Cognitive Behavior Therapy for Fibromyalgia: A Meta-Analysis

Fibromyalgia is a chronic illness involving widespread pain, and many related symptoms such as fatigue, mood disorders, headache, and sleep disturbance. This condition has been traditionally difficult for health care providers to treat with medications. Increasingly, treatment programs for individuals with Fibromyalgia have included psychological therapies such as Cognitive Behavioral Therapy (CBT). CBT has shown preliminary evidence to support its use in Fibromyalgia; however, there is a limited understanding of CBT in this population. This meta-analysis examined all treatment studies, which included at least one group of patients receiving CBT. Functional Status, Pain Symptoms, Depression, Anxiety and Psychological distress were used as separate outcome variables to examine the effects of CBT. A literature review was conducted using Medline, PsycINFO, and the Cochrane Central Register of Controlled Trials. Of the 2000 studies that were found, 29 research studies met criteria for inclusion in the study. This resulted in 1220 participants and 167 effect sizes that could be examined. Effect sizes were corrected using Hedge’s correction for small sample bias aggregated at the study level and the dependent variable level (function, pain, depression, anxiety and psychological distress). All dependent variables in this analysis were significant and at least a medium effect size: Function d=0.65 (95%CI 0.30 – 0.99), Pain Symptoms d=0.85 (95%CI 0.53 – 1.17), Depression d=0.69 (95%CI 0.34 – 1.04), Anxiety d=0.66 (95%CI 0.22 – 1.10), Psychological Distress d=0.76 (95%CI 0.37 – 1.14). Factors that increased effect sizes across outcomes were the number of sessions and the use of a multidisciplinary therapy. In summary, the evidence supporting the use of CBT to treat individuals with Fibromyalgia to improve functioning, decrease pain, depression symptoms, anxiety symptoms and psychological distress is strong. Degree Type Dissertation Rights Terms of use for work posted in CommonKnowledge. Comments Library Use: LIH This dissertation is available at CommonKnowledge: http://commons.pacificu.edu/spp/233 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license.] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This dissertation is available at CommonKnowledge: http://commons.pacificu.edu/spp/233 COGNITIVE BEHAVIOR THERAPY FOR FIBROMYALGIA: A META-ANALYSIS A DISSERTATION SUBMITTED TO THE FACULTY OF SCHOOL OF PROFESSIONAL PSYCHOLOGY PACIFIC UNIVERSITY, HILLSBORO, OREGON BY SUSAN M. GRITZNER IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PSYCHOLOGY November 15, 2011 Jennifer R. Antick, Ph.D. Chair Michael S. Christopher, Ph.D. Reader Paul G. Michael, Ph.D. Consultant James B. Lane, Ph.D. Dean