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Access Type

WSU Access

Date of Award

January 2018

Degree Type


Degree Name




First Advisor

Mark A. Lumley


Fibromyalgia (FM) is a condition of widespread pain and associated symptoms, including fatigue and nonrestorative sleep which are thought to stem from central nervous system sensitization and augmentation. Approximately 2% of the US population, predominantly women, qualify for a diagnosis of FM and the condition causes significant suffering and disability. Factors found to be related to FM include psychological trauma or stress, childhood adversity, and physical or sexual abuse, and the condition is often comorbid with anxiety and depression. Psychological treatments for FM tend to have modest effects, suggesting that individual differences influence responses to treatment. This study presents secondary analyses from a clinical trial in which 230 patients with FM were randomized into one of three interventions: Emotional Awareness and Expression Therapy (EAET), Cognitive Behavioral Therapy (CBT), or an active control FM Education (EDU). All interventions were delivered in eight, weekly group sessions and patients were assessed for a variety of physical and psychological variables before beginning the treatment, approximately two weeks after completing treatment, and six months later. Moderator analyses were conducted to determine whether alexithymia, trauma, and interpersonal distress moderated the effects of treatment condition on a number of outcomes, comparing EAET to CBT and EDU. Results indicated that for patients with low to moderate levels of alexithymia, EAET had better effects on widespread pain, pain severity, and perceived change in health status at posttreatment than did CBT or EDU and that some of these effects were maintained at follow up. For patients who had experienced a low to moderate number of traumatic events, EAET had better effects on perceived change in health status at posttreatment than did EDU, and for patients who perceived that their partner’s response to their pain was highly negative, EAET had better effects on depressive symptoms at follow up than did CBT.

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