Fibromyalgia syndrome (FMS) is a prevalent, chronic musculoskeletal pain disorder. Despite extensive research the etiology and pathophysiologic mechanisms of FMS are not well understood, and no treatment has been shown to be universally effective. In this project, we propose that FMS is a complex disorder involving multiple factors, both physical and psychosocial-behavioral. In our previous research, we have demonstrated that FMS patients are heterogeneous in the psychosocial-behavioral axis and can be classified into 3 distinct subgroups on a basis of their psychosocial adaptation to symptoms. In this application we will extend our previous research and attempt to match treatments to patients psychosocial-behavioral characteristics. Specifically, we will test the efficacy of uniquely tailored treatment for each psychosocial subgroup. Three groups of FMS patients will be treated with one of the 3 treatment protocols with standard physical therapy and varying psychological treatments. A total of 312 FMS patients will undergo a 6 half-day interdisciplinary treatment sessions consisting of physical therapy and psychological treatments. All protocols include a standardized physical therapy but include either cognitive-behavioral pain management therapy, interpersonal skill training, or supportive counseling. In addition to the treatment outcome study, various symptoms of FMS will be assessed prospectively in the patients natural habitats to better understand covariations of FMS symptoms. The repeated daily monitoring using the palm-top computer (ecological momentary assessment) will permit us to evaluate the value of process ratings compared to retrospective reports. Overall, the results of these studies should establish the benefit of matching treatments to subject characteristics, and enhance our understanding of the roles of cognitive-affective-behavioral adaptation of FMS patients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR044724-05
Application #
6511897
Study Section
Special Emphasis Panel (ZRG5-CFS (01))
Program Officer
Ader, Deborah N
Project Start
1998-07-20
Project End
2005-06-30
Budget Start
2002-07-01
Budget End
2005-06-30
Support Year
5
Fiscal Year
2002
Total Cost
$455,279
Indirect Cost
Name
University of Washington
Department
Anesthesiology
Type
Schools of Medicine
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Thieme, Kati; Turk, Dennis C; Gracely, Richard H et al. (2015) The relationship among psychological and psychophysiological characteristics of fibromyalgia patients. J Pain 16:186-96
Robinson, James P; Theodore, Brian R; Wilson, Hilary D et al. (2011) Determination of fibromyalgia syndrome after whiplash injuries: methodologic issues. Pain 152:1311-6
Turk, Dennis C; Wilson, Hilary D (2010) Fear of pain as a prognostic factor in chronic pain: conceptual models, assessment, and treatment implications. Curr Pain Headache Rep 14:88-95
Wilson, Hilary D; Robinson, James P; Turk, Dennis C (2009) Toward the identification of symptom patterns in people with fibromyalgia. Arthritis Rheum 61:527-34
Wilson, Hilary D; Starz, Terence W; Robinson, James P et al. (2009) Heterogeneity within the fibromyalgia population: theoretical implications of variable tender point severity ratings. J Rheumatol 36:2795-801
Turk, Dennis C; Swanson, Kimberly S; Tunks, Eldon R (2008) Psychological approaches in the treatment of chronic pain patients--when pills, scalpels, and needles are not enough. Can J Psychiatry 53:213-23
Gatchel, Robert J; Peng, Yuan Bo; Peters, Madelon L et al. (2007) The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull 133:581-624
Thieme, Kati; Turk, Dennis C; Flor, Herta (2007) Responder criteria for operant and cognitive-behavioral treatment of fibromyalgia syndrome. Arthritis Rheum 57:830-6
Thieme, Kati; Rose, Ulrike; Pinkpank, Thomas et al. (2006) Psychophysiological responses in patients with fibromyalgia syndrome. J Psychosom Res 61:671-9
Thieme, Kati; Turk, Dennis C (2006) Heterogeneity of psychophysiological stress responses in fibromyalgia syndrome patients. Arthritis Res Ther 8:R9

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