Training Focused on Constructive Actions & Attitudes Produces Strong, Lasting FM Symptom Improvements, Study Finds

A randomized, controlled, blinded study involving 125 diagnosed male and female Fibromyalgia patients compared the impact on pain intensity and other quality-of-life measures of three approaches to behavioral treatment of symptoms.

Two approaches involved guidance, and produced significant improvements in pain and other symptoms – though the benefit profiles of the two approaches differed, reflecting their different emphases. And the third approach, including placebo or “fake” sessions offering no guidance, actually proved to be detrimental.

The study, conducted by researchers at the University of Heidelberg, Germany, divided patients randomly into three groups:

n One group participated in a course that focused on explaining and supporting effective and constructive symptom-management actions. This was termed “operant-behavioral” therapy.

n The second group participated in a course designed to explain and support choice of constructive and adaptive attitudes regarding symptoms and their management, versus “maladaptive” attitudes. This was termed “cognitive-behavioral” therapy.

n The third group took part in a series of undirected discussions of Fibromyalgia symptoms, or “placebo.”

The researchers measured each FM patient’s symptom profile and symptom severity before the study started, then at study completion, and at six- and 12-month follow-up. The measures included pain intensity, physical functioning, emotional distress, attitude, and behavior.

The results indicated that:

n Both the action-focused and the attitude-focused treatments resulted in significantly reduced measures of average pain intensity.

n Additionally, the guided action (operant-behavioral) therapy group achieved statistically significant improvements in physical functioning and behaviors.

n And the guided attitude (cognitive-behavioral) therapy group achieved statistically significant improvements in emotional distress and attitudes.

n By comparison, average pain intensity and other quality-of-life measures for the patients who participated in unguided discussion of symptoms treatment course that involved only discussions of Fibromyalgia symptoms had actually worsened post-treatment.

The researchers note that Fibromyalgia patients fall into several categories “characterized by several patterns, based on how they respond to their symptoms.” They suggest that the individual’s response pattern might be used to determine a choice between guided action (operant-behavioral) therapy or guided attitude (cognitive-behavioral) therapy.

The report of this study, “Psychological Pain Treatment in Fibromyalgia Syndrome: Efficacy of Operant-Behavioral and Cognitive-Behavioral Treatments,” by Kati Thieme, PhD, et al., was published in the July 19, 2006 issue of the journal Arthritis Research & Therapy. The full text is available online free of charge.

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