{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T16:37:21Z","timestamp":1767890241495,"version":"3.49.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A recent randomized controlled trial (<jats:italic>N<\/jats:italic>\u00a0=\u00a0140) was indicative of large and sustained average improvements of Internet\u2010based exposure for fibromyalgia, as compared to a waitlist. However, little is known about who benefits the most from this treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To test for potential moderating effects of age, educational attainment, the duration of fibromyalgia, baseline overall fibromyalgia severity, pain intensity, fibromyalgia\u2010related avoidance behaviour and symptom preoccupation on the waitlist\u2010controlled effect of 10\u2009weeks of Internet\u2010based exposure for fibromyalgia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Secondary analysis of a randomized controlled trial (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> NCT02638636). We used linear mixed effects models to determine whether the waitlist\u2010controlled effect of exposure therapy on overall fibromyalgia severity (Fibromyalgia Impact Questionnaire) differed as a function of the potential moderators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only pain intensity (0\u201310) was found to be a significant moderator, where a higher baseline pain intensity predicted a more limited waitlist\u2010controlled effect of Internet\u2010based exposure (<jats:italic>B<\/jats:italic>\u00a0=\u00a03.48, 95% CI: 0.84\u20136.13). Standardized point estimates of effects were small for the sociodemographic variables, and in the moderate range for some clinical variables that did not reach statistical significance such as behavioural avoidance and time with the fibromyalgia diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results suggest that Internet\u2010based exposure treatment was more useful for participants with lower baseline levels of pain, and less so for participants with higher baseline levels of pain. The treatment had relatively similar effects across the other tested moderators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This study evaluated potential effect moderators in exposure\u2010based treatment for fibromyalgia. Results indicated that a higher level of pain intensity at baseline was predictive of a less favourable outcome. It may be extra important to monitor progression for these patients and to provide additional therapeutic support when needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2074","type":"journal-article","created":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T14:28:30Z","timestamp":1672496910000},"page":"507-517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effect moderators in Internet\u2010based exposure therapy for fibromyalgia: The role of pain intensity"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-099X","authenticated-orcid":false,"given":"Maria","family":"Hedman\u2010Lagerl\u00f6f","sequence":"first","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0088-8719","authenticated-orcid":false,"given":"Erik","family":"Andersson","sequence":"additional","affiliation":[{"name":"Division of Psychology, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8086-1668","authenticated-orcid":false,"given":"Brj\u00e1nn","family":"Lj\u00f3tsson","sequence":"additional","affiliation":[{"name":"Division of Psychology, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1624-8858","authenticated-orcid":false,"given":"Johanna","family":"Engelbrektsson","sequence":"additional","affiliation":[{"name":"Division of Psychology, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"Lundb\u00e4ck","sequence":"additional","affiliation":[{"name":"Division of Psychology, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Bj\u00f6rkander","sequence":"additional","affiliation":[{"name":"Department of Psychology Stockholms Universitet  Stockholm Sweden"},{"name":"Liljeholmen Primary Health Care Center Region Stockholm  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7939-9848","authenticated-orcid":false,"given":"Erik","family":"Hedman\u2010Lagerl\u00f6f","sequence":"additional","affiliation":[{"name":"Division of Psychology, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Gustavsberg Primary Health Care Centre  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2718-7402","authenticated-orcid":false,"given":"Ida","family":"Flink","sequence":"additional","affiliation":[{"name":"Center for Health and Medical Psychology (CHAMP) \u00d6rebro Universitet  \u00d6rebro Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2562-2925","authenticated-orcid":false,"given":"Erland","family":"Axelsson","sequence":"additional","affiliation":[{"name":"Liljeholmen Primary Health Care Center Region Stockholm  Stockholm Sweden"},{"name":"Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society Karolinska Institutet  Stockholm Sweden"},{"name":"Academic Primary Health Care Center Region Stockholm  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2020.01.012"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191105283504"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191107313003"},{"issue":"5","key":"e_1_2_10_5_1","article-title":"The fibromyalgia impact questionnaire (FIQ): A review of its development, current version, operating characteristics and uses","volume":"23","author":"Bennett R.","year":"2005","journal-title":"Clinical and Experimental Rheumatology"},{"issue":"9","key":"e_1_2_10_6_1","article-title":"Cognitive behavioural therapies for fibromyalgia. 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