• Annika Kohl, Winfried Rief, and Julia Anna Glombiewski.
• Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstr.18, D-35032 Marburg, Germany. Electronic address: kohlan@gmx.de.
• J Behav Ther Exp Psychiatry. 2014 Dec 1; 45 (4): 467-74.

Background And ObjectivesThe aim of this study was to clarify mechanisms of psychological fibromyalgia treatment by experimentally examining the effectiveness of its core elements. We assessed the effects of cognitive restructuring and acceptance on experimentally-induced heat and cold pain tolerance and pain intensity in fibromyalgia patients.MethodsCold and heat pain were induced in a sample of 60 fibromyalgia patients using a thermode. We conducted ANCOVAs to examine group differences in posttest scores, co-varying for pretest scores. The between-groups factor was the type of instruction provided (acceptance, cognitive restructuring, and a control condition). In addition, we controlled for pain sensitivity, age, and depression.ResultsWe found that acceptance and cognitive restructuring were superior to the control condition in increasing heat pain tolerance, but did not differ from one another. With respect to cold pain tolerance, cognitive restructuring was associated with increases in cold pain tolerance compared to the control condition, while acceptance did not differ either from the control condition or from cognitive restructuring.LimitationsFurther experimental research on chronic pain treatment mechanisms is needed, particularly research on individually tailoring treatment strategies according to patients characteristics.ConclusionResults show that both, cognitive restructuring and acceptance instructions, enhance pain tolerance in fibromyalgia patients.Copyright © 2014 Elsevier Ltd. All rights reserved.

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