%0 Journal Article
%T Affective-Cognitive Behavioral Therapy for Fibromyalgia: A Randomized Controlled Trial
%A Robert L. Woolfolk
%A Lesley A. Allen
%A Jeffrey T. Apter
%J Pain Research and Treatment
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/937873
%X A randomized controlled trial was conducted to assess the efficacy of an individually administered form of cognitive behavioral treatment for fibromyalgia. In an additive design, 76 patients diagnosed with fibromyalgia were randomly assigned to either the experimental treatment (affective-cognitive behavioral therapy, 10 individual sessions, one per week) administered concurrently with treatment-as-usual or to an unaugmented treatment-as-usual condition. Statistical analysis conducted at the end of treatment (3 months after the baseline assessment) and at a followup (9 months after the baseline assessment) indicated that the patients receiving the experimental treatment reported less pain and overall better functioning than control patients, both at posttreatment and at followup. The implications of these findings for future research are discussed. 1. Introduction Fibromyalgia (FM) is a prevalent and disabling syndrome. It is characterized by widespread musculoskeletal pain, multiple tender points, sleep disturbance, fatigue, and stiffness [1, 2]. The prevalence of FM has been estimated to be about 2% of the population [2]. Patients meeting criteria for FM have been shown to overuse health care services and experience high rates of disability [3¨C5]. At present, FM appears to be extremely challenging to treat [6]. Although some pharmacological and nonpharmacological treatments have produced moderate benefits, no intervention has yet been demonstrated capable of generating clinically significant improvement in the majority of FM patients [6]. The controlled clinical trial literature suggests that pharmacological agents provide some relief to FM patients, though the magnitude of these effects is modest [7, 8]. Psychosocial interventions also have shown some promise in alleviating FM symptoms, with exercise programs and cognitive-behavioral treatments appearing most potent [8, 9]. Notwithstanding, empirical reviews of the efficacy of cognitive-behavioral treatment (CBT) for FM have revealed mixed results, some showing low-to-medium effect sizes [9, 10], others showing no effect [11]. Because, to date, CBT for FM has been administered in groups, the efficacy of individually administered CBT for FM has not been assessed within a controlled experimental design. We hypothesized that an individually administered, intensive, and individualized CBT treatment would achieve more powerful effects than previous group-administered CBT. We developed an individually administered (CBT) for FM that includes relaxation training, activity regulation, facilitation of
%U http://www.hindawi.com/journals/prt/2012/937873/