Comparison Between Three Techniques Of Pyschological Intervention For The Treatment Of Fibromyalgia: Stress Control Training, Progressive Relaxation And Cognitive Restructuring
Keywords:
fibromyalgia, psychological disorder, psychological intervention, intervention studies, cognitive therapyAbstract
Introduction
Fibromyalgia is a chronic syndrome with unknown etiology, characterized by musculoskeletal pain that affects several areas of the body. Due to the lack of organic changes, the presence of psychological factors such as stress, anxiety, depression, lack of assertiveness and irrational beliefs seem to influence its onset and maintenance.
Objective
Compare the effectiveness of three psychological intervention techniques: Stress Management Training, Progressive Relaxation and Cognitive Restructuring.
Methods
21 female patients with fibromyalgia participated, from the Rheumatology Outpatient Clinic of a University Hospital in the interior of São Paulo, randomly divided into three groups. Group I participated in Stress Control Training; Group II underwent Progressive Relaxation and, in Group III, Cognitive Restructuring was performed. The patients received simultaneous medical treatment and were contacted through an interview and submitted to the application of the Stress Symptoms Inventory, Anxiety and Depression Scale, the Inassertiveness Levels Survey, Irrational Beliefs and the Visual Analogue Scale.
Results
They revealed that the three techniques made it possible to reduce the level of stress; the reduction of anxiety and depression and the development of assertiveness. They also revealed that none of the techniques proved to be significant in reducing the perception of pain.
Conclusion
The controversies regarding the etiology of this disease are confirmed and the need for further work is raised to verify the most effective type of intervention.
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References
Bellometti S, Galzina L. Function of hypotalamic adrenal axis in patients with fibromyalgia. lnt J Clin Pharmacol Res 1999; 19(1)27-33
Fransen JRN, Russel IJ. The Fibromyalgia help book: practical guide to living better with fibromyalgia. New York: Smith House Press; 1996.
Goldenberg DL What's the future of Fibromyalgia? Rheumatic Dis Clinics North Am 1996; 22(2):393-405. Lipp MEN. Como enfrentar o stress. São Paulo ícone; 1990.
Lipp MEN, Malagris LEN. O Manejo do stress. ln: Range B, organizador. Psicoterapia comportamental e cognitiva. Campinas: Editora Psy; 1995; 24 279-92.
Lipp MEN. Stress e suas implicações Estudos de Psicologia 1984; 1 (3-4) 5-19.
Jacobson E. Progressive relaxation. Chicago: University of Chicago Press; 1938.
Everly GS, Rosenfield R. The Nature and treatment of the stress response. New York: Plenum Press; 1981.
Meichenbaum D. Stress inoculation training New York: Plenun Press; 1985.
Ellis A. Humanistc psychology: the rational emotive approach. New York: Julian; 1973.
Lipp MEN, Nogueira JCP, Nery MJS. Estudo experimental de duas condições .de tratamento médico-psicológico a pessoas portadoras de psoríase. Campinas NEP; 1991.
Dias RR. Stress e Psoríase: assertividade e crenças irracionais [dissertação]. PUC-Campinas: Campinas; 1998.
Lipp MEN, Bignotto MM, Alcino AB. Efeitos do treino de controle do stress social na reatividade cardiovascular de hipertensos. Psicologia: Teoria, Investigação e Prática 1997; 2:137-46.
Brasio KM. Eficácia do treino de controle de stress na retocolite ulcerativa inespecífica [tese]. PUC-Campinas: Campinas; 2000.
Torrezan EA. O efeito do controle de stress no resultado da gravidez [tese]. PUC-Campinas: Campinas; 1999.
Kirkby RJ Changes im premenstrual symptons and irrational thinking following cognitive-behavioral coping skills training. J Consulting Clin Psychol 1994; 62(5): 1026-32.
Silverglade, L, Tosi DJ, Wise PS, D'Costa A. lrrational beliefs and emotionality in adolecentes with and without bronchial asthma. J Gen Psychology 1994; 12(3):199-207.
Lichtenberg JW, Johnson DDV, Arachtingi BM. Physical illness and subscription to Elli's lrrational Beliefs J Counseling Dev 1992; 71(6): 157-63.
Klages U. Life events and irrational atitudes in patients with rheumatoid arthritis: relations to pain, disability and general health condition. lnt J Psychosomatics 1991; 38:21-26.
Sternbach R. Principies of psychophysiology. New York: Academic Press; 1966.
Caballo VE. Manual de técnicas de terapia e modificação do comportamento. São Paulo: Santos; 1996.
Davis M, Eshelman ER, Mackay M. Manual de relaxamento e redução do estresse. São Paulo: Summus; 1996.
Laloni DT O relaxamento físico: significado, uso e metodologia. ln: Lipp MEN. Relaxamento para todos: controle o seu stress. Campinas: Papirus; 1997. 2:33-6.
Campos LFL. Terapia racional-emotivo-comportamental. ln: Rangé B. Psicoterapia comportamental e cognitiva: pesquisa, prática, aplicações e problemas. Campinas; Editora Psy; 1998. 7:79-88.
Lipp MEN. O valor do controle estresse como terapêutica de hipertensão arteira!. ln: Knobel M. Psicossomática. Campinas: NEP; 1991. p.83-162.
Lipp MEN, Guevara AJH. Validação empírica do inventário de sintomas de stress. Est Psicologia, 1994; 11 (3):42-4.
Rathus S. A 30 - Item schedule for assetive behavior. Behavior Res Ther 1973; 4:398-406
Rimm DC, Masters JC. Técnicas e resultados experimentais. Rio de Janeiro: Manole; 1983.
Soares DM. O estresse do executivo brasileiro: diferenças e similaridades entre homens e mulheres [dissertação]. PUC-Campinas; 1990.
