Mental Function And Quality Of Life With Chronic Pain

慢性疼痛的心理功能和生活质量

基本信息

  • 批准号:
    10254010
  • 负责人:
  • 金额:
    --
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2021
  • 资助国家:
    美国
  • 起止时间:
    2021-07-01 至 2023-06-30
  • 项目状态:
    已结题

项目摘要

Background: Chronic pain is common in Veterans and astute rehabilitation plans are critical to avoid deleterious outcomes for functional outcomes and other quality of life (QoL). Attaining optimal functional outcomes after pain rehabilitation is challenging, however, in cases when a significant portion of disability stems from “nonorganic” psychological factors. Disability from primarily psychologically-driven factors would make a Veteran a poor candidate for invasive medical procedures (which would have minimal benefit and potential harms). Nonorganic pain has been traditionally probed using clinician-rated “Waddell signs.” However, these signs are inconsistently probed, with questionable inter-rater reliability and can be challenging in the VHA wherein symptom endorsement can be financially reinforced. Therefore, there is a critical need for a time-sensitive, hard-to-feign objective marker of psychologically-driven disability for treatment planning. This project is a proof-of-concept study to determine whether subconscious bias toward pain, such as attentional capture by pain-related stimuli, correlates with mood symptomatology and clinician impressions of psychologically-driven disability at intake, with an exploratory aim of relating bias metrics to pain treatment outcomes. Approach: Over a 15-month period, 50 Veterans slated for assessment at a VA medical center (VAMC) pain clinic and 30 “control” Veterans slated for a non-pain-related appointment (e.g. Primary Care) with minimal pain histories will identified from electronic medical records (EMR) and approached prior to their intake appointment and invited to complete a ~90-minute assessment battery on a portable touchscreen-tablet-PC, either in their home or at the VAMC. This battery will be composed of interview-based instruments of pain symptomatology and disability (e.g. occupational function), affective symptomatology and QoL, as well as performance of neurocognitive tasks of subconscious bias toward pain- related concepts/words and pain-related images. Comparator tasks of impulsivity and frustration tolerance will also be included. This assessment will conclude with the patient making ratings of the burden or aversiveness of the assessments themselves. Six months following this assessment, participants will repeat by telephone interview the pain symptom, pain disability and QoL assessment items probed at baseline. In addition to the core goal of probing the feasibility of computerized bias assessment in Veterans with chronic pain, analyses will test for: 1) differences in subconscious pain bias between pain and non-pain patients, and 2) correlations between subconscious bias and mood/pain/disability/QoL symptom scores at baseline, to assess the core validity of probing subconscious bias measures in pain patients. As value-added supplemental analyses, we will: 1) relate assessment items (both bias tasks and interview instrument scores) to Waddell ratings of intake clinicians noted in EMR, 2) relate attentional (implicit) bias scores to pain and disability ratings at follow-up. Follow-on MERIT projects: Many Veterans who show signs of psychologically-driven disability are reluctant to adopt provider recommendations to seek integrative mental health care. To help providers motivate these patients, follow-on MERIT studies will collect evidence that Veterans with psychologically-driven pain disability selectively benefit from wrap-around mental health care. The strongest neurobehavioral markers (of self-reported and clinician- rated psychological distress) from the laptop assessment of this I21 project will be ported to a mobile app testing platform for a full-scale observational study designed to show whether app (task) results are predictive of pain treatment outcomes, as a function of whether mental health services were utilized. These data will enable the testing app to return actual bias “risk” scores to the patient and provider. In a subsequent clinical trial of the app’s risk score, we will compare functional rehabilitation outcomes when the psychological risk rating is (one study arm) vs is not (other arm) available to the provider for treatment planning. Rehabilitation outcomes in terms of whole QoL and pain symptomatology will be tracked and compared between groups as a function of (interaction with) whether app-flagged (probable-nonorganic pain) cases were given integrative mental health services.
背景:慢性疼痛是常见的退伍军人和精明的康复计划是关键,以避免有害的

项目成果

期刊论文数量(0)
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会议论文数量(0)
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James M Bjork其他文献

James M Bjork的其他文献

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{{ truncateString('James M Bjork', 18)}}的其他基金

Mental Function And Quality Of Life With Chronic Pain
慢性疼痛的心理功能和生活质量
  • 批准号:
    10814126
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
Mental Function And Quality Of Life With Chronic Pain
慢性疼痛的心理功能和生活质量
  • 批准号:
    10391343
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
20/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT VCU
20/21 ABCD-美国联盟:弗吉尼亚联邦大学研究项目现场
  • 批准号:
    10594478
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
20/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT VCU
20/21 ABCD-美国联盟:弗吉尼亚联邦大学研究项目现场
  • 批准号:
    10399189
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
20/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT VCU
20/21 ABCD-美国联盟:弗吉尼亚联邦大学研究项目现场
  • 批准号:
    10379286
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
20/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT VCU
20/21 ABCD-美国联盟:弗吉尼亚联邦大学研究项目现场
  • 批准号:
    9983351
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
Reward context and brain signatures of drug abuse risk in adolescents
青少年药物滥用风险的奖励背景和大脑特征
  • 批准号:
    9316900
  • 财政年份:
    2017
  • 资助金额:
    --
  • 项目类别:
Examining Brain Development, Context, and Culture as Mediators and Moderators of the Relation between Adverse Childhood Experiences (ACEs) and Substance (Ab)use
检查大脑发育、背景和文化作为不良童年经历 (ACE) 和药物 (Ab) 使用之间关系的中介和调节因素
  • 批准号:
    10618501
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:

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