Abstract
Sense of Coherence (SOC) is conceptualized as a disposition to experience life as meaningful and manageable. Research suggests a protective effect of SOC on psychological health in stressful circumstances. This study assessed the capacity of SOC to buffer the effect of illness symptoms on psychological distress among patients with fibromyalgia. Self-reported changes in SOC after participation in a Mindfulness-Based Stress Reduction (MBSR) program were also examined. Ninety-one women with fibromyalgia provided baseline data pertaining to illness symptoms, perceived stress, and depression prior to participation in a randomized trial of MBSR. SOC and fibromyalgia symptoms were independently related to perceived stress and depression at baseline. SOC was not a statistically significant moderator of symptom effects on psychological distress. In comparison with wait-listed controls, program participants reported a significant increase in SOC after MBSR participation. These results provide the first demonstration from a randomized trial that SOC may be enhanced via intervention.
Similar content being viewed by others
Explore related subjects
Discover the latest articles and news from researchers in related subjects, suggested using machine learning.REFERENCES
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks, CA: Sage.
Antonovsky, A. (1979). Health, stress, and coping: New perspectives on mental and physical well-being. San Francisco: Jossey-Bass.
Antonovsky, A. (1983). The sense of coherence: Development of a research instrument. In W. S. Schwartz (Ed.), Newsletter and research reports (Vol. 1, pp. 1–11). Tel Aviv: Tel Aviv University, Research Center for Behavioral Medicine.
Antonovsky, A. (1987a). The salutogenic perspective: Toward a new view of health and illness. Advances, 4, 47–55.
Antonovsky, A. (1987b). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass.
Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Social Science and Medicine, 36, 725–733.
Baron, R. M., & Kenny, D. A. (1986). The moderator‐mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.
Bengel, J., Strittmatter, R., & Willmann, H. (1999). What keeps people healthy? The current state of discussion and the relevance of Antonovsky's salutogenetic model of health (4th ed.). Cologne, Germany: Federal Centre for Health Education (FCHE).
Bennett, R. M. (1996). Fibromyalgia and the disability dilemma. A new era in understanding a complex, multidimensional pain syndrome. Arthritis and Rheumatism, 39, 1627–1634.
Bias, E. S. (1998). Mediating the stress‐outcome relationship in Alzheimer's caregiving: The reciprocal influences of sense of coherence, coping, and boundary ambiguity. Dissertation Abstracts International: Section B: The Sciences and Engineering, 59(6-B), 3046.
Bishop, G.D. (1993). The sense of coherence as a resource in dealing with stress. Psychologia, 36, 259–263.
Bishop, S. R. (2002). What do we really know about mindfulnessbased stress reduction? Psychosomatic Medicine, 64, 71–84.
Blackburn-Munro, G., & Blackburn-Munro, R. E. (2001). Chronic pain, chronic stress and depression: Coincidence or consequence? Journal of Neuroendocrinology, 13, 1009–1023.
Boissevain, M. D., & McCain, G. A. (1991). Toward an integrated understanding of fibromyalgia syndrome. I: Medical and pathophysiological aspects. Pain, 45, 227–238.
Bowman, B. J. (1996). Cross-cultural validation of Antonovsky's Sense Of Coherence Scale. Journal of Clinical Psychology, 52, 547–549.
Bradley, L. A. (1996). Cognitive‐behavioral therapy for chronic pain. In R. J. Gatchel & D. C. Turk (Eds.), Psychological approaches to pain management: A practitioner's handbook (pp. 131–147). New York: Guilford.
Buckelew, S. P., Conway, R., Parker, J., Deuser, W. E., Read, J., Witty, T. E., et al. (1998). Biofeedback/relaxation training and exercise interventions for fibromyalgia: A prospective trial. Arthritis Care and Research, 11, 196–209.
Burckhardt, C. S., Clark, S. R., & Bennett, R. M. (1991). The fi-bromyalgia impact questionnaire: Development and validation. Journal of Rheumatology, 18, 728–733.
Callahan, L. F.,& Pincus, T. (1995). The sense of coherence scale in patients with rheumatoid arthritis. Arthritis Care and Research, 828–35.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24385–396.
Creamer, P., Singh, B.B., Hochberg, M.C., & Berman, B. M. (2000). Sustained improvement produced by nonpharmacologic intervention in fibromyalgia: Results of a pilot study. Arthritis Care and Research, 13, 198–204.
Crofford, L. J., & Demitrack, M. A. (1996). Evidence that abnormalities of central neurohormonal systems are key to understanding fibromyalgia and chronic fatigue syndrome. Rheumatic Diseases Clinics of North America, 22, 267–284.
Delbar, V., & Benor, D. E. (2001). Impact of nursing intervention on cancer patients' ability to cope. Journal of Psychosocial Oncology, 19, 57–75.
Deluze, C., Bosia, L., Zirbs, A., Chantraine, A., & Vischer, T. L. (1992). Electroacupuncture in fibromyalgia: Results of a controlled trial. BMJ, 305, 1249–1252.
Doan, B. D., & Wadden, N. P. (1989). Relationships between depressive symptoms and descriptions of chronic pain. Pain, 36, 75–84.
Epstein, S., Kay, G., Clauw, D., Heaton, R., Klein, D., Krupp, L., et al. (1999). Psychiatric disorders in patients with fibromyalgia: A multicenter investigation. Psychosomatics, 40, 57–63.
Fishbain, D. A., Cutler, R., Rosomoff, H. L., & Rosomoff, R. S. (1997). Chronic pain-associated depression: Antecedent or consequence of chronic pain? A review. Clinical Journal of Pain, 13, 116–137.
Flannery, R.B., Jr., Perry, J.C., Penk, W. E., & Flannery, G. J. (1994). Validating Antonovsky's Sense of Coherence Scale. Journal of Clinical Psychology, 50, 575–577.
Forsberg, C., & Bjorvell, H. (1996). Living with cancer: Perceptions of well-being. Scandinavian Journal of Caring Sciences, 10109–115.
Frenz, A.W., Carey, M. P., & Jorgensen, R. S. (1993). Psychometric evaluation of Antonovsky's Sense of Coherence Scale. Psychological Assessment, 5, 145–153.
Funch, D. P., & Gale, E.N. (1986). Predicting treatment completion in a behavioral therapy program for chronic temporomandibular pain. Journal of Psychosomatic Research, 30, 57–62.
Germano, D., Misajon, R., & Cummins, R. A. (2001). Quality of life and sense of coherence in people with arthritis. Journal of Clinical Psychology in Medical Settings, 8, 253–261.
Hakinnen, A., Hakkinen, K., Hannonen, P., & Alen, M. (2001). Strength training induced adaptations in neuromuscular function of premenopausal women with fibromyalgia: Comparison with healthy women. Annals of Rheumatic Disease, 60, 21–26.
Hawley, D. J., Wolfe, F., & Cathey, M. A. (1992). The sense of coherence questionnaire in patients with rheumatic disorders. Journal of Rheumatology, 19, 1912–1918.
Hood, S. C., Beaudet, M. P., & Catlin, G. (1996). A healthy outlook. Health Reports, 7, 25–35.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47.
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte Press.
Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal Behavioral Medicine, 8, 163–190.
Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., et al. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936–943.
Kabat-Zinn, J., Skillings, A., & Salmon, P. (unpublished manuscript).The effect of mindfulness meditation-based stress reduction training on stress mediating trait measures in medical patients: Short and long-term observations.
Kaiser, C. F., Sattler, D. N., Bellack, D. R., & Dersin, J. (1996). A conservation of resources approach to a natural disaster: Sense of coherence and psychological distress. Journal of Social Behavior and Personality, 11, 459–476.
Kaplan, K. H., Goldenberg, D. L., & Galvin-Nadeau, M. (1993). The impact of a meditation-based stress reduction program on fibromyalgia. General Hospital Psychiatry, 15, 284–289.
Keefe, F. J., Dunsmore, J., & Burnett, R. (1992). Behavioral and cognitive‐behavioral approaches to chronic pain: Recent advances and future directions. Journal of Consulting and Clinical Psychology, 60, 528–536.
Keel, P. J., Bodoky, C., Gerhard, U., & Muller, W. (1998). Comparison of integrated group therapy and group relaxation training for fibromyalgia. Clinical Journal of Pain, 14, 232–238.
Korotkov, D. L. (1993). An assessment of the (short-form) sense of coherence personality measure: Issues of validity and well-being. Personality and Individual Differences, 14, 538–575.
Larsson, G., & Kallenberg, K. O. (1996). Sense of coherence, socioeconomic conditions and health. European Journal of Public Health, 6, 175–180.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Masi, A. T., & Yunus, M. B. (1986). Concepts of illness in populations as applied to fibromyalgia syndromes. American Journal of Medicine, 81, 19–25.
McSherry, W. C., & Holm, J. E. (1994). Sense of coherence: Its effects on psychological and physiological processes prior to, during, and after a stressful situation. Journal of Clinical Psychology, 50476–487.
Nicassio, P. M., Radojevic, V., Weisman, M. H., Schuman, C., Kim, J., Schoenfeld-Smith, K., et al. (1997). A comparison of behavioral and educational interventions for fibromyalgia. Journal of Rheumatology, 24, 2000–2007.
Parmelee, P. A., Katz, I. R., & Lawton, M. P. (1991). The relation of pain to depression among institutionalized aged. Journals of Gerontology, 46, 15–21.
Post-White, J. (1998). The role of sense of coherence in mediating the effects of mental imagery on immune function, cancer outcome, and quality of life. In H. I. McCubbin & E.A. Thompson (Eds.), Stress, coping, and health in families: Sense of coherence and resiliency (Vol. 1, pp. 279–291). Thousand Oaks, CA: Sage.
Rena, F., Moshe, S., & Abraham, O. (1996). Couples' adjustment to one partner's disability: The relationship between sense of Sense of Coherence is Enhanced by Meditation 307 coherence and adjustment. Social Science and Medicine, 43, 163–171.
Rimann, M., & Udris, I. (1998). “Koh¨arenzerleben” (sense of coherence): Zentraler Bestandteil von Gesundheit oder Gesundheitsressource? In W. Schüffel (Ed.), Handbuch der Salutogenese. Konzept und Praxis. Wiesbaden, Germany: Ullstein & Mosby.
Rossy, L. A., Buckelew, S. P., Dorr, N., Hagglund, K. J., Thayer, J. F., McIntosh, M. J., et al. (1999). A meta-analysis of fibromyalgia treatment interventions. Annals of Behavioral Medicine, 21, 180–191.
Roth, B., & Creaser, T. (1997). Mindfulness meditation-based stress reduction: Experience with a bilingual inner-city program. Nurse Practitioner, 22, 150–157.
Sammallahti, P. R., Holi, M. J., Komulainen, E. J., & Aalberg, V. A. (1996). Comparing two self-report measures of coping–The Sense of Coherence Scale and the Defense Style Questionnaire. Journal of Clinical Psychology, 52, 517–524.
Schnyder, U., Buechi, S., Sensky, T., & Klaghofer, R. (2000). Antonovsky's Sense of Coherence: Trait or state? Psychotherapy and Psychosomatics, 69, 296–302.
Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21, 581–599.
Soderberg, S., Lundman, B., & Norberg, A. (1997). Living with fibromyalgia: Sense of coherence, perception of well-being, and stress in daily life. Research in Nursing Health, 20, 495–503.
Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry, 49624–629.
Urrows, S., Affleck, G., Tennen, H., & Higgins, P. (1994). Unique clinical and psychological correlates of fibromyalgia tender points and joint tenderness in rheumatoid arthritis. Arthritis and Rheumatism, 37, 1513–1520.
Wallace, D. J. (1997). The fibromyalgia syndrome. Annals of Medicine, 29, 9–21.
Wolfe, F. (1997). The relation between tender points and fibromyalgia symptom variables: Evidence that fibromyalgia is not a discrete disorder in the clinic. Annals of the Rheumatic Diseases, 56268–71.
Wolfe, F., Aarflot, T., Bruusgaard, D., Henriksson, K.G., Littlejohn, G., Moldofsky, H., et al. (1995). Fibromyalgia and disability (Report of the Moss International Working Group on medicolegal aspects of chronic widespread musculoskeletal pain complaints and fibromyalgia). Scandinavian Journal of Rheumatology, 24112–118.
Wolfe, F., Smythe, H. A., Yunus, M.B., Bennett, R. M., Bombardier, C., Goldenberg, D. L., et al. (1990). The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia (Report of the Multicenter Criteria Committee). Arthritis and Rheumatism, 33, 160–172.
Worrel, L., Krahn, L., Kletten, C., & Pond, G. (2001). Treating fi-bromyalgia with a brief interdisciplinary program: Initial outcomes and predictors of response. Mayo Clinic Proceedings, 76384–390.
Ying, Y. W. (1999). Strengthening intergenerational/intercultural ties in migrant families: A new intervention for parents. Journal of Community Psychology, 27, 89–96.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Weissbecker, I., Salmon, P., Studts, J.L. et al. Mindfulness-Based Stress Reduction and Sense of Coherence Among Women with Fibromyalgia. Journal of Clinical Psychology in Medical Settings 9, 297–307 (2002). https://doi.org/10.1023/A:1020786917988
Issue Date:
DOI: https://doi.org/10.1023/A:1020786917988