The purpose of this study was to investigate the effects of spouse participation in treatment on symptomatology in individuals suffering from fibrositis, a form of soft tissue rheumatism which has no identifiable, organic etiology and which represents a chronic, intractable pain disorder. While spouse participation has been widely advocated in the treatment of fibrositis and other chronic pain disorders, its effects as a unitary variable had not yet been objectively measured. In the present study, spouse participation consisted of a six-week, seven session group therapy program. Educational materials, counseling, and mutual support were utilized. Patients themselves were not directly exposed to treatment. Five patient-spouse diads were randomly assigned to each of the two treatment groups. Coincidental attrition resulted in the loss of one diad from each group. A time-series design was used in which treatment and nontreatment intervals were alternated for the two treatment groups. Six dependent measures were administered to the patients at pretest, posttest, and follow-up. The measures assessed were: pain intensity, functional activity, psychological adjustment, emotional dependency, and awareness of disability. The last two measures were also administered at pretest, posttest, and follow-up to the spouses. Significant results beyond the .05 level of confidence were yielded on psychological adjustment and awareness of disability for the patients. Analysis of individual subscales revealed that a significant reduction had occurred on the following scales: somatization, depression, obsessive-compulsiveness, psychoticism, and emotional reliance on others. Improvement did not reach a statistically significant level on pain intensity, functional activity, or overall dependency. Significant results were achieved only on the variable of awareness of disability for the spouses. The findings indicate that spouse participation in treatment had measurable, beneficial effects on symptomatology for the patients in this study, and support the application of similar interventions with other fibrositis and/or chronic pain patients.

A series of five individual studies explored: (1) Whether a treatment focus emphasizing active anger expression would alter the subject's awareness of and ability to express anger and (2) Whether such a treatment focus would alter the subject's experience of illness in the form of her report of pain and stiffness as "better", "the same", or "worse" than yesterday's experience. The treatment strategy utilized general Gestalt principles and was further focused on specific techniques of Anger Therapy as an agent of change. Evaluation of outcome in this time-lagged multiple baseline design viewed the overall process from the beginning of a baseline observation period through a maximum of one week following the conclusion of the last six weekly treatment sessions; daily measurement of the process of change during treatment; and clinical description of the subjects and of the treatment process itself. The overall process was formally assessed in pre and post treatment testing which included the Novaco Anger Inventory, Buss-Durkee Hostility Inventory, Marlowe-Crowne Social Desirability Scale, and FIRO-B. Daily telephone interview measured the frequency of anger awareness, anger expression; and ratings of anger intensity, overall daily mood, pain, and stiffness. Information from the treatment process was integrated with that obtained from other sources in discussing the outcome for each subject. It was concluded that intense anger expression appeared to effect temporary or transitory improvement in pain; that there was a relationship between each subject's perceived daily anger intensity and pain which appeared consistent for all subjects studied; and that issues of need for approval and control appeared related to anger awareness and expression as measured by the psychometrics utilized. These were recommended as potentially fruitful areas of future investigation. Background data revealed striking similarities in birth order and parenting practices which seemed worthy of further study as well.