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Internet-Delivered Exposure Therapy for Fibromyalgia: A Randomized Controlled Trial
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
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2018 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 34, no 6, p. 532-542Article in journal (Refereed) Published
Abstract [en]

Background: Fibromyalgia (FM) is a common and disabling chronic pain disorder, for which existing pharmacological and psychological treatments have yet yielded insufficient effects. Previous literature has shown that exposure therapy may be an effective treatment for chronic pain. This study constitutes the first randomized controlled trial evaluating exposure therapy for FM.

Methods: A total of 140 participants with diagnosed FM were randomized to a 10-week Internet-delivered exposure treatment (iExp; n=70) or a waitlist control condition (WLC; n=70). Primary outcome measure were FM symptoms and impact, and secondary outcome measures were fatigue, disability, quality of life, pain-related distress and avoidance behaviors, insomnia, depression, and anxiety.

Results: Data retention was high (100% data completion at posttreatment for primary outcome, 96% at 6-month follow-up and 94% at 12-month follow-up). Results showed that participants in the iExp group made large and superior improvements compared with WLC on FM symptoms and impact (B, ?1.93; z, ?10.14; P<0.001, betweengroup Cohen d=0.90), as well as all secondary outcomes (betweengroup Cohen d ranging from 0.44 to 1.38) with sustained results.

Conclusions: We conclude that iExp seems to be an efficacious treatment for FM compared with no treatment, and the results also highlight the potential increase of accessibility by using the Internet format to deliver psychological treatments for these patients. Future trials with active control conditions are warranted.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018. Vol. 34, no 6, p. 532-542
Keywords [en]
Fibromyalgia, exposure therapy, cognitive behavior therapy, randomized controlled trial, clinical trial, chronic pain
National Category
Applied Psychology Anesthesiology and Intensive Care Neurology
Identifiers
URN: urn:nbn:se:oru:diva-63394DOI: 10.1097/AJP.0000000000000566ISI: 000432189500006PubMedID: 29077623Scopus ID: 2-s2.0-85046896272OAI: oai:DiVA.org:oru-63394DiVA, id: diva2:1167095
Note

Funding Agencies:

Fredrik and Ingrid Thuring Foundation, Stockholm, Sweden  

Söderström-König Foundation, Stockholm, Sweden 

Stockholm County Council, Stockholm, Sweden  

Karolinska Institutet, Stockholm, Sweden 

Available from: 2017-12-18 Created: 2017-12-18 Last updated: 2018-09-16Bibliographically approved

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