levels of catastrophizing and perceived control over pain, and low levels of tenderness. A second subgroup (n = 31) displayed significantly elevated values on the mood assessments, the highest values on the catastrophizing subscale, the lowest values for perceived control over pain, and high levels of tenderness. The third group (n = 16) had normal mood ratings, very low levels of catastrophizing, and the highest level of perceived control over pain, but these subjects showed extreme tenderness on evoked‐pain testing. Conclusion: These data help support the clinical impression that there are distinct subgroups of patients with fibromyalgia. There appears to be a group of fibromyalgia patients who exhibit extreme tenderness but lack any associated psychological/cognitive factors, an intermediate group who display moderate tenderness and have normal mood, and a group in whom mood and cognitive factors may be significantly influencing the symptom report.

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Crossref · 10.1002/art.11272

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Research works printed but not linked: 2

  1. Bennett RM, 1991, A multidisciplinary approach to fibromyalgia management: balanced approach provides small but significant gains, J Musculoskeletal Medicine, 8, 21
  2. Spielberger CD, 2000, Preliminary manual for the State‐Trait Personality Inventory (STPI)

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Metadata

Authors
Giesecke, T., Williams, D. A., Harris, R. E., Cupps, T. R., Tian, X., Tian, T. X., Gracely, R. H., & Clauw, D. J.
Affiliations
  • University of Michigan (US)
  • Georgetown University (US)
ORCID
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
2003-10
Volume
48
Issue
10
Pages
2916-2922
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
DOI
10.1002/art.11272
OpenAlex
W2086137478
Cited by
424
References
30
Citations by year
2026: 6 · 2025: 7 · 2024: 5 · 2023: 13 · 2022: 10 · 2021: 12 · 2020: 19 · 2019: 7 · 2018: 16 · 2017: 19 · 2016: 22 · 2015: 19 · 2014: 25 · 2013: 32 · 2012: 23
FWCI
7.07
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6 d)
Locations
  • Arthritis & Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
  • Department of Army (DAMD 17-00-2-0018)
  • NIH (5-R01-AT 000004-02)
  • General Clinical Research Center Program of the National Center for Research Resources, NIH (5-M01-RR13297)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Myofascial pain diagnosis and treatment
Keywords
patient subgroups, pressure pain threshold, tenderness, hyperalgesia, pain catastrophizing, pain coping, depression, anxiety, mood, evoked pain, clustering, ACR diagnostic criteria, widespread pain, psychological factors, cognitive factors, symptom heterogeneity
MeSH terms
Adolescent, Adult, Cognition, Female, Fibromyalgia, Humans, Hyperalgesia, Male, Middle Aged, Pressure, Pain Threshold

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