Examining domains of trauma response and their link to chronic pain

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PROJECT SUMMARY/ABSTRACT Physical and emotional trauma are linked to numerous negative health effects, including a nearly three-fold increase in the odds of reporting chronic pain. Research suggests that post-traumatic chronic pain is preceded by at least three classes of factors (i.e., psychological, neurobiological, and social) that might allow for earlier identification of vulnerable individuals. Yet, current data used to elucidate potential mechanisms linking traumatic events to pain development have been limited. Capturing longitudinal data that identifies early risk factors and vulnerabilities to pain is particularly difficult. Additionally, few studies have evaluated the role of social perception and sensitivity to negative social stimuli (i.e., ‘social sensitivity’) as potential mediators linking trauma exposure to physical pain. The current proposal seeks to address these limitations by integrating multiple domains and levels of analysis to examine the impact of traumatic response on the development and persistence of chronic pain. The project will first leverage existing longitudinal and experimental data collected as part of the Advancing Understanding of RecOvery afteR traumA (AURORA) study (NIMH U01MH110925) to explore psychological and neurobiological contributions to post-traumatic pain vulnerability. The project will then expand beyond the data available in AURORA by conducting an experimental study in participants with varying histories of trauma and clinical pain characteristics to examine the associations between social perception and sensitivity, trauma sequelae, and pain. The study will utilize experimental paradigms measuring emotion perception, perspective-taking, and social sensitivity and assess these social processing factors as potential mediators of the association between trauma sequelae and pain characteristics. The association between survey measures of social perception and pain symptoms will also be assessed over time. This research proposal is part of a larger training plan that allows the candidate to develop expertise in trauma and pain, longitudinal data analysis, and experimental methodology; and leadership skills through management of a small study team. The candidate has assembled a mentorship team of experts with extensive expertise in pain phenotyping, trauma, experimental methodology, and statistical analysis. Combined with the rich environment of the University of Michigan, this award will provide focused training to establish a unique niche of expertise and an independent research program focused on the intersection of trauma and pain. It will also provide critical preliminary data for future funding dedicated to advancing our understanding in this critical area of research.