The Effectiveness of Cognitive-Behavioral Therapy on Pain Severity and Alexithymia in Female Patients with Fibromyalgia

Abstract

This study aimed to determine the effectiveness of cognitive-behavioral therapy on pain severity and alexithymia in female patients with fibromyalgia. This study employed a quasi-experimental pretest-posttest design with a three-month follow-up and a control group. The statistical population consisted of female patients with fibromyalgia attending the rheumatology clinic of Sina Hospital in Tehran between September and November 2024. Thirty eligible participants were selected through purposive sampling and randomly assigned to an experimental group and a control group, with 15 participants in each group. The experimental group received eight weekly sessions of cognitive-behavioral therapy, whereas the control group received no psychological intervention during the study period. Data were collected using the Toronto Alexithymia Scale and the McGill Pain Questionnaire at pretest, posttest, and follow-up. Repeated-measures analysis of variance and pairwise comparisons were used for data analysis. The results revealed a significant time-by-group interaction for difficulty identifying feelings (F=58.91, p<0.001, ηp²=0.68). A significant interaction was also observed for difficulty describing feelings (F=80.37, p<0.001, ηp²=0.74) and externally oriented thinking (F=91.12, p<0.001, ηp²=0.77). Moreover, the time-by-group interaction for total pain was statistically significant (F=31.74, p<0.001, ηp²=0.53). Pairwise comparisons indicated significant differences between pretest and posttest and between pretest and follow-up for all study variables (p<0.001), whereas no significant differences were found between posttest and follow-up. Cognitive-behavioral therapy was effective in reducing pain severity and alexithymia in female patients with fibromyalgia. The maintenance of treatment gains at the three-month follow-up suggests that CBT may be considered an effective complementary psychological intervention within multidisciplinary treatment programs for women with fibromyalgia.