Sustained pain reduction through affective self-awareness in fibromyalgia: a randomized controlled trial
Open accessAbstract
Background and objective Affect and how it is regulated plays a role in pain perception, maintenance of pain, and its resolution. This randomized, controlled trial evaluated an innovative affective self-awareness (ASA) intervention, which was designed to reduce pain and improve functioning in individuals with fibromyalgia.Participants and methods Forty-five women with fibromyalgia were randomized to a manualized ASA intervention (n = 24) or wait-list control (n = 21). The intervention began with a one-time physician consultation, followed by 3 weekly, 2-h group sessions based upon a mind-body model of pain. Sessions focused on structured written emotional disclosure and emotional awareness exercises. Outcomes in both conditions were measured by a blinded assessor at baseline, post-intervention, and 6-month follow-up.Measures The primary outcome was pain severity (Brief Pain Inventory); secondary outcomes included tender-point threshold and physical function (SF-36 Physical Component Summary). Intent-to-treat analyses compared groups on outcomes using analysis of covariance and on the proportion of patients achieving ≥ 30% and ≥ 50% pain reduction at 6 months.Results Adjusting for baseline scores, the intervention group had significantly lower pain severity (p < 0.001), higher self-reported physical function (p < 0.001), and higher tender-point threshold (p = 0.02) at 6 months compared to the control group. From baseline to 6 months, 45.8% of the ASA intervention group had ≥ 30% reduction in pain severity, compared to none of the controls (p < 0.001).Conclusions The affective self-awareness intervention improved pain, tenderness, and self-reported physical function for at least 6 months in women with fibromyalgia compared to wait-list control. This study suggests the value of interventions targeting emotional processes in fibromyalgia, although further studies should evaluate the efficacy of this intervention relative to active controls.
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Moderate evidence showed that self-awareness intervention effectively increased pressure pain threshold in the long term.
“Regarding PE, moderate evidence showed that self-awareness intervention was effective for increasing PPT in the long term [63].”
From Effectiveness of non-pharmacological conservative therapies in adults with fibromyalgia: A systematic review of high-quality clinical trials (2022) · cites this paper as [63]
Moderate evidence suggested that affective self-awareness intervention and motivational interviewing to encourage exercise reduced pain intensity in the short and long term.
“Moderate evidence suggested that affective self-awareness intervention and motivational interviewing for encourage exercise reduced pain intensity in the short and long term [57,63].”
From Effectiveness of non-pharmacological conservative therapies in adults with fibromyalgia: A systematic review of high-quality clinical trials (2022) · cites this paper as [63]
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- Authors
- Hsu, M. C., Schubiner, H., Lumley, M. A., Stracks, J. S., Clauw, D. J., & Williams, D. A.
- Affiliations
- Kaiser Permanente (US)
- Wayne State University (US)
- Northwestern University (US)
- University of Michigan (US)
- Corresponding author
- Schubiner, Howard
- Venue
- Journal of General Internal Medicine
- Published
- 2010-06-08
- Volume
- 25
- Issue
- 10
- Pages
- 1064-1070
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2955480
- OpenAlex
- W1976850677
- Cited by
- 102
- References
- 65
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 10 · 2020: 5 · 2019: 7 · 2018: 6 · 2017: 11 · 2016: 8 · 2015: 6 · 2014: 9 · 2013: 6 · 2012: 6
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Defense (DAMD170020018)
- American Academy of Physical Medicine and Rehabilitation
- National Institutes of Health (5t32hd007422-20)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR049059, AR049059)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD001097, T32-HD007422)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- fibromyalgia, analgesia, emotional awareness, emotional disclosure, physical function, women, group intervention
- MeSH terms
- Adult, Affect, Aged, Analgesia, Female, Fibromyalgia, Follow-Up Studies, Humans, Middle Aged, Pain, Self Concept, Severity of Illness Index, Time Factors, Treatment Outcome, Mind-Body Therapies, Pain Management
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