Study of Healthy Adaptation and Resilience to Pain in Emerging Adulthood (SHARPE)

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PROJECT SUMMARY/ABSTRACT Chronic musculoskeletal (MSK) pain is the leading source of persistent pain among late adolescents and young adults (AYAs) and contributes to significant functional disability, psychosocial impairment, and reduced quality of life. Moreover, the transitional stage of emerging adulthood presents unique challenges which can further complicate pain-related coping and adjustment in late AYAs. The influence of risk factors on maladaptive pain- related outcomes in youth is well-documented. However, much less is known about protective factors that may mitigate these negative consequences and promote healthy adaptation to pain during the transition to adulthood. It is imperative to identify these protective variables to foster positive outcomes throughout the life course. Resilience, characterized as a dynamic, malleable process leading to positive adaptation in the face of adversity, plays an important role in conferring adaptive responses to pain. However, resilience examined across multiple domains of functioning (i.e., psychological, social, biological, and health/lifestyle) is yet to be explored in late AYAs with and without chronic MSK pain. Thus, the overarching goal of this career development award (K23) is to fill this knowledge gap by: 1) characterizing multi-domain pain resiliency (MDPR) profiles during the transition to adulthood, and 2) investigating the utility of these profiles in predicting pain, functioning, and pain modulatory capacity over time. Information gained from this project will be invaluable for developing patient-centered prevention/intervention efforts. This K23 proposes scientific and training objectives that will be instrumental for launching an independent program of research that advances the science and treatment of pain and disability in late AYAs. The multidisciplinary mentoring team includes experts in biopsychosocial pain mechanisms, resilience/positive psychology, pediatric/adolescent pain, and biostatistics who will provide guidance and training necessary for achievement of professional goals that will facilitate the PI's transition to independence. Primary training objectives for the current proposal are to: 1) expand knowledge of biopsychosocial determinants of chronic pain, specifically factors related to promoting pain resilience across multiple domains of functioning, 2) develop a comprehensive knowledge base for variables influencing pain during the transition to adulthood and enhance training in the assessment and treatment of pain in late adolescents and young adults, 3) augment statistical acumen by increasing familiarity with advanced statistical analytics necessary for clinical research, especially for patient classification to inform patient-centered care, 4) enhance knowledge and skills necessary for clinical trial design and implementation, as well as prevention science methodology, and 5) advance leadership, mentoring, scholarly productivity, and other professional skills integral for fostering competency as an academic and independent clinical and translational investigator. The proposed career development plan extends from the PI's prior work on vulnerability mechanisms in pain, and will forge a path towards investigating strategies that promote resilience and improve pain and disability during the transition to adulthood.