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Cited by 242Fibromyalgia and Chronic Fatigue Syndrome ResearchPsychosomatic Disorders and Their TreatmentsMindfulness and Compassion Interventions

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

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Lumley, Mark A., Schubiner, Howard, Lockhart, Nancy A., Kidwell, Kelley M., Harte, Steven E., Clauw, Daniel J., Williams, David A.·2017·Pain
DOI 10.1097/j.pain.0000000000001036PMC PMC5680092
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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 summary, an intervention targeting emotional awareness and expression related to psychosocial adversity and conflict was well received, more effective than a basic educational intervention, and had some advantages over CBT on pain. We conclude that EAET should be considered as an additional treatment option for FM.

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Metadata

Authors
Lumley, M. A., Schubiner, H., Lockhart, N. A., Kidwell, K. M., Harte, S. E., Clauw, D. J., & Williams, D. A.
Affiliations
  • Wayne State University (US)
  • Ascension (US)
  • Biostatistics
Corresponding author
Lumley, Mark A.
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-08-08
Volume
158
Issue
12
Pages
2354-2363
ISSN
  • 0304-3959 (ISSN-L)
  • 1872-6623
DOI
10.1097/j.pain.0000000000001036
PMC
PMC5680092
OpenAlex
W2742876406
Cited by
242
References
20
Citations by year
2026: 25 · 2025: 41 · 2024: 30 · 2023: 24 · 2022: 34 · 2021: 33 · 2020: 19 · 2019: 17 · 2018: 15 · 2017: 3
FWCI
12.13
Type
journal article
Language
en
Open access
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Wayne State University
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR057808)
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
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords
fibromyalgia, cognitive behavioral therapy, patient education, psychosocial adversity, emotional conflict, widespread pain, pain intensity, anxiety, depression, life satisfaction, cognitive impairment, physical function
MeSH terms
Adult, Awareness, Behavior, Depression, Emotions, Female, Fibromyalgia, Humans, Male, Middle Aged, Pain Measurement, Quality of Life, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome

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