Investigation of the effect of online dialectical behavior therapy skills training on fibromyalgia and psychological symptoms in female patients diagnosed with fibromyalgia

This thesis primarily aims to investigate the effect of Dialectical Behavioral Therapy Group Skills Training (DBG-GST) on Fibromyalgia (FMS) symptoms and pain among female patients diagnosed with FMS and compare these effects with Cognitive Behavioral Therapy (CBT) Pain Management Program and control group. Additionally, it explores the effects of DBT-GST on emotion regulation skills, mindfulness, distress tolerance, depression, anxiety, quality of sleep, and interpersonal effectiveness compared to CBT and the control group in FMS patients. Within this scope, 42 female patients diagnosed with FMS were randomly assigned to DBT-GST, CBT, and waitlist groups. The age of the participants ranged from 22 to 45. The DBT (n=14) group received DBT-GST involving mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills. And the CBT group (n=14) underwent CBT Focused Pain Management Program, which included the psychology of pain, recognizing negative automatic thoughts, cognitive restructuring, stress management, pain coping techniques, relaxation and increasing mobility skills. Those in the control group (n=14) were placed on the waiting list. Skills training sessions were conducted online for 2 hours, once a week over 12 weeks. The Revised Fibromyalgia Impact Questionnaire (FIQR) was used to assess disease severity and the patient's overall functionality, and the Visual Analog Pain Scale (VAS) was used to measure pain levels. For the secondary purposes of the research, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Mindful Attention Awareness Scale (MAAS), Emotion Regulation Difficulties Scale (DERS), Distress Tolerance Scale (DTS), Pittsburgh Sleep Quality Index (PSQI) and Inventory of Interpersonal Problems (IIP) were administered. Data were collected pre-intervention, at the 6th week, at the end of the intervention, and 3-month follow-up. Two-Way Analysis of Variance in Repeated Measurements was used to analyze the data. Results indicate that compared to CBT and waitlist groups, DBT-GST effectively reduces pain levels and severity of FMS and improves general functionality of the patients. Moreover, DBT-GST is also effective in reducing the depression and anxiety levels of the patients and difficulties experienced in emotion regulation and interpersonal effectiveness compared to CBT and the control group. Therefore, DBT-GST can be psychotherapy method in treating FMS patients. Keywords: Dialectical Behaviour Therapy, Fibromyalgia, Difficulty in Emotional Regulation, Chronic Pain, Online Therapy