Effect of behavioral activation treatment on chronic fibromyalgia pain: Replication and extension.

Abstract

A multiple-baseline-across two behavior sets and positions (reclined, upright) was used to experimentally examine the effect of Behavioral Activation Treatment for Pain (BAT-P) on pain-related behavior of a 44-year-old woman with a 22-year history of fibromyalgia (FM). BAT-P, based on the matching law, is comprised of Behavioral Relaxation Training (BRT), scheduled relaxation-activity cycles, daily relaxation practice, shaping performance of valued activities, visual feedback of performance and descriptive praise. Visual feedback was provided for pain interference rating, performance of relaxation skills, and self-rated depression. A behavioral contract was implemented to increase maintenance of intervention effects. Percent-relaxed behavior was functionally related to BRT with limited generalization from reclined to upright positions or across behavior sets. BAT-P resulted in clinically significant decreases in self-reported pain interference, pain anxiety, and depression and medication usage. Pain anxiety cognition declined without direct cognitive restructuring. Results were maintained at three- and sixmonth follow up. Findings replicate results of BAT-P for FM pain interference and pain anxiety cognition. Use of systematic maintenance procedures extends past research on BAT-P. Results provide further support for the utility of “pure” behavior analytic interventions for FM and the benefit of such procedures for pain anxiety cognition.