Comorbidity of Mental Disorders and Pain

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DESCRIPTION (provided by applicant): This request for an NIMH Senior Scientist Award (K05) focuses on better understanding the biopsychosocial mechanisms associated with the comorbidity of mental disorders and complex pain problems. The program addresses Goal 1 of "Healthy People 2010: Understanding and Improving Health"--to improve health-related quality of life, with a special focus on comorbid mental health disorders and one of the most prevalent and costly forms of pain (chronic back pain). We will also focus on successful translational intervention research, which is a high priority of NIH. My ongoing biopsychosocial research program investigating the comorbidity of mental disorders and pain contains four inter-related components: early intervention translational research; cost-effectiveness translational research; underlying neuromatrix model-related research; and fMRI research. To that end, we will pursue three separate research projects over the next five years and beyond: preventing comorbid mental disorders and physical health disability; an evaluation and early intervention study of comorbid psychiatric and temporomandibular (TMD) disorders; and a randomized trial of comorbid mental disorders and musculoskeletal pain intervention in a military population. All of these projects will focus on early detection to prevent the development of such chronic disorders, recognized as a high priority research area in the PHS Report of "Healthy People 2000." Many of my current and future research projects will also evaluate a potentially heuristic theory of the interaction between pain and stress (the neuromatrix model of pain). In addition, we plan to use new fMRI technology in our future research projects to develop a more comprehensive understanding of biopsychosocial mechanisms of comorbid mental disorders and pain. This Award will enable me to maintain the momentum and clinical research advances of two previous consecutive K02 awards from NIMH.