Evaluating the efficacy of an attention modification program for patients with fibromyalgia: a randomized controlled trial

R.N. Carleton*, G.J.G. Asmundson, S.L. Korol, D.M. LeBouthillier, K. Hozempa, J.D. Katz, J.W.S. Vlaeyen, G. Crombez

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Persons with chronic musculoskeletal pain may be hypervigilant for pain-related cues which, paradoxically, may be maintaining their pain. Several randomized controlled trials have assessed whether a modified dot-probe protocol (ie, attention bias modification [ABM]) reduces chronic pain- and pain-related symptoms in persons with several diagnoses, including fibromyalgia. Scalability and economic efficiency potentiates the appeal of ABM protocols; however, research results have been mixed, with only some studies evidencing significant symptom gains from ABM and some evidencing gains for the control group. The current randomized controlled trial sought to replicate and extend previous ABM research using idiosyncratic word stimuli and a 1-month follow-up. Participants included treatment-seeking adult women (n = 117) with fibromyalgia who were randomly assigned to a standard (ie, control) or active (ie, ABM) condition. The protocol was delivered online and involved twice-weekly 15-minute sessions, for 4 weeks, with questionnaires completed at baseline, posttreatment, and 1-month follow-up. Symptom reports were analysed with mixed hierarchical modelling. There was no evidence of differences between the control and ABM groups. Both groups had small significant (Ps < 0.05) improvements in pain experiences at posttreatment, but not at follow-up (Ps > 0.05). There were no significant changes for either group on measures of anxiety sensitivity, illness/injury sensitivity, pain-related fear, pain-related anxiety, or attentional biases (Ps > 0.05). The current findings add to the emerging and mixed literature regarding ABM for pain by demonstrating that ABM produces no substantive improvements in pain or pain-related constructs in a large sample of patients with fibromyalgia.
Original languageEnglish
Pages (from-to)584-594
Number of pages11
JournalPain
Volume161
Issue number3
DOIs
Publication statusPublished - 1 Mar 2020

Keywords

  • anxiety
  • anxiety-stress scales
  • attention modification
  • bias modification
  • chronic musculoskeletal pain
  • depression-anxiety
  • fear
  • fibromyalgia
  • modified stroop paradigm
  • pain-related information
  • psychometric properties
  • selective attention
  • social anxiety
  • special section
  • ANXIETY-STRESS SCALES
  • SELECTIVE ATTENTION
  • Fibromyalgia
  • SOCIAL ANXIETY
  • BIAS MODIFICATION
  • PAIN-RELATED INFORMATION
  • CHRONIC MUSCULOSKELETAL PAIN
  • Anxiety
  • MODIFIED STROOP PARADIGM
  • DEPRESSION-ANXIETY
  • PSYCHOMETRIC PROPERTIES
  • Chronic musculoskeletal pain
  • Attention modification
  • Fear
  • SPECIAL SECTION

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