ORIGINAL ARTICLE An Online Mindfulness Intervention Targeting Socioemotional Regulation in Fibromyalgia: Results of a Randomized Controlled Trial Mary C. Davis, Ph.D. & Alex J. Zautra, Ph.D. Published online: 14 May 2013 # The Society of Behavioral Medicine 2013 Abstract Background Patients with fibromyalgia (FM) experience pain as well as deficits in positive affect and social relations that are not explicitly addressed in most behavioral treatments. Purpose The purpose of this study is to compare the effects of a 12-module online intervention targeting socioemotional regulation via mindful awareness/acceptance (MSER) with those of an attention-control treatment, healthy lifestyle tips (HT). Methods Seventy-nine FM patients were randomly assigned to MSER or HT, with outcomes assessed via online diary reports of pain, coping efficacy, affect, and social relations. Multilevel analyses revealed greater improve- ments in social functioning, positive affect, and coping efficacy for pain and stress (all ps<.05) in MSER versus HT across the 6-week trial. Conclusions FM patients experience increases in self- efficacy for coping with pain and positive engagement in relationships, marginal increases in positive affect, and de- creases in relationship stress from an automated online inter- vention that targets socioemotional regulation skills. Findings highlight the potential utility of widely accessible, low-cost intervention methods for fibromyalgia (Clinicaltrials.gov number NCT01748786). Keywords Fibromyalgia . On-line interventions . Mindfulness . Emotion regulation . Social relations Introduction Fibromyalgia (FM) is a disorder of widespread pain and fatigue that affects 1–4 % of individuals over their lifetimes, most of them women [1]. Like other chronic pain condi- tions, FM often leads to disability, affective disturbance, and poor quality of life [2, 3]; however, FM presents unique challenges. Even compared with pain patients experiencing similar levels of pain, FM patients show greater social and emotional dysregulation; they report higher levels of anxiety and depression, lower levels of positive affect, and greater alienation from others in their social networks [4–6]. Without effective means to cope with their condition, pain can come to dominate patients’ lives, diminishing their engagement with positive affective resources, and ultimately increasing long-term physical and psychological disability. The health and well-being of FM patients may hinge on their ability to meet two central challenges to emotional regulation that arise from their condition: (1) minimizing the negative consequences of pain and other stressors, and (2) sustaining positive engagement in social relations, key sources of positive affect, despite their pain. Cognitive- behavioral therapy, the most widely used behavioral treat- ment for pain, primarily targets management of pain but devotes some attention to increasing positive activity and social engagement. Cognitive-behavioral therapy produces modest improvements in pain and pain coping but has met with limited success ameliorating affective and social com- plaints in FM patients [7–10]. A mindfulness-based approach offers an alternative to cognitive-behavioral therapy for chronic pain. Mindfulness cultivates awareness and nonjudgmental acceptance of cur- rent experiences, including aversive ones. By interrupting maladaptive automatic responding, mindfulness can not This research was supported by grants from the Arizona Institute for Mental Health Research to Mary C. Davis and Pfizer to Alex J. Zautra. M. C. Davis (*) : A. J. Zautra Department of Psychology, Arizona State University, P.O. Box 1104, Tempe, AZ 85287-1104, USA e-mail: mary.davis@asu.edu ann. behav. med. (2013) 46:273–284 DOI 10.1007/s12160-013-9513-7