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The efficacy of a combined cognitive-behavioural and interpersonal therapy approach to the treatment of fibromyalgia syndrome : a randomized controlled trial

dc.contributor.advisorMacGregor, Michael Wm.en_US
dc.contributor.committeeMemberMcMullen, Lindaen_US
dc.contributor.committeeMemberBusch, Angelaen_US
dc.contributor.committeeMemberBuckelew, Susanen_US
dc.contributor.committeeMembervon Baeyer, Carlen_US
dc.creatorLangford, Melanie Marieen_US
dc.date.accessioned2008-07-23T11:38:42Zen_US
dc.date.accessioned2013-01-04T04:46:44Z
dc.date.available2009-07-24T08:00:00Zen_US
dc.date.available2013-01-04T04:46:44Z
dc.date.created2008en_US
dc.date.issued2008en_US
dc.date.submitted2008en_US
dc.description.abstractThe purpose of the current study was to develop a manualized treatment for fibromyalgia syndrome (FM) and to examine the efficacy of the treatment in a randomized controlled clinical trial. FM is a chronic musculoskeletal pain disorder characterized by tender points and generalized pain. Depression, chronic fatigue, and sleep disturbance are common. A biopsychosocial model served as a framework for understanding FM by integrating psychological, social, and physical factors. Cognitive-behavioural therapy (CBT), an empirically validated treatment for arthritis, has also been used with FM patients in an attempt to improve pain control, reduce disability, and increase self-efficacy. Overall, the attention/placebo controlled studies employing CBT as a treatment for FM show that it is not superior to a credible attention placebo. The current study attempted to combine the necessary components of CBT with interpersonal therapy to address relational patterns and personality characteristics that can affect ability to cope with chronic pain. One hundred and five women diagnosed with FM by a rheumatologist were randomly assigned to the CBT-interpersonal treatment condition or an attention-control condition. There were 8 treatment groups with a mean of 6-7 participants in each. The treatment consisted of weekly 2-hour sessions over 8 consecutive weeks. Outcome measures included: FM impact, pain, health care utilization, depression, coping, and self-efficacy. An intention-to-treat analysis was conducted. Results showed that the impact of FM symptoms was reduced following treatment compared to the control group and this was statistically and clinically significant, but was not maintained at 3-month follow-up. Significant improvements were also observed in coping strategies, some of which were maintained at follow-up. Importantly, self-efficacy improved significantly following treatment compared to the control group. Self-efficacy beliefs have been related to pain, coping efforts, disability, and psychological functioning. Directions for future research may include a focus on long-term maintenance of treatment gains that may be mediated by improvements in self-efficacy. There is strong evidence that changes in self-efficacy are enduring and affect changes in health behaviours and health status.en_US
dc.identifier.urihttp://hdl.handle.net/10388/etd-07232008-113842en_US
dc.language.isoen_USen_US
dc.subjectfibromyalgia syndromeen_US
dc.subjectinterpersonal therapyen_US
dc.subjectcognitive-behavioural therapyen_US
dc.subjectrandomized controlled trialen_US
dc.titleThe efficacy of a combined cognitive-behavioural and interpersonal therapy approach to the treatment of fibromyalgia syndrome : a randomized controlled trialen_US
dc.type.genreThesisen_US
dc.type.materialtexten_US
thesis.degree.departmentPsychologyen_US
thesis.degree.disciplinePsychologyen_US
thesis.degree.grantorUniversity of Saskatchewanen_US
thesis.degree.levelDoctoralen_US
thesis.degree.nameDoctor of Philosophy (Ph.D.)en_US

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