A Wayne State University researcher is investigating whether therapy that focuses on education, symptom management or confronting avoided emotional experiences is the best approach for fibromyalgia, a common and disabling pain condition.
Mark A. Lumley, professor of psychology in the College of Liberal Arts and Sciences, received a five-year, $3,373,000 grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health for the study “Pain and Stress Management for Fibromyalgia.”
The study’s co-investigators are David A. Williams and Daniel J. Clauw, M.D., of the University of Michigan Medical Center, and Howard Schubiner, M.D., of St. John Providence Health System.
Fibromyalgia afflicts 2 to 4 percent of U.S. adults, the majority of whom are women. Notoriously difficult to treat, FM is marked by widespread muscular pain and tenderness, fatigue, sleep problems and mood disturbance. FM is a complex condition. Its onset and course involve biological as well as psychological factors including beliefs, emotions and behaviors. Stressful life experiences, which are especially prevalent in patients with FM, likely contribute to the condition.
The five-year grant will test three competing psychological and behavioral interventions for fibromyalgia: patient education, cognitive behavior therapy and a novel emotional awareness and exposure therapy.
The CBT approach focuses on teaching patients skills to manage their pain and decrease their disability. Techniques include relaxation, distraction, problem solving and cognitive restructuring. Although CBT is the best supported psychological intervention for FM, research suggests that CBT helps only about a third of FM patients and is not as effective for patients who have unresolved stress or emotional issues.
Lumley and colleagues have developed and pilot-tested Emotional Exposure Therapy, which focuses on reducing stress by helping people confront emotions that they usually avoid. This is done through techniques such as expressive writing, mindfulness exercises and assertiveness training.
Lumley’s team brings together experts in all three of the interventions being tested. Lumley has focused on the relationships between stress, emotion regulation and pain for the past 17 years and has developed and tested various methods to help patients reduce stress and pain.
“Research has shown that the brain-and the pain that it generates-are greatly influenced by experiences and how people deal with their thoughts and emotions,” Lumley said. “Our goal is to test the effects of helping patients understand their condition, cope with pain or resolve stress.”
The study will also examine which types of patients respond best to which intervention. Lumley and colleagues will take into account factors such as trauma history, emotion regulation abilities, history of depression and degree of tenderness as predictors of which treatment option will have the most successful outcome for which participants.
“Because there are different factors that cause and maintain fibromyalgia, there likely is not a one-size-fits-all therapy,” Lumley said. “The hope for this study is that we may better understand these differences among patients, so that more treatment options are available and higher success rates are achieved by those who suffer with the disorder.”
Recruitment for the study will begin in February 2011. Recruitment will be open to all patients with a diagnosis of FM, but the researchers are especially interested in those patients diagnosed with FM in the past few years, including those meeting the new clinical FM diagnostic criteria. For information about participating in the study, contact the project manager at the Detroit/Southfield location at (313) 577-2258 or the Ann Arbor location at (866) 288-0046.
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