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: 7902139
• 负责人: Mary Colleen Davis
• 金额: --
• 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 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7902139
• 关键词: Address; Affect; Affective; Anxiety; Area; Attention; Behavior Therapy; Behavioral; Clinical; Cognitive; Cognitive Therapy; 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 Depression; 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; comparison group; coping; 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，1999）被诊断出患有纤维肌痛（FM），这是一种未知病因的慢性疼痛状况，几乎没有令人满意的治疗选择。 FM的特征是广泛的疼痛，睡眠障碍和疲劳，经常导致广泛的功能局限性。尽管最广泛使用的慢性疼痛心理干预措施，即认知行为疗法（CBT），已成功解决了疼痛管理，但它并未直接解决FM患者面临的情绪调节所面临的明显挑战。正面和负面影响调节的缺陷是FM患者临床特征的显着特征。一种综合方法，它可以提高CBT提供的疼痛管理中的治疗性增长，并注意改善情感调节缺陷，这不仅有可能促进我们对情绪在慢性疼痛中的作用的了解，而且还提供了当前未用于FM的经验验证的治疗方案。该赠款建议通过针对情绪调节来测试FM认知行为治疗对FM的有效性，以补充现有治疗的疼痛管理重点。两个焦点是情绪调节组成部分的核心：1）最大程度地减少复发性疼痛的负面情感后果，包括抑郁症和焦虑症状，以及2）尽管疼痛疼痛，还要维持积极影响的关键来源。 FM患者（n = 180）将随机分配到三种治疗方法之一：疼痛认知疗法（CBT-P），疼痛和情绪调节的认知行为疗法（CBT-PE）或仅教育对照组（EC）。干预前和干预后的评估将包括对疼痛和自然主义压力源的认知，情感和行为反应的日期记录，并得到了基于实验室对标准化疼痛和情感刺激的反应性的测试。预计CBT-P和CBT-PE将相对于EC改善疼痛管理，但是CBT-PE有望通过增加积极的情感参与度并减少对疼痛和压力的反应性来改善身体和心理功能。因此，CBT-PE应提高FM患者应对其疾病及其生活其他领域的压力方面的能力，从而与CBT-P和EC组相比，对功能健康和福祉产生更大的长期影响。