Approach as a key for success: Reduced avoidance behaviour mediates the effect of exposure therapy for fibromyalgia.

Approach as a key for success: Reduced avoidance behaviour mediates the effect of exposure therapy for fibromyalgia. Behav Res Ther. 2019 Sep 12;122:103478 Authors: Hedman-Lagerlöf M, Andersson E, Hedman-Lagerlöf E, Wicksell RK, Flink I, Ljótsson B Abstract Fibromyalgia (FM) is a prevalent chronic pain disorder associated with large suffering and substantial societal costs. Pain-related avoidance behaviour and hypervigilance to bodily symptoms are common in FM and contribute in maintaining and exacerbating the disorder. Exposure therapy targeting avoidance behaviours and hypervigilance has shown promise in the treatment of FM. The present study investigated mediators of treatment outcome in exposure therapy for FM. We used data from a randomised trial, where 140 participants were allocated to 10-week internet-delivered exposure therapy or to a waiting-list control condition. The main outcome variable (FM symptoms) and the hypothesized mediators (FM-related avoidance behaviour, mindful non-reactivity and FM-related worry) were measured weekly throughout treatment. Mediation analyses were conducted using linear mixed effects models with bootstrap replication and time-lagged analysis. Results indicated that all three process variables were significant mediators of FM severity. However, in the time-lagged analyses, only FM-related avoidance behaviour displayed a unidirectional relationship over time with FM symptoms, suggesting a caus...
Source: Behaviour Research and Therapy - Category: Psychiatry & Psychology Authors: Tags: Behav Res Ther Source Type: research