Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: a cluster-randomized controlled trial

Abstract Patients with fibromyalgia (FM) experience increased lifetime levels of psychosocial adversity, trauma, and emotional conflict. To address these risk factors, we developed emotion awareness and expression therapy (EAET) and tested its benefits against an active control condition, FM education, and the field's gold standard intervention for FM, cognitive behavioral therapy (CBT) for symptom management. Adults with FM (N = 230) formed 40 treatment groups, which were randomized to EAET, CBT, or education and given 8, 90-minute sessions. Patient-reported outcomes were assessed at baseline, posttreatment, and 6-month follow-up (primary end point). Retention of patients to follow-up was excellent (90.4%). Intent-to-treat analyses indicated that although EAET did not differ from FM education on pain severity (primary outcome), EAET had significantly better outcomes than FM education on overall symptoms, widespread pain, physical functioning, cognitive dysfunction, anxiety, depression, positive affect, and life satisfaction (between-condition d's ranging from 0.29-0.45 SD) and the percentage of patients reporting being “very much/much” improved (34.8% vs 15.4%). Emotional awareness and expression therapy did not differ from CBT on the primary or most secondary outcomes, but compared to CBT, EAET led to significantly lower FM symptoms (d = 0.35) and widespread pain (d = 0.37) and a higher percentage of patients achieving 50% pain reduction (22.5% vs 8.3%). In su...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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Pain makes us human. It is a bell, fine-tuned by evolution, that often rings in moments necessary for our survival. Because of pain, we can receive warnings that trigger the reflexes to escape potential danger. But what happens when that bell continues to ring? How do we respond to a signal when it interferes with the other elements that make us human? Pain that lasts longer than six months is considered chronic, and it may not go away. With chronic pain, the bell’s ongoing signal gets your nervous system wound up and increases its reactivity to incoming messages. This can be quite distressing and anxiety-provoking. ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Mind body medicine Pain Management Source Type: blogs
Conclusions: Monitoring the affective dimension of pain should be included in an integrated approach to pain, and Hatha yoga may be beneficial in the pain management of FM participants. PMID: 31370034 [PubMed - in process]
Source: Advances in Mind Body Medicine - Category: Psychiatry Tags: Adv Mind Body Med Source Type: research
Abstract Fibromyalgia (FM) is a chronic pain syndrome involving complex interplay of biogenic amines and NMDA receptor mediated hypersensitization of nociceptive pathways. Clinical management of FM is poorly addressed with only a few available therapeutic options. Coumarins are active phenolic molecules of natural origin found to have broad pharmacological activities. Current investigation explores the role of naturally occurring coumarin, imperatorin in mouse model of fibromyalgia. Administration of reserpine (0.5 mg/kg, s.c.) thrice at 24 h intervals induced behavioral and neurochemical alterations characteristi...
Source: Biochemical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Biochem Pharmacol Source Type: research
Conclusion: These findings support the hypothesis that in FM a deteriorated function of cortical inhibition, indexed by a higher SICI parameter, a lower function of the DPMS, together with a higher level of BDNF indicate that FM has different pathological substrates from depression. They suggest that an up-regulation phenomenon of intracortical inhibitory networks associated with a disruption of the DPMS function occurs in FM. Introduction Major depressive disorder (MDD) and fibromyalgia (FM) present overlapped symptoms. Although the connection between these two disorders has not been elucidated yet, the disruption...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
CONCLUSIONS: At the moment, ozone therapy seems a treatment that, also because without any side effect, is possible to be proposed to patients with fibromyalgia that are not obtaining adequate results from other available treatments and it can be considered as complementary/integrative medicine. PMID: 30840304 [PubMed - in process]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
ConclusionsAbdominal bloating in IBS is associated with increased symptoms and pain severity, somatization, depression, fibromyalgia, and altered dietary fluids composition. Recognizing and addressing these factors in the diagnosis and management of patients with IBS may improve clinical outcome.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
Publication date: 1 February 2019Source: NeuroImage, Volume 186Author(s): Noam Goldway, Jacob Ablin, Omer Lubin, Yoav Zamir, Jackob Nimrod Keynan, Ayelet Or-Borichev, Marc Cavazza, Fred Charles, Nathan Intrator, Silviu Brill, Eti Ben-Simon, Haggai Sharon, Talma HendlerAbstractVolitional neural modulation using neurofeedback has been indicated as a potential treatment for chronic conditions that involve peripheral and central neural dysregulation. Here we utilized neurofeedback in patients suffering from Fibromyalgia - a chronic pain syndrome that involves sleep disturbance and emotion dysregulation. These ancillary symptom...
Source: NeuroImage - Category: Neuroscience Source Type: research
Publication date: Available online 5 November 2018Source: NeuroImageAuthor(s): Noam Goldway, Jacob Ablin, Omer Lubin, Yoav Zamir, Jackob Nimrod Keynan, Ayelet Or-Borichev, Marc Cavazza, Fred Charles, Nathan Intrator, Silviu Brill, Eti Ben-Simon, Haggai Sharon, Talma HendlerAbstractVolitional neural modulation using neurofeedback has been indicated as a potential treatment for chronic conditions that involve peripheral and central neural dysregulation. Here we utilized neurofeedback in patients suffering from Fibromyalgia - a chronic pain syndrome that involves sleep disturbance and emotion dysregulation. These ancillary sy...
Source: NeuroImage - Category: Neuroscience Source Type: research
Abstract BACKGROUND: This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and is associated with disability, anxiety, and depressive symptoms. OBJECTIVES: The aim of this review was to update the published evidence on the efficacy of psychological treatments for chronic and recurrent pain in children and adolescents.The primary objective of this updated review was to dete...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
New research evaluated the effect of depression on the cognition of fibromyalgia patients, finding that these patients have a distinct cognitive profile. Researchers note that emotional symptoms, such as depression and anxiety, are essential to the cognitive performance of fibromyalgia patients and that treating these symptoms may reduce cognitive impairment...
Source: The Rheumatologist - Category: Rheumatology Authors: Tags: Conditions Soft Tissue Pain cognitive dysfunction Depression Fibromyalgia Mental Health Pain Management Source Type: research
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