Psychological and Physiological Correlates of a Brief Intervention to Enhance Self-Regulation in Patients with Fibromyalgia

Abstract

Objectives

The main objectives of this study were to determine whether training and practice of a brief focused breathing technique is associated with improvements in physiological reactivity to a standard laboratory stressor [cold pressor test] and improvements in affect [anxiety, depression], self-efficacy, fatigue, sleep quality, and pain measures.

Methods

The patients for this study were diagnosed with fibromyalgia syndrome [N = 20]. Study patients completed an initial laboratory assessment including a diaphragmatic breathing training session. Patients were instructed to practice the technique for three 10-min sessions daily and returned to the lab for a second assessment after two weeks.

Results

All study patients showed significant improvements in pain severity, fatigue, pain self-efficacy, cold pressor tolerance, and heart rate variability indices between the two laboratory assessments.

Conclusions

The study results suggest that the practice of a brief diaphragmatic breathing technique is associated with significant changes in a number of areas of physiological and psychological functioning in patients with fibromyalgia. In particular, the increase in the heart rate variability total power may represent a significant change in post-training self-regulatory ability. The greater improvements in somatic symptoms suggest that using this diaphragmatic breathing technique daily may enhance the inhibitory ability of sympathetic tone, achieving improved autonomic balance, physiological reactivity, and daily functioning.

Keywords:

• Self-regulation
• heart rate variability
• diaphragmatic breathing
• fibromyalgia
• psychophysiology

ACKNOWLEDGEMENTS

This study was supported in part by a small grant award from the Department of Psychiatry and Psychology, Mayo Clinic to Dr. Schmidt. Additional support was provided by the Mayo Clinic CTSA: RR-024150. Dr. Joyner is the Frank R. and Shari Caywood Professor of Anesthesiology at Mayo Clinic College of Medicine. Portions of these data were presented at the 2008 annual meeting of the American Pain Society and the 2009 annual meeting of the American Psychosomatic Society.

DECLARATION OF INTEREST The authors declare no conflict of interest.