SUBGROUPS OF FMS--SYMPTOMS, BELIEFS & TAILORED TREATMENT

纤维肌痛综合征（FMS）是一种常见的慢性肌肉骨骼疼痛 disorder. 尽管有广泛的研究， FMS的机制还没有很好地理解，也没有治疗方法。 证明是普遍有效的。 在这个项目中，我们建议FMS 是一种复杂的疾病，涉及多种因素，包括身体和 心理社会行为 在我们之前的研究中，我们已经证明了 FMS患者在心理社会行为轴上是异质性的， 并可分为3个不同的亚组的基础上， 对症状的心理适应 在这个应用程序中，我们将扩展 我们以前的研究和尝试， 心理社会行为特征 具体来说，我们将测试 为每个心理社会亚组量身定制的独特治疗效果。 三组FMS患者将接受3种治疗之一 标准的物理治疗和不同的心理治疗 治疗。 共有312名FMS患者将接受为期6个半天的 包括物理治疗和 心理治疗 所有协议都包括标准化的物理 治疗，但包括认知行为疼痛管理治疗， 人际关系技巧培训或支持性咨询。 除了 治疗结果研究，将评估FMS的各种症状 前瞻性地在患者的自然栖息地，以更好地了解 FMS症状的协变。 每天重复监测， 掌上电脑（生态瞬时评估）将允许我们 与回顾性报告相比，评估过程评级的价值。 总的来说，这些研究的结果应确定以下益处： 匹配治疗对象的特点，并提高我们的 理解认知-情感-行为适应的作用 FMS患者

Fibromyalgia syndrome (FMS) is a prevalent, chronic musculoskeletal pain disorder. Despite extensive research the etiology and pathophysiologic mechanisms of FMS are not well understood, and no treatment has been shown to be universally effective. In this project, we propose that FMS is a complex disorder involving multiple factors, both physical and psychosocial-behavioral. In our previous research, we have demonstrated that FMS patients are heterogeneous in the psychosocial-behavioral axis and can be classified into 3 distinct subgroups on a basis of their psychosocial adaptation to symptoms. In this application we will extend our previous research and attempt to match treatments to patients psychosocial-behavioral characteristics. Specifically, we will test the efficacy of uniquely tailored treatment for each psychosocial subgroup. Three groups of FMS patients will be treated with one of the 3 treatment protocols with standard physical therapy and varying psychological treatments. A total of 312 FMS patients will undergo a 6 half-day interdisciplinary treatment sessions consisting of physical therapy and psychological treatments. All protocols include a standardized physical therapy but include either cognitive-behavioral pain management therapy, interpersonal skill training, or supportive counseling. In addition to the treatment outcome study, various symptoms of FMS will be assessed prospectively in the patients natural habitats to better understand covariations of FMS symptoms. The repeated daily monitoring using the palm-top computer (ecological momentary assessment) will permit us to evaluate the value of process ratings compared to retrospective reports. Overall, the results of these studies should establish the benefit of matching treatments to subject characteristics, and enhance our understanding of the roles of cognitive-affective-behavioral adaptation of FMS patients.