BACKGROUND AND OBJECTIVE: Affect and how it is regulated plays a role in pain perception, maintenance of pain, and its resolution. This randomized, controlled trial evaluated an innovative affective self-awareness (ASA) intervention, which was designed to reduce pain and improve functioning in individuals with fibromyalgia. PARTICIPANTS AND METHODS: Forty-five women with fibromyalgia were randomized to a manualized ASA intervention (n = 24) or wait-list control (n = 21). The intervention began with a one-time physician consultation, followed by 3 weekly, 2-h group sessions based upon a mind-body model of pain. Sessions focused on structured written emotional disclosure and emotional awareness exercises. Outcomes in both conditions were measured by a blinded assessor at baseline, post-intervention, and 6-month follow-up. MEASURES: The primary outcome was pain severity (Brief Pain Inventory); secondary outcomes included tender-point threshold and physical function (SF-36 Physical Component Summary). Intent-to-treat analyses compared groups on outcomes using analysis of covariance and on the proportion of patients achieving ≥ 30% and ≥ 50% pain reduction at 6 months. RESULTS: Adjusting for baseline scores, the intervention group had significantly lower pain severity (p < 0.001), higher self-reported physical function (p < 0.001), and higher tender-point threshold (p = 0.02) at 6 months compared to the control group. From baseline to 6 months, 45.8% of the ASA intervention group had ≥ 30% reduction in pain severity, compared to none of the controls (p < 0.001). CONCLUSIONS: The affective self-awareness intervention improved pain, tenderness, and self-reported physical function for at least 6 months in women with fibromyalgia compared to wait-list control. This study suggests the value of interventions targeting emotional processes in fibromyalgia, although further studies should evaluate the efficacy of this intervention relative to active controls.
RCT Entities:
BACKGROUND AND OBJECTIVE: Affect and how it is regulated plays a role in pain perception, maintenance of pain, and its resolution. This randomized, controlled trial evaluated an innovative affective self-awareness (ASA) intervention, which was designed to reduce pain and improve functioning in individuals with fibromyalgia. PARTICIPANTS AND METHODS: Forty-five women with fibromyalgia were randomized to a manualized ASA intervention (n = 24) or wait-list control (n = 21). The intervention began with a one-time physician consultation, followed by 3 weekly, 2-h group sessions based upon a mind-body model of pain. Sessions focused on structured written emotional disclosure and emotional awareness exercises. Outcomes in both conditions were measured by a blinded assessor at baseline, post-intervention, and 6-month follow-up. MEASURES: The primary outcome was pain severity (Brief Pain Inventory); secondary outcomes included tender-point threshold and physical function (SF-36 Physical Component Summary). Intent-to-treat analyses compared groups on outcomes using analysis of covariance and on the proportion of patients achieving ≥ 30% and ≥ 50% pain reduction at 6 months. RESULTS: Adjusting for baseline scores, the intervention group had significantly lower pain severity (p < 0.001), higher self-reported physical function (p < 0.001), and higher tender-point threshold (p = 0.02) at 6 months compared to the control group. From baseline to 6 months, 45.8% of the ASA intervention group had ≥ 30% reduction in pain severity, compared to none of the controls (p < 0.001). CONCLUSIONS: The affective self-awareness intervention improved pain, tenderness, and self-reported physical function for at least 6 months in women with fibromyalgia compared to wait-list control. This study suggests the value of interventions targeting emotional processes in fibromyalgia, although further studies should evaluate the efficacy of this intervention relative to active controls.
Authors: David A Williams; Meredith A Cary; Kimberly H Groner; William Chaplin; Lara J Glazer; Alyssa M Rodriguez; Daniel J Clauw Journal: J Rheumatol Date: 2002-06 Impact factor: 4.666
Authors: Ather Ali; Theresa R Weiss; Anne Dutton; Douglas McKee; Kim D Jones; Susmita Kashikar-Zuck; Wendy K Silverman; Eugene D Shapiro Journal: J Pediatr Date: 2017-01-12 Impact factor: 4.406
Authors: Andrew Schrepf; Bruce Naliboff; David A Williams; Alisa J Stephens-Shields; J Richard Landis; Arpana Gupta; Emeran Mayer; Larissa V Rodriguez; Henry Lai; Yi Luo; Catherine Bradley; Karl Kreder; Susan K Lutgendorf Journal: Ann Behav Med Date: 2018-09-13
Authors: Barbara L Loevinger; Elizabeth A Shirtcliff; Daniel Muller; Carmen Alonso; Christopher L Coe Journal: Clin Rheumatol Date: 2011-12-27 Impact factor: 2.980
Authors: Mark A Lumley; Jay L Cohen; George S Borszcz; Annmarie Cano; Alison M Radcliffe; Laura S Porter; Howard Schubiner; Francis J Keefe Journal: J Clin Psychol Date: 2011-06-06