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An in-depth Examination of the Psychological Processes involved in the Transition from Acute to Chronic Pain after a Traumatic Musculoskeletal Injury

Award Number: K01AR073300
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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PROJECT SUMMARY/ABSTRACT Identifying modifiable biopsychosocial factors that can reduce the high proportion (>20%) of injured patients who transition from acute pain (AP) to chronic pain (CP) could reduce the burden and disability from this condition. Maladaptive cognitive-behavioral strategies (e.g., fear-avoidance beliefs; catastrophizing) and emotional factors (e.g., general distress) are consistently associated with post-injury pain, especially in patients with pre-injury psychological vulnerabilities. However, it is unknown whether these psychological processes are causal in the transition from post-injury AP to CP, and are thus a target for CP prevention. For this K01 proposal, I will conduct a prospective cohort study in 200 motor vehicle crash patients with musculoskeletal injury to determine the temporal associations between maladaptive psychological processes and the development of CP. Preliminary data support the feasibility of recruitment and retention, the use of electronic communication, and collection of longitudinal data among trauma patients. We aim to: 1. Examine the concurrent association of psychological and physiological (heart rate activity and 24-hour activity patterns) processes with average levels of injury-related pain intensity throughout 3-months post-injury; 2. Determine the time windows when specific maladaptive cognitive-behavioral and emotional processes appear during the transition from injury-related AP to CP; and 3. Assess the biopsychosocial moderators of the transition from injury-related AP to CP. We will intensively examine interactions of cognitive-behavioral and emotional factors from the point of injury (emergency department) to acute (< 4 weeks), subacute (˜ 4 to 12 weeks post-injury), and chronic (> 12 weeks post-injury) time periods. We will augment traditional retrospective self-report surveys with prospective ecological momentary assessment (EMA) via text messages and biomarkers of distress via Fitbit devices. This project will foster career development through hands-on training in: 1. The design and conduct of rigorous prospective research on the transition to CP/disability after musculoskeletal injury and on clinical trial design for secondary pain prevention; 2. The use of multimodal techniques to measure and monitor post-injury maladaptive psychological and physiological responses and pain-related processes; 3. The data management, analysis and interpretation of a prospective, longitudinal study with intensive data collection; and 4. Grantsmanship skills. These proposed research and training activities will capitalize on the multidisciplinary environment at the University of Pittsburgh to advance strategies for pain prevention. This goal is well-aligned with the NIAMS Long-Range Plan for FY 2015-2019 to use multidisciplinary, multilevel, and non-pharmacological approaches to prevent chronic pain (CP) in the injury population at large. This K01 application will help the PI launch an independent program of impactful patient- oriented research to become an independent investigator with expertise in: 1) the psychological contributors to CP, and 2) prevention efforts to reduce the burden of CP and improve recovery after acute physical injury.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $123,254 )
2024	2024	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	11/17/2023	NON-COMPETING CONTINUATION	$123,254
														Subtotal = $123,254

Issue Date FY: 2023 ( Subtotal = $123,254 )
2023	2023	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	4	1/2/2023	NON-COMPETING CONTINUATION	$123,254
														Subtotal = $123,254

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	1/14/2022	NON-COMPETING CONTINUATION	$0
2022	2021	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	3	1/14/2022	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $177,254 )
2021	2021	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	1/15/2021	NON-COMPETING CONTINUATION	$123,254
2021	2021	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	3	1/21/2021	SUPPLEMENT FOR EXPANSION	$54,000
														Subtotal = $177,254

Issue Date FY: 2020 ( Subtotal = $123,254 )
2020	2020	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	1/24/2020	NON-COMPETING CONTINUATION	$123,254
														Subtotal = $123,254

Issue Date FY: 2019 ( Subtotal = $123,254 )
2019	2019	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	2/28/2019	NEW	$123,254
														Subtotal = $123,254

Grand Total All Awards = $670,270

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An in-depth Examination of the Psychological Processes involved in the Transition from Acute to Chronic Pain after a Traumatic Musculoskeletal Injury

Award Number: K01AR073300

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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