{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:09:12Z","timestamp":1762542552347},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T00:00:00Z","timestamp":1465948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["KT Th 877\/1\u20102"],"award-info":[{"award-number":["KT Th 877\/1\u20102"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["01EC1010D"],"award-info":[{"award-number":["01EC1010D"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2016,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Determination of psychophysiological effects of operant behavioural (OBT<\/jats:styled-content>) and cognitive behavioural treatment (CBT<\/jats:styled-content>) for fibromyalgia patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>One hundred and fifteen female patients randomized to OBT<\/jats:styled-content> (N<\/jats:italic>\u00a0=\u00a043), CBT<\/jats:styled-content> (N<\/jats:italic>\u00a0=\u00a042), or whole\u2010body infrared heat (IH<\/jats:styled-content>) (N<\/jats:italic>\u00a0=\u00a030) were compared before and after group treatment as well as at 6\u2010 and 12\u2010month follow\u2010ups using intent\u2010to\u2010treat analysis (12 drop\u2010outs). Thirty matched pain\u2010free controls (CON<\/jats:styled-content>) served as reference group for the initial psychophysiological analysis. Surface electromyogram (EMG<\/jats:styled-content>), blood pressure, heart rate (HR<\/jats:styled-content>) and skin conductance levels (SCL<\/jats:styled-content>) were continuously recorded during adaptation, baseline, social conflict, mental arithmetic and relaxation tasks.<\/jats:p><\/jats:sec>Results<\/jats:title>At baseline, fibromyalgia patients showed higher SCL<\/jats:styled-content> and HR<\/jats:styled-content>, lower diastolic blood pressure and EMG<\/jats:styled-content> in comparison to controls. OBT<\/jats:styled-content> and CBT<\/jats:styled-content> compared to IH<\/jats:styled-content> significantly reduced pain intensity [OBT<\/jats:styled-content>: effect size (ES<\/jats:styled-content>)\u00a0=\u00a01.21 CI<\/jats:styled-content>: 0.71\u20131.71, CBT<\/jats:styled-content>: ES<\/jats:styled-content>\u00a0=\u00a01.23, CI<\/jats:styled-content>: 0.72\u20131.74]. OBT<\/jats:styled-content> increased diastolic blood pressure [ES<\/jats:styled-content>\u00a0=\u00a01.13, CI<\/jats:styled-content>: 0.63\u20131.63 and CBT<\/jats:styled-content> reduced SCL<\/jats:styled-content> (ES<\/jats:styled-content>)\u00a0=\u00a0\u22120.66, CI<\/jats:styled-content>: \u22121.14\u20130.18] 12 months after treatment. Both CBT<\/jats:styled-content> and OBT<\/jats:styled-content> significantly increased EMG<\/jats:styled-content> levels (OBT<\/jats:styled-content>: ES<\/jats:styled-content>\u00a0=\u00a00.97, CI<\/jats:styled-content>: 0.48\u20131.46, CBT<\/jats:styled-content>: ES<\/jats:styled-content>\u00a0=\u00a01.17, CI<\/jats:styled-content>: 0.67\u20131.68). In contrast, the IH<\/jats:styled-content> group did not show any significant changes in the psychophysiological parameters.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Increased diastolic blood pressure and decreased pain after OBT<\/jats:styled-content> suggest a reactivation of baroreflex\u2010mechanisms in fibromyalgia and a normalization of the blood pressure and pain functional relationship. Reduced SCL<\/jats:styled-content> following CBT<\/jats:styled-content> may indicate reduced general arousal levels. Increased muscle tension after CBT<\/jats:styled-content> and OBT<\/jats:styled-content> suggest a normalization of physical parameters. The reduction in pain seems to be mediated by different psychophysiological processes, providing support for mechanism\u2010based treatments might be indicated for CBT<\/jats:styled-content> and OBT<\/jats:styled-content>.<\/jats:p><\/jats:sec>What does this study add?<\/jats:title>\n\n\nDifferential physiological stress responses followed different psychological interventions.<\/jats:p><\/jats:list-item>\n\nWhile OBT influenced blood pressure by restoring blood pressure\u2010pain interaction, CBT reduced stress\u2010related sudomotor activity.<\/jats:p><\/jats:list-item>\n\nThese results implicate specific mediating mechanisms in fibromyalgia suggesting a basis for matching based on specific patient psychophysiological features.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.872","type":"journal-article","created":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T16:53:02Z","timestamp":1466009582000},"page":"1478-1489","source":"Crossref","is-referenced-by-count":14,"title":["Differential psychophysiological effects of operant and cognitive behavioural treatments in women with fibromyalgia"],"prefix":"10.1002","volume":"20","author":[{"given":"K.","family":"Thieme","sequence":"first","affiliation":[{"name":"Department of Medical Psychology Philipps\u2010University Marburg Germany"},{"name":"Center for Pain Research and Innovation University of North Carolina Chapel Hill USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.C.","family":"Turk","sequence":"additional","affiliation":[{"name":"Center for Pain Research on Impact, Measurement & Effectiveness (C\u2010PRIME) Department of Anesthesiology and Pain Medicine University of Washington Seattle USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.H.","family":"Gracely","sequence":"additional","affiliation":[{"name":"Center for Pain Research and Innovation University of North Carolina Chapel Hill USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Flor","sequence":"additional","affiliation":[{"name":"Department of Clinical and Cognitive Neuroscience Central Institute of Mental Health Medical Faculty Mannheim University of Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,6,15]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.41.2.104"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151116"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-06968-4"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31802b4f80"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00295-6"},{"key":"e_1_2_5_7_1","unstructured":"Burckhardt C.S. 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