It is not feasible to obtain self report in individuals with severe IDD. Sometimes the only way to assess the pain level of an individual with IDD is to obtain information from the proxy. While this may not be the best option, it is better than not assessing the pain level at all. There is a lack of understanding in what factors may influence the accuracy of these reports. 


Proxy-Report Biases

In this procedure, patients are assessed using the widespread pain index which consists of dividing the body in to 19 different regions and patients report scores of how many regions are painful. There is also a symptom severity score which evaluates the severity of fatigue, unrefreshing sleep, and cognitive symptoms. The two studies are combined into a single self-report questionnaire which has a maximum score of 31.


University of Colorado at Denver

Fibromyalgia does not have a specific test for diagnosis, but usually patients need to meet certain requirements. Different doctors use different criteria to diagnose but usually try to rule out other disorders before giving this diagnosis.

Diagnosis of Fibromyalgia

Häuser, W., Ablin, J., Fitzcharles, M.-A., Littlejohn, G., Luciano, J. V., Usui, C., & Walitt, B. (2015). Fibromyalgia. Nature Reviews Disease Primers, 1(1). https://doi.org/10.1038/nrdp.2015.22

Fibromyalgia (Häuser et al., 2015)

Self-Report Questionnaire

One approach for diagnosing fibromyalgia in a patient with chronic widespread pain is testing 18 specific sites on the bodies surface. If 11 of the 18 specific sites are tender when touched, many doctors will place a diagnosis, but this method may be unreliable because healthy individuals can also be sensitive in these specific sites.


18 Tender Points Test

Doctors will generally try to rule out any other diagnosis that may be causing symptoms through a diagnostic work-up. If the chronic pain persists for more than 6 months and there is no evidence of another condition causing the symptoms that meet the fibromyalgia criteria, doctors will give the fibromyalgia diagnosis.


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