Project 2: MSC

Baylor College Of Medicine, Houston TX

Investigators

Linked publications, trials & patents

Abstract

PROJECT SUMMARY (Project 2 - Mindful self-compassion for pain interference) Over 60% of adults with osteogenesis imperfecta (OI) experience chronic pain, which, for most, profoundly disrupts functionality and quality of life. Currently available pain therapies provide marginal efficacy, are often not preferred by patients, and may lead to concerning pain management outcomes (e.g., excessive opioid use). Novel, safe, acceptable, and mechanistically informed treatment approaches are urgently needed. Self- compassion involves being open to one's own suffering and treating oneself with the same care one would show to loved ones. Mindful self-compassion (MSC) interventions have been successful in decreasing pain interference in adults with chronic pain. Our pilot data demonstrate the feasibility and acceptability of a virtual MSC program among adults with OI and chronic pain. We hereby propose to evaluate the efficacy of a virtual MSC program on pain interference in adults with OI and elucidate core treatment mechanisms at play through a randomized controlled trial. The MSC program will be delivered together with instructors with lived experience of OI. Aim 1 compares the effects of an 8-week virtual MSC program versus relaxation training (RT) control at 1-month post treatment on self-reported pain interference (primary outcome) and pain-related outcomes (pain catastrophizing, pain intensity), psychological outcomes (global impression of change, quality of life) and physical functioning (sleep, physiologic flexibility as assessed by heart rate variability, and work productivity). We will also evaluate the relative stability of MSC and RT intervention changes during a 6-month follow-up period. Aim 2 characterizes the mechanism associated with pain interference response to MSC, specifically whether the virtual MSC intervention influences the targets of pain acceptance, emotional regulation and experiential avoidance and evaluate if changes (or lack of) in these mechanisms are associated with changes in pain interference. Aim 3 explores factors that may contribute to the inter-individual variability in pain interference response to MSC and RT. We will assess if sex, as well as baseline levels of self- compassion, pain catastrophizing, anxiety and depression moderate the response to MSC or RT on pain interference. Finally, we will explore if genotype reported by Project 1 whole genome sequencing of nature, location and type of mutation is associated with response. This study will establish the first psychological, evidence-based treatment approach to decrease the impact of pain on the lives of individuals with OI, which may serve as a model for other disorders characterized by high pain interference. This virtual MSC program could be easily implemented into practice, transforming the lives of individuals who endure chronic pain in spite of existing treatments.