PRIMARY JUVENILE FIBROMYALGIA - PSYCHOLOGICAL ADJUSTMENT, FAMILY FUNCTIONING, COPING, AND FUNCTIONAL DISABILITY

Objectives. 1) To determine the importance of psychological adjustment and family functioning in primary juvenile fibromyalgia by assessing these factors in children with fibromyalgia and in their parents, comp ared with children with juvenile rheumatoid arthritis (JRA) and with p ain-free control children and their parents, 2) To examine which of th ese factors predict functional disability. Methods. Fifteen children i n each of the 3 study groups, and their parents, completed self-report questionnaires and pain diaries, A medical evaluation of each child w as performed, including assessment of tender points by palpation and b y dolorimetry. Results. All children in the fibromyalgia group met the Yunus and Masi criteria for fibromyalgia, and 11 met the American Col lege of Rheumatology criteria, There were almost no significant group differences in the children's or parents' psychological adjustment, ra tings of family functioning, or coping strategies, Significant group d ifferences in functional disability, pain, fatigue, tender point thres hold, and control point tolerance were found, A number of the psycholo gical adjustment, pain, fatigue, and coping variables were significant ly associated with functional disability. Conclusion. The notion that fibromyalgia is a psychogenic condition is not supported by these resu lts, Fibromyalgia is associated with disability of a magnitude compara ble to that of other chronic pain conditions, Disability among childre n with fibromyalgia or JRA is a function of the children's psychologic al adjustment and physical state, and of the parents' physical state a nd method of coping with pain.