Wednesday, April 2, 2025
4/2/2025
Pain Disengagement Training: A self-directed intervention for pain catastrophizing - PROJECT SUMMARY This career development award proposal describes a research and training plan that will provide Dr. Katherine McDermott with the resources needed to establish a career as an independent clinical scientist developing and testing scalable interventions for the treatment of chronic pain. Background: Chronic musculoskeletal pain is one of the leading causes of disability, with millions of individuals suffering from its effects. Pain catastrophizing is a key predictor of pain interference and is characterized by magnification of the intensity of pain, rumination, and feelings of helplessness to cope. While some interventions target pain catastrophizing, they offer modest effects and require extensive resources due to reliance on clinician involvement. Self-directed interventions that parsimoniously and effectively target pain catastrophizing are needed. Specific aims and research design: This project will involve the development, refinement, and preliminary evaluation of Pain Disengagement Training (PDT), a self-directed intervention for pain catastrophizing. The aims of this project are 1) To develop PDT using qualitative focus groups to solicit patient input on intervention components and protocol considerations (N=4 groups, ~20 participants); 2) To refine PDT using an open pilot (N=10) with pre/post intervention self-report assessments and qualitative exit interviews to obtain feedback on the intervention experience and procedures; and 3) To evaluate the feasibility, acceptability, and credibility of PDT in a pilot randomized controlled trial (N=50) of PDT vs. Healthy Writing Control (HWC). Results will inform a multi-site feasibility RCT R01 submission. Training and mentoring: Three primary training aims will be accomplished in the present proposal to fill key gaps in the candidate’s training: 1) Qualitative and mixed methods, including the design of focus group procedures and qualitative and mixed methods data analysis; 2) Chronic pain intervention development and refinement, including developing protocols to optimize intervention acceptability and feasibility in a pain patient sample; and 3) Management of rigorous randomized clinical trials, including establishing standard operating procedures to maximize fidelity and retention. This training will be provided by a team of expert mentors including Dr. Ana- Maria Vranceanu, Dr. Francis Keefe, and Dr. Mark Lumley, who have a wealth of experience designing and evaluating interventions for chronic pain. Additional training will be provided by advisors (Drs. Parker and Yousif), didactics, scientific publications, and experiential training, including manuscript writing. Relevance to NCCIH: This study is well-aligned with NCCIH’s focus on Whole Health research and support of impactful clinical trials of complementary and integrative health approaches, including the advancement of the complementary and integrative management of pain. Impact: The proposed project and training plan will provide the candidate with the training needed to transition to independence as an intervention researcher committed to creating scalable treatments to address the key predictors of chronic pain interference.
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