Fibromyalgia: Interventions for pain and mood regulation

纤维肌痛：疼痛和情绪调节的干预措施

• 批准号: 7682294
• 负责人: Mary Colleen Davis
• 金额: $ 64.24万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7682294
• 关键词: Address; Affect; Affective; Anxiety; Area; Attention; Behavior Therapy; Behavioral; Clinical; Cognitive; Complement; Control Groups; Data; Diagnosis; Education; Effectiveness; Emotional; Emotions; Etiology; Fatigue; Fibromyalgia; Grant; Health; Intervention; Knowledge; Laboratories; Laboratory Research; Lead; Learning; Life; Long-Term Effects; Mediating; Mediator of activation protein; Mental Health; Methods; Outcome; Pain; Pain management; Patients; Population Intervention; Psyche structure; Randomized; Records; Recurrent pain; Regulation; Relative (related person); Research Personnel; Resources; Role; Sleep disturbances; Social Functioning; Source; Stimulus; Stress; Symptoms; Testing; Therapeutic; Treatment Efficacy; Woman; Work; base; chronic pain; cognitive behavior therapy; comparison group; coping; depression; depressive symptoms; design; diaries; emotion regulation; follow-up; improved; meetings; men; mood regulation; physical conditioning; post intervention; psychologic; response; stressor; success; treatment effect

DESCRIPTION (provided by applicant): Approximately 5% of women and 1.6% of men (White et al., 1999) have been diagnosed with Fibromyalgia (FM), a chronic pain condition of unknown etiology with few satisfactory treatment options. FM is characterized by widespread pain, sleep disturbance, and fatigue that frequently lead to extensive functional limitations. Although the most widely used psychological intervention for chronic pain, cognitive behavioral therapy (CBT), has successfully addressed pain management, it has not directly addressed the distinct challenges to emotion regulation faced by FM patients. Deficits in positive and negative affect regulation are salient features of the clinical profile of FM patients. An integrated approach that fortifies the therapeutic gains in pain management provided by CBT with attention to ameliorating affective regulation deficits has the potential not only to advance our knowledge of the role of emotion in chronic pain but also to provide an empirically validated treatment option not currently available for FM. This grant proposes to test the effectiveness of a cognitive-behavioral treatment for FM that supplements the pain management emphasis of existing treatments by also targeting emotion regulation. Two foci are central to the emotion regulation component: 1) minimizing the negative affective consequences of recurrent pain, including depression and anxiety symptoms, and 2) sustaining key sources of positive affect in spite of pain. FM patients (N=180) will be randomly assigned to one of three treatments: Cognitive-Behavior Therapy for Pain (CBT-P), Cognitive-Behavior Therapy for Pain and Emotion Regulation (CBT-PE), or an Education-Only Control Group (EC). Pre- and post-intervention assessments will include within-day field records of cognitive, affective, and behavioral responses to pain and naturalistic stressors, complemented by laboratory-based tests of reactivity to standardized pain and affective stimuli. Both CBT-P and CBT-PE are expected to improve pain management relative to EC, but CBT-PE is expected to have a broader impact, improving physical and psychological functioning by increasing positive affective engagement and decreasing reactivity to pain and stress. Thus, CBT-PE should enhance the capacity of FM patients to cope with stressful aspects of their illness and other areas of their lives, leading to more beneficial long-term effects on functional health and well being compared to CBT-P and EC groups.

描述(由申请人提供)：大约5%的女性和1.6%的男性(White等人，1999年)被诊断为纤维肌痛(FM)，这是一种病因不明的慢性疼痛状况，几乎没有令人满意的治疗选择。FM的特点是广泛的疼痛、睡眠障碍和疲劳，经常导致广泛的功能限制。尽管最广泛使用的慢性疼痛心理干预-认知行为疗法(CBT)已经成功地解决了疼痛管理问题，但它并没有直接解决FM患者面临的情绪调节方面的明显挑战。积极的和消极的情绪调节缺陷是FM患者临床特征的显著特征。一种综合的方法，通过注意改善情感调节缺陷，加强CBT在疼痛管理方面的治疗收益，不仅有可能促进我们对情绪在慢性疼痛中作用的了解，而且还提供了一种目前尚不适用于FM的经验性验证的治疗选择。这项拨款建议测试FM认知行为治疗的有效性，该治疗通过瞄准情绪调节来补充现有治疗的疼痛管理重点。情绪调节的核心是两个焦点：1)最大限度地减少反复疼痛的负面情感后果，包括抑郁和焦虑症状；2)尽管疼痛，但保持积极情感的关键来源。FM患者(N=180)将被随机分配到三种治疗方法中的一种：疼痛认知行为疗法(CBT-P)、疼痛和情绪调节认知行为疗法(CBT-PE)或仅接受教育的对照组(EC)。干预前和干预后的评估将包括对疼痛和自然应激源的认知、情感和行为反应的当天现场记录，并辅之以基于实验室的对标准化疼痛和情感刺激的反应测试。与EC相比，CBT-P和CBT-PE都有望改善疼痛管理，但CBT-PE有望产生更广泛的影响，通过增加积极的情感投入和降低对疼痛和压力的反应性来改善身体和心理功能。因此，与CBT-P和EC组相比，CBT-PE应该提高FM患者应对疾病和生活其他方面的压力的能力，从而对功能健康和幸福感产生更有益的长期影响。