Abstract
A quasi-experimental design was used to assess a multimodal pain treatment program for female patients with fibromyalgia to ascertain immediate and long-term effects. Laboratory and self-report pain measures together with psychological measures were obtained from patients who were tested up to 6 months after treatment. Comparison data were also obtained from fibromyalgia patients who failed to qualify for the treatment program because of insurance coverage. Immediate and long-term treatment effects were evident with the psychological measures and the subjective pain measures but not with the laboratory pain measures. Participants who attended the month-long multimodal program achieved significant and positive changes on most of the outcome measures. However, relapse prevention must be addressed.
Similar content being viewed by others
References
Ahles, T. A., Yunus, M. B., Riley, S. D., Bradley, J. M., and Masi, A. T. (1984). Psychological factors associated with primary fibromyalgia syndrome. Arth. Rheum. 27: 1101–1106.
Ahles, T. A., Yunus, M. B., and Masi, A. T. (1987). Is chronic pain a variant of depressive disease? The case of primary fibromyalgia syndrome. Pain 9: 105–111.
Basler, H.-D., and Rehfisch, H. P. (1990). Follow-up results of a cognitive-behavioral treatment for chronic pain in a primary care setting. Psychol. Health 4: 293–304.
Baumstark, K. E., and Buckelew, S. P. (1992). Fibromyalgia: Clinical signs, research findings, treatment: Implications and future directions. Ann. Behav. Med. 14: 282–291.
Baumstark, K. E., Buckelew, S. P., Sher, K. J., Beck, N., Buescher, K. L., Hewett, J., and Crews, T. M. (1993). Pain behavior predictors among fibromyalgia patients. Pain 55: 339–346.
Beck, A. T., and Beamesderfer, A. (1974). Assessment of depression: The depression inventory. In Pichot, P. (ed.), Psychological Measurements in Psychopharmacology. Modern Problems in PharmacoPsychiatry, Vol. 7, Karger, Basel, pp. 151–169.
Bennett, R. M. (1993). A multidisciplinary approach to treating fibromyalgia. In Vaeroy, H., and Merskey, H. (eds.), Pain Research and Clinical Management, Vol. 6. Progress in Fibromyalgia and Myofascial Pain, Elsevier, New York, pp. 393–410.
Blasco, T., and Bayes, R. (1988). Unreliability of the cold pressor te st method in pain studies. Methods Find. Exp. Clin. Pharmacol. 10: 767–772.
Bradley, L. A. (1989). Cognitive-Behavioral therapy for primary fibromyalgia. J. Rheumatol. 16(Suppl. 19): 131–136.
Buckelew, S. P. (1989). Fibromyalgia: A rehabilitation approach. Am. J. Phys. Med. Rehab. 68: 37–42.
Burckhardt, C. S., Clark, S. R., and Bennett, R. M. (1991). The fibromyalgia impact questionnaire: Deve lopment and validation. J. Rheumatol. 18: 728–733.
Carette, S., Bell, M. J, Reynolds, W. J., Haraoui, B., McCain, G. A., Bykerk, V. P., Edworthy, S. M., Baron, M., Koehler, B. E., Fam, A. G., Bellamy, N., and Guimont, C. (1994). Comparison of Amitriptyline, Cyclobenzaprine and placebo in the treatment of fibromyalgia. Arth. Rheum. 37: 32–40.
Clark, S., Campbell, S. M., Forehand, M. E., Tindall, E. A., and Bennett, R. M. (1985). Clinical characteristics of fibrositis. II. A “blinded” controlled study using standard psychological tests. Arthr. Rheum. 28: 132–137.
Deardorff, W. W., Rubin, H. S., and Scott, D. W. (1991). Comprehensive multidisciplinary treatment of chronic pain: A follow-up study of treated and non-treated groups. Pain 45: 35–43.
Guck, T. P., Skultety, F. M., Meilman, P. W., and Dowd, E. T. (1985). Multidisciplinary pain center follow-up study: Evaluation with a no-treatment control group. Pain 21: 295–306.
Hines, E. A., and Brown, G. E. (1933). Standard test for measuring the variability of blood pressure: Its significance as an index of the prehypertensive state. Ann. In tern. Med. 7: 209–217.
Keefe, F. J., Caldwell, D. S., Queen, K. T., Gil, K. M., Martinez, S., Crisson, J. E., Ogden, W., and Nunley J. (1987). Pain coping strategies in osteoarthritis patients. J. Consult. Clin. Psychol. 55: 208–212.
Linssen, A. C. G., and Spinhoven, P. (1992). Multimodal treatment programs for chronic pain: A quantitative analysis of existing re search data. J. Psychosom. Res. 6: 275–286.
McCain, G. A., Bell, D. A., Mai, F. M., and Halliday, P. D. (1988). A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arth. Rheum. 31: 1135–1141.
McCracken, L. M. (1991). Cognitive-be havioral treatme nt of rheumatoid arthritis: A preliminary review of efficacy and methodology. Ann. Behav. Med. 13: 57–65.
Nielson, W. R., Walker, C., and McCain, G. A. (1992). Cognitive behavioral treatment of fibromyalgia syndrome: Preliminary findings. J. Rheumatol. 19: 98–103.
Price , D. D., McGrath, P. A., Rafii, A., and Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17: 45–56.
Rollman, G. B. (1989). Measurement of pain in fibromyalgia in the clinic and laboratory. J. Rheumatol. 16(Suppl. 19): 113–119.
Rollman, G. B., and Lautenbacher, S. (1993). Hypervigilance effects in fibromyalgia: Pain experience and pain perception. In Vaeroy, H., and Merskey, H. (eds.), Pain Research and Clinical Management, Vol. 6. Progress in Fibromyalgia and Myofascial Pain, Elsevier, New York, pp. 149–159.
Rosenstiel, A. K., and Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment. Pain 17: 33–44.
Scott, J., and Huskisson, E. C. (1976). Graphic represe ntation of pain. Pain 2: 175–184.
Turk, D. C., Meichenbaum, D., and Genest, M. (1983). Pain an d Behavioral Medicine: A Cognitive-Behavio ral Perspective, Guilford Press, New York.
Ursin, H., Endresen, I. M., Haland, E. M., and Mjellem, N. (1993). Sensitization: a neurobiological theory for muscle pain. In Vaeroy, H., and Merskey, H. (eds.), Pain Research and Clinical Management, Vol. 6. Progress in Fibromyalgia and Myofascial Pain, Elsevier, New York, pp. 413–427.
Wolfe, F., Smythe, H. A., Yunus, M. B., Bennett, R. M., Bombardie r, C., Goldenberg, D. L., Tugwell, P., Campbe ll, S. M., Abeles, M., Clark, P., Fam, A. G., Farber, S. J., Fiechtner, J. J., Franklin, C. M., Gatter, R. A., Hamaty, D., Lessard, J., Lichtbroun, A. S., Masi, A. T., McCain, G. A., Reynolds, W. J., Romano, T. J., Russell, I. J., and Sheon, R. P. (1990). The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arth. Rheum. 33: 160–172.
Yunus, M. B. (1992). Fibromyalgia: A dysfunctional syndrome with chronic pain. In Sicuteri, F., et al. (eds.), Advances in Pain Research and Therapy, Vol. 20, Raven Press, New York, pp. 133–140.
Rights and permissions
About this article
Cite this article
Mason, L.W., Goolkasian, P. & McCain, G.A. Evaluation of a Multimodal Treatment Program for Fibromyalgia. J Behav Med 21, 163–178 (1998). https://doi.org/10.1023/A:1018727924432
Issue Date:
DOI: https://doi.org/10.1023/A:1018727924432