{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:46:25Z","timestamp":1792737985284,"version":"4.5.0"},"reference-count":70,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T00:00:00Z","timestamp":1602979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Institute of Health Carlos III","doi-asserted-by":"publisher","award":["CPII19\/00003"],"award-info":[{"award-number":["CPII19\/00003"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>A recent study (FIBROWALK) has supported the effectiveness of a multicomponent treatment based on pain neuroscience education (PNE), exercise therapy (TE), cognitive behavioral therapy (CBT), and mindfulness in patients with fibromyalgia. The aim of the present RCT was: (a) to analyze the effectiveness of a 12-week multicomponent treatment (nature activity therapy for fibromyalgia, NAT-FM) based on the same therapeutic components described above plus nature exposure to maximize improvements in functional impairment (primary outcome), as well as pain, fatigue, anxiety-depression, physical functioning, positive and negative affect, self-esteem, and perceived stress (secondary outcomes), and kinesiophobia, pain catastrophizing thoughts, personal perceived competence, and cognitive emotion regulation (process variables) compared with treatment as usual (TAU); (b) to preliminarily assess the effects of the nature-based activities included (yoga, Nordic walking, nature photography, and Shinrin Yoku); and (c) to examine whether the positive effects of TAU + NAT-FM on primary and secondary outcomes at post-treatment were mediated through baseline to six-week changes in process variables. A total of 169 FM patients were randomized into two study arms: TAU + NAT-FM vs. TAU alone. Data were collected at baseline, at six-week of treatment, at post-treatment, and throughout treatment by ecological momentary assessment (EMA). Using an intention to treat (ITT) approach, linear mixed-effects models and mediational models through path analyses were computed. Overall, TAU + NAT-FM was significantly more effective than TAU at posttreatment for the primary and secondary outcomes evaluated, as well as for the process variables. Moderate-to-large effect sizes were achieved at six-weeks for functional impairment, anxiety, kinesiophobia, perceived competence, and positive reappraisal. The number needed to treat (NNT) was 3 (95%CI = 1.6\u20133.2). The nature activities yielded an improvement in affective valence, arousal, dominance, fatigue, pain, stress, and self-efficacy. Kinesiophobia and perceived competence were the mediators that could explain a significant part of the improvements obtained with TAU + NAT-FM treatment. TAU + NAT-FM is an effective co-adjuvant multicomponent treatment for improving FM-related symptoms.<\/jats:p>","DOI":"10.3390\/jcm9103348","type":"journal-article","created":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T21:26:06Z","timestamp":1603056366000},"page":"3348","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":81,"title":["Effectiveness of a Multicomponent Treatment for Fibromyalgia Based on Pain Neuroscience Education, Exercise Therapy, Psychological Support, and Nature Exposure (NAT-FM): A Pragmatic Randomized Controlled Trial"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5591-9407","authenticated-orcid":false,"given":"Mayte","family":"Serrat","sequence":"first","affiliation":[{"name":"Unitat d\u2019Expertesa en S\u00edndromes de Sensibilitzaci\u00f3 Central, Servei de Reumatologia, Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Stress and Health Research Group, Departament de Psicologia B\u00e0sica, Evolutiva i de l\u2019Educaci\u00f3, Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"},{"name":"Escola Universit\u00e0ria de Fisioter\u00e0pia, Escoles Universit\u00e0ries Gimbernat, Universitat Aut\u00f2noma de Barcelona, Sant Cugat del Vall\u00e8s, 08174 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4874-8013","authenticated-orcid":false,"given":"M\u00edriam","family":"Almirall","sequence":"additional","affiliation":[{"name":"Unitat d\u2019Expertesa en S\u00edndromes de Sensibilitzaci\u00f3 Central, Servei de Reumatologia, Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Must\u00e9","sequence":"additional","affiliation":[{"name":"Unitat d\u2019Expertesa en S\u00edndromes de Sensibilitzaci\u00f3 Central, Servei de Reumatologia, Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1688-435X","authenticated-orcid":false,"given":"Juan P.","family":"Sanabria-Mazo","sequence":"additional","affiliation":[{"name":"Stress and Health Research Group, Departament de Psicologia B\u00e0sica, Evolutiva i de l\u2019Educaci\u00f3, Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"},{"name":"Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Catalonia, Spain"},{"name":"Teaching, Research, &amp; Innovation Unit\u2014Parc Sanitari Sant Joan de D\u00e9u, St. Boi de Llobregat, 08830 Catalonia, Spain"},{"name":"Department of Medicine, International University of Catalonia, C\/Josep Trueta s\/n, Sant Cugat del Vall\u00e8s, 08195 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2810-7670","authenticated-orcid":false,"given":"Albert","family":"Feliu-Soler","sequence":"additional","affiliation":[{"name":"Stress and Health Research Group, Departament de Psicologia B\u00e0sica, Evolutiva i de l\u2019Educaci\u00f3, Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"},{"name":"Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Catalonia, Spain"},{"name":"Teaching, Research, &amp; Innovation Unit\u2014Parc Sanitari Sant Joan de D\u00e9u, St. Boi de Llobregat, 08830 Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9718-0607","authenticated-orcid":false,"given":"Jorge L.","family":"M\u00e9ndez-Ulrich","sequence":"additional","affiliation":[{"name":"Research Group on Socioeducative Interventions in Childhood and Youth (GRISIJ), Department of Methods of Research and Diagnosis in Education, Faculty on Education, University of Barcelona, 08007 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0750-1599","authenticated-orcid":false,"given":"Juan V.","family":"Luciano","sequence":"additional","affiliation":[{"name":"Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Catalonia, Spain"},{"name":"Teaching, Research, &amp; 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Proyecto EPISER2016","volume":"38","author":"Ferrer","year":"2020","journal-title":"Clin. Exp. Rheumatol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ejpain.2009.03.010","article-title":"Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain","volume":"14","author":"Gormsen","year":"2010","journal-title":"Eur. J. Pain"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"15022","DOI":"10.1038\/nrdp.2015.22","article-title":"Fibromyalgia","volume":"1","author":"Ablin","year":"2015","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 Revisions to the 2010\/2011 fibromyalgia diagnostic criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Wolfe, F., Walitt, B., Perrot, S., Rasker, J.J., and H\u00e4user, W. (2018). Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0203755"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/1477-7525-9-71","article-title":"The comparative burden of mild, moderate and severe Fibromyalgia: Results from a cross-sectional survey in the United States","volume":"9","author":"Schaefer","year":"2011","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/10582450801960339","article-title":"The Role of Peripheral Input for Chronic Pain Syndromes like Fibromyalgia Syndrome","volume":"16","author":"Staud","year":"2008","journal-title":"J. Musculoskelet. Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.pain.2010.09.030","article-title":"Central sensitization: Implications for the diagnosis and treatment of pain","volume":"152","author":"Woolf","year":"2011","journal-title":"Pain"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e12137","DOI":"10.1111\/jabr.12137","article-title":"The neurobiology of central sensitization","volume":"23","author":"Harte","year":"2018","journal-title":"J. Appl. Biobehav. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.math.2009.12.001","article-title":"Recognition of central sensitization in patients with musculoskeletal pain: Application of pain neurophysiology in manual therapy practice","volume":"15","author":"Nijs","year":"2010","journal-title":"Man. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/acr.20140","article-title":"The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity","volume":"62","author":"Wolfe","year":"2010","journal-title":"Arthritis Care Res. (Hoboken)"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Feliu-Soler, A., Borr\u00e0s, X., Pe\u00f1arrubia-Mar\u00eda, M., Rozadilla-Sacanell, A., D\u2019Amico, F., Moss-Morris, R., Howard, M., Fayed, N., Soriano-Mas, C., and Puebla-Guedea, M. (2016). Cost-utility and biological underpinnings of Mindfulness-Based Stress Reduction (MBSR) versus a psychoeducational programme (FibroQoL) for fibromyalgia: A 12-month randomised controlled trial (EUDAIMON study). BMC Complement. Altern. Med., 16.","DOI":"10.1186\/s12906-016-1068-2"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"021004","DOI":"10.1136\/bmjopen-2017-021004","article-title":"Effects of a community-based multicomponent rehabilitation programme for patients with fibromyalgia: Protocol for a randomised controlled trial","volume":"8","author":"Haugmark","year":"2018","journal-title":"BMJ Open"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.20452\/pamw.3877","article-title":"Management of fibromyalgia: Practical guides from recent evidence-based guidelines","volume":"127","author":"Ablin","year":"2017","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2508","DOI":"10.1097\/j.pain.0000000000001655","article-title":"A randomized controlled efficacy trial of Mindfulness-Based Stress Reduction compared to an active control group and usual care for fibromyalgia: The EUDAIMON study","volume":"160","author":"McCracken","year":"2019","journal-title":"Pain"},{"key":"ref_16","first-page":"108","article-title":"Interdisciplinary consensus document for the treatment of fibromyalgia","volume":"38","author":"Campayo","year":"2011","journal-title":"Actas Esp. Psiquiatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1002\/art.24276","article-title":"Efficacy of multicomponent treatment in fibromyalgia syndrome: A meta-analysis of randomized controlled clinical trials","volume":"61","author":"Bernardy","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1136\/annrheumdis-2016-209724","article-title":"EULAR revised recommendations for the management of fibromyalgia","volume":"76","author":"Macfarlane","year":"2016","journal-title":"Ann. Rheum. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1002\/ejp.1121","article-title":"Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome\u2014A systematic review and meta-analysis of randomized controlled trials","volume":"22","author":"Bernardy","year":"2018","journal-title":"Eur. J. Pain"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Galan-Martin, M.A., Montero-Cuadrado, F., Lluch-Girbes, E., Coca-L\u00f3pez, M.C., Mayo-Iscar, A., and Cuesta-Vargas, A. (2020). Pain Neuroscience Education and Physical Exercise therapy for Patients with Chronic Spinal Pain in Spanish Physiotherapy Primary Care: A Pragmatic Randomized Controlled Trial. J. Clin. Med., 9.","DOI":"10.3390\/jcm9041201"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1080\/09593985.2017.1331481","article-title":"Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia\/chronic fatigue syndrome: An explorative study","volume":"33","author":"Malfliet","year":"2017","journal-title":"Physiother. Theory Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1249\/MSS.0000000000001290","article-title":"The Effects of Exercise Training on Anxiety in Fibromyalgia Patients: A Meta-analysis","volume":"49","author":"McDowell","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0025-7753(06)72237-0","article-title":"Non-pharmacologic and alternative treatments in fibromyalgia","volume":"127","author":"Nishishinya","year":"2016","journal-title":"Med. Clin."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1002\/ejp.1561","article-title":"Necessary components of psychological treatment in pain management programs: A Delphi study","volume":"24","author":"Sharpe","year":"2020","journal-title":"Eur. J. Pain"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Sosa-Reina, M.D., N\u00fa\u00f1ez-Nagy, S., Gallego-Izquierdo, T., Pecos-Mart\u00edn, D., Monserrat, J., and \u00c1lvarez-Mon, M. (2017). Effectiveness of Exercise therapy in fibromyalgia syndrome: A systematic review and meta-analysis of randomized clinical trials. BioMed Res. Int., 2356346.","DOI":"10.1155\/2017\/2356346"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Aranda, A., D\u2019Amico, F., Feliu-Soler, A., McCracken, L.M., Pe\u00f1arrubia-Mar\u00eda, M.T., Andr\u00e9s-Rodr\u00edguez, L., and Luciano, J.V. (2019). Cost\u2013Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study). J. Clin. Med., 8.","DOI":"10.3390\/jcm8071068"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Serrat, M., Sanabria-Mazo, J.P., Must\u00e9, M., Soler, A.F., M\u00e9ndez-Ulrich, J.L., Sanz, A., Luciano, J.V., and Almirall, M. (2020). Effectiveness of a Multicomponent Treatment based on Pain Neuroscience Education, Therapeutic Exercise, Cognitive Behavioural Therapy, and Mindfulness in Patients with Fibromyalgia (FIBROWALK study): A Randomized Controlled Trial. PsyArXiv.","DOI":"10.31234\/osf.io\/kj8sp"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Serrat, M., Sanabria-Mazo, J.P., Garc\u00eda-Troiteiro, E., Fontcuberta, A., Mateo-Canedo, C., Almirall, M., Feliu-Soler, A., M\u00e9ndez-Ulrich, J.L., Sanz, A., and Luciano, J.V. (2020). Efficacy of a Multicomponent Intervention for Fibromyalgia Based on Pain Neuroscience Education, Exercise Therapy, Psychological Support, and Nature Exposure (NAT-FM): Study Protocol of a Randomized Controlled Trial. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17020634"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.healthplace.2019.02.001","article-title":"Determining the health benefits of green space: Does gentrification matter?","volume":"57","author":"Cole","year":"2019","journal-title":"Health Place"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Preu\u00df, M., Nieuwenhuijsen, M., M\u00e1rquez, S., Cirach, M., Dadvand, P., Triguero-Mas, M., Gidlow, C., Grazuleviciene, R., Kruize, H., and Zijlema, W.L. (2019). Low Childhood Nature Exposure is Associated with Worse Mental Health in Adulthood. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16101809"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s11136-019-02125-9","article-title":"The effect of nature exposure on the mental health of patients: A systematic review","volume":"28","author":"Christiansen","year":"2019","journal-title":"Qual. Life Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.envint.2018.10.002","article-title":"Active commuting through natural environments is associated with better mental health: Results from the PHENOTYPE project","volume":"121","author":"Zijlema","year":"2018","journal-title":"Environ. Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jad.2012.03.012","article-title":"Interacting with nature improves cognition and affect for individuals with depression","volume":"140","author":"Berman","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Luttenberger, K., Stelzer, E.-M., F\u00f6rst, S., Schopper, M., Kornhuber, J., and Book, S. (2015). Indoor rock climbing (bouldering) as a new treatment for depression: Study design of a waitlist-controlled randomized group pilot study and the first results. BMC Psychiatry, 15.","DOI":"10.1186\/s12888-015-0585-8"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"109641","DOI":"10.1016\/j.envres.2020.109641","article-title":"Exposure to greenspaces could reduce the high global burden of pain","volume":"187","author":"Stanhope","year":"2020","journal-title":"Environ. Res."},{"key":"ref_36","first-page":"1","article-title":"Sense of Well-Being in Patients with Fibromyalgia: Aerobic Exercise Program in a Mature Forest\u2014A Pilot Study","volume":"2015","author":"Blanco","year":"2015","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/2167702618772296","article-title":"The Future of Intervention Science: Process-Based Therapy","volume":"7","author":"Hofmann","year":"2019","journal-title":"Clin. Psychol. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Sanabria-Mazo, J.P., Serrat, M., Canedo, C.M., Soler, A.F., Almirall, M., M\u00e9ndez-Ulrich, J.L., Luciano, J.V., and Sanz, A. (2020). Proof of Concept of a Treatment for Fibromyalgia Based on Physical Activity, Psychological Support, and Exposure to Nature (NAT-FM). PsyArXiv.","DOI":"10.31234\/osf.io\/hyc86"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c869","article-title":"CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomized trials","volume":"340","author":"Moher","year":"2010","journal-title":"BMJ"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/art.1780330203","article-title":"The american college of rheumatology. Criteria for the classification of fibromyalgia","volume":"33","author":"Wolfe","year":"1990","journal-title":"Arthritis Rheum."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.3899\/jrheum.100594","article-title":"Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: A Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia","volume":"38","author":"Wolfe","year":"2011","journal-title":"J. Rheumatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1093\/rheumatology\/keu169","article-title":"Validation of the modified 2010 American College of Rheumatology diagnostic criteria for fibromyalgia in a Spanish population","volume":"53","author":"Aparicio","year":"2014","journal-title":"Rheumatology (Oxford)"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"R120","DOI":"10.1186\/ar2783","article-title":"The Revised Fibromyalgia Impact Questionnaire (FIQR): Validation and psychometric properties","volume":"11","author":"Bennett","year":"2009","journal-title":"Arthritis Res. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1002\/acr.22034","article-title":"Dimensionality, reliability, and validity of the Revised Fibromyalgia Impact Questionnaire in two Spanish samples","volume":"65","author":"Luciano","year":"2013","journal-title":"Arthritis Care Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S1699-258X(07)73594-5","article-title":"Propuesta de una versi\u00f3n de consenso del Fibromyalgia Impact Questionnaire (FIQ) para la poblaci\u00f3n espa\u00f1ola","volume":"3","author":"Redondo","year":"2007","journal-title":"Reumatol. Clin."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/1477-7525-11-132","article-title":"Validation of a Spanish version of the Revised Fibromyalgia Impact Questionnaire (FIQR)","volume":"11","author":"Salgueiro","year":"2013","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0163-8343(03)00043-4","article-title":"A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population","volume":"25","author":"Herrero","year":"2003","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36) (I). Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med. Care"},{"key":"ref_50","first-page":"771","article-title":"The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): An instrument for measuring clinical results","volume":"104","author":"Alonso","year":"1995","journal-title":"Med. Clin. (Barc.)"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1037\/0022-3514.54.6.1063","article-title":"Development and validation of brief measures of positive and negative affect: The PANAS Scales","volume":"54","author":"Watson","year":"1998","journal-title":"J. Person. Soc. Psych."},{"key":"ref_52","first-page":"529","article-title":"Adaptaci\u00f3n de la \u201cEscala de afecto positivo y negativo\u201d (PANAS) en una muestra general espa\u00f1ola","volume":"23","year":"2015","journal-title":"Behav. Psychol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Rosenberg, M. (1965). Society and the Adolescent Self-Image, Princeton University Press.","DOI":"10.1515\/9781400876136"},{"key":"ref_54","first-page":"247","article-title":"Escala de autoestima de Rosenberg: Fiabilidad y validez en poblaci\u00f3n cl\u00ednica espa\u00f1ola","volume":"22","year":"2004","journal-title":"Apuntes Psicol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A Global Measure of Perceived Stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J. Health Soc. Behav."},{"key":"ref_56","first-page":"305","article-title":"La \u201cEscala de Estr\u00e9s Percibido\u201d: Estudio psicom\u00e9trico sin restricciones en poblaci\u00f3n no cl\u00ednica y adictos a sustancias en tratamiento","volume":"23","author":"Pedrero","year":"2015","journal-title":"Behav. Psychol."},{"key":"ref_57","first-page":"35","article-title":"Kinesiophobia: A new view of chronic pain behavior","volume":"3","author":"Kori","year":"1990","journal-title":"Pain Manag."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.jpain.2010.08.004","article-title":"Psychometric Properties of the Spanish Version of the Tampa Scale for Kinesiophobia (TSK)","volume":"12","year":"2011","journal-title":"J. Pain"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1037\/1040-3590.7.4.524","article-title":"The Pain Catastrophizing Scale: Development and validation","volume":"7","author":"Sullivan","year":"1995","journal-title":"Psychol. Assess."},{"key":"ref_60","first-page":"487","article-title":"Validaci\u00f3n de la versi\u00f3n espa\u00f1ola de la escala de la catastrofizaci\u00f3n ante el dolor (Pain Catastrophizing Scale) en la fibromialgia","volume":"131","author":"Rodero","year":"2008","journal-title":"Med. Cl\u00edn."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/BF01173488","article-title":"Hocus-pocus, the focus isn\u2019t strictly on locus: Rotter\u2019s social learning theory modified for health","volume":"16","author":"Wallston","year":"1992","journal-title":"Cogn. Ther. Res."},{"key":"ref_62","first-page":"31","article-title":"Validaci\u00f3n de la Escala de Competencia Personal de Wallston: Implicaciones para el estudio del estr\u00e9s","volume":"4","author":"Doval","year":"1998","journal-title":"Ans. Est."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/S0191-8869(00)00113-6","article-title":"Negative life events, cognitive emotion regulation and emotional problems","volume":"30","author":"Garnefski","year":"2001","journal-title":"Pers. Individ. Differ."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Feliu-Soler, A., Reche-Camba, E., Borr\u00e0s, X., P\u00e9rez-Aranda, A., Andr\u00e9s-Rodr\u00edguez, L., Pe\u00f1arrubia-Mar\u00eda, M.T., Navarro-Gil, M., Garc\u00eda-Campayo, J., Bell\u00f3n, J.A., and Luciano, J.V. (2017). Psychometric Properties of the Cognitive Emotion Regulation Questionnaire (CERQ) in Patients with Fibromyalgia Syndrome. Front. Psychol., 8.","DOI":"10.3389\/fpsyg.2017.02075"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1146\/annurev.clinpsy.3.022806.091415","article-title":"Ecological Momentary assessment","volume":"4","author":"Shiffman","year":"2008","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Csikszentmihalyi, M. (2014). Validity and Reliability of the Experience-Sampling Method, Springer.","DOI":"10.1007\/978-94-017-9088-8_3"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.jpain.2018.01.006","article-title":"Ecological Momentary Assessment Methodology in Chronic Pain Research: A Systematic Review","volume":"19","author":"May","year":"2018","journal-title":"J. Pain"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.jclinepi.2013.03.017","article-title":"Multiple imputation of missing values was not necessary before performing a longitudinal mixed-model analysis","volume":"66","author":"Twisk","year":"2013","journal-title":"J. Clin. Epidemiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1177\/1094428106291059","article-title":"Estimating Effect Sizes From Pretest-Posttest-Control Group Designs","volume":"11","author":"Morris","year":"2008","journal-title":"Organ. Res. Methods"},{"key":"ref_70","first-page":"1","article-title":"A 12-week multicomponent therapy in fibromyalgia improves health but not in concomitant moderate depression, an exploratory pilot study","volume":"29","author":"Ollevier","year":"2019","journal-title":"Disabil. Rehabil."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/10\/3348\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:23:35Z","timestamp":1760178215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/10\/3348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,18]]},"references-count":70,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["jcm9103348"],"URL":"https:\/\/doi.org\/10.3390\/jcm9103348","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,18]]}}}