Emotional Exposure and Cognitive Behavioral Therapies for Fibromyalgia

纤维肌痛的情绪暴露和认知行为疗法

• 批准号: 8512557
• 负责人: MARK A LUMLEY
• 金额: $ 58.99万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-15 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8512557
• 关键词: Address; Adult; Affect; Affective; Aftercare; Anxiety; Anxiety Disorders; Awareness; Behavior; Behavior Therapy; Behavioral; Clinical; Clinical Research; Cognition; Cognitive Therapy; Collaborations; Comorbidity; Coping Skills; Data; Disease; Education; Emotional; Emotional Stress; Emotions; Evaluation; Failure; Fatigue; Fibromyalgia; Functional disorder; Goals; Individual; Individual Differences; Intervention; Lead; Life; Literature; Measures; Mediating; Mediation; Mediator of activation protein; Medical; Mental Depression; Michigan; Mood Disorders; Moods; Outcome; Outcome Measure; Pain; Pain management; Patients; Physical Function; Physical activity; Placebo Control; Post-Traumatic Stress Disorders; Process; Psychophysics; Randomized; Randomized Controlled Trials; Recording of previous events; Regulation; Research; Research Personnel; Resolution; Risk Factors; Sampling; Site; Sleep; Solid; Stress; Subgroup; Symptoms; Syndrome; Techniques; Testing; Translations; Trauma; Treatment Efficacy; Universities; Victimization; Work; active method; base; chronic pain; cognitive function; comparative efficacy; coping; design; disability; efficacy testing; emotion regulation; emotional experience; experience; follow-up; heart rate variability; improved; indexing; innovation; intervention effect; multidisciplinary; novel; psychologic; public health relevance; satisfaction; showing emotion; skills training; success; treatment effect; trial comparing

DESCRIPTION (provided by applicant): Fibromyalgia (FM) is a common and disabling pain condition, which is notoriously difficult to treat. Traditional non-pharmacological therapies for pain, such as cognitive behavioral therapy, are of benefit, but their efficacy may be limited by a failure to directly address stress and emotional dysregulation. A substantial literature reveals that many patients with FM have increased lifetime trauma or stress and emotional regulation problems, and the subsequent failure to process difficult emotional experiences appears to contribute to pain and other symptoms in many individuals with FM. Emotional exposure and processing treatments are highly successful with trauma and anxiety problems-which are common co-morbidities in patients with FM and other chronic pain conditions. We have solid preliminary data on the efficacy of emotion regulation-based interventions for FM, and the proposed research will test an innovative and promising emotional awareness and exposure intervention. This application combines the clinical research, chronic pain, and FM expertise of two research teams to conduct a 2-site, randomized controlled trial of emotional exposure therapy (EET) against both a standard cognitive-behavioral therapy (CBT; pain coping skills training) and control condition (FM education) in a design that controls for non-specific factors and experimenter allegiance to the different treatments. Adults with FM (N = 270) will be randomized to 1 of 3 treatment groups, which will receive 1 individual and 8 group-format treatment sessions. A comprehensive battery of outcome measures, including both psychophysical pain and objective activity measures, will be assessed at baseline and two post-treatment evaluations over a 1-year follow-up. We will test whether both active treatments are more efficacious than the control condition, and whether EET surpasses CBT on affective outcomes and CBT surpasses EET on behavioral outcomes. This study also will test whether the effects of the interventions are mediated by treatment-specific or more general change processes, including improved autonomic regulation as indexed by heart rate variability, increased emotional awareness and expression, and improved pain coping. Finally, because FM is increasingly recognized as heterogeneous and only a subset of patients have any given risk factor-including stress and emotional avoidance-we will explore several proposed moderators of the effects of EET and CBT, including trauma history, emotion regulation abilities, depression, and interpersonal difficulties. This research has the potential to greatly advance treatment options and success rates for FM and other conditions that are influenced by stress and emotional regulation problems, and it will illuminate change processes, individual differences, and treatment matching or tailoring.

描述（由申请人提供）：纤维肌痛（FM）是一种常见且残疾的疼痛状况，众所周知，很难治疗。传统的非药物治疗疼痛（例如认知行为疗法）有益，但是它们的功效可能受到直接解决压力和情绪失调的限制。大量文献表明，许多FM患者的终身创伤或压力和情绪调节问题增加，随后未能处理困难的情绪经历的未能导致许多FM患者的疼痛和其他症状。情绪暴露和处理治疗在创伤方面非常成功，焦虑问题是FM和其他慢性疼痛状况的常见合并症。我们拥有有关基于情绪调节的FM干预措施有效性的扎实初步数据，拟议的研究将测试一种创新且有希望的情绪意识和暴露干预措施。该应用程序结合了两个研究团队的临床研究，慢性疼痛和FM专业知识，以对情绪暴露疗法（EET）进行2个，随机对照试验（EET），以在控制非特异性因素和经验性验证范围的设计中，在设计的设计中，在设计的设计中，在设计中，在设计中，在设计设计方面的标准认知行为疗法（CBT;疼痛应对技能培训）和对照疾病（FM教育）进行了。 FM（n = 270）的成年人将被随机分为3个治疗组中的1个，该组将接受1个个人和8个组形式的治疗课程。将在基线时评估一系列全面的结果指标，包括心理物理疼痛和客观活动措施，并在1年的随访中进行两次治疗后评估。我们将测试两种主动治疗是否比对照条件更有效，并且EET在情感结果和CBT上是否超过CBT在行为结果上超过EET。这项研究还将测试干预措施的影响是由治疗特异性或更一般的变化过程介导的，包括改善了由心率变异性索引的自主神经调节，情绪意识和表达的提高以及改善的疼痛应对。最后，由于FM越来越多地被认为是异质性的，并且只有一部分患者具有任何给定的风险因素，包括压力和情绪避免，我们将探索几个提出的EET和CBT影响的主持人，包括创伤历史，情绪调节能力，抑郁症，抑郁症和人际关系困难。这项研究有可能极大地提高FM和其他受压力和情绪调节问题影响的状况的治疗选择和成功率，并且会阐明变化过程，个体差异以及治疗匹配或剪裁。