Social & Behavioral Rhythms in Chronic Pain

NCT ID: NCT03022643

Last Updated: 2019-03-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-30

Study Completion Date

2017-06-30

Brief Summary

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Behavioral and biological rhythms are essential for health. No study evaluated behavioral rhythm or rhythm regulation in chronic pain and how this impacts functioning. The objective of this study is to gather preliminary data, focusing on the role of behavioral rhythms in the cardinal clinical symptoms of chronic pain (i.e., sleep, fatigue, and mood). Additionally, this study will provide preliminary data for the feasibility and acceptability of the therapeutic approach aiming to strengthen behavioral rhythms for patients with chronic pain.

Detailed Description

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The overall goal of this study is to gather preliminary data, focusing on behavioral rhythms in patients with chronic pain as well as the relationship between behavioral rhythms and the pain-related clinical symptoms. Additionally, this study will provide preliminary data for the feasibility, acceptability, and treatment effects of repurposing interpersonal social rhythm therapy (IPSRT) along with light therapy for patients with chronic pain exhibiting significant rhythm dysregulation, sleep disturbances, and mood symptoms. The deliverables at the end of this project will include 1) preliminary evidence concerning the prevalence of behavioral rhythm disturbances in patients with chronic pain; 2) the association between such behavioral rhythm disruptions and the symptom cluster of pain-sleep-fatigue-mood; 3) feasibility and acceptability of a prototype IPSRT repurposed for chronic pain patients along with bright light therapy. The specific aims of this proposed study are as follows:

Aim 1: To evaluate regularity of social and behavioral rhythms (SBR), disruption of circadian activity rhythms (CAR), and the relationship of SBR and CAR with clinical symptoms of pain-sleep-fatigue-mood in chronic pain patients compared to healthy control.

Hypothesis 1: Patients with chronic pain will show high degrees of SBR and CAR disruption compared to controls.

Hypothesis 2: Patients with increasingly dysregulated SBR and attenuated CAR will exhibit worse clinical symptoms.

Hypothesis 3: SBR will be associated with CAR in patients with chronic pain and in controls.

Aim 2: To assess feasibility and acceptance of interpersonal social rhythm therapy repurposed for chronic pain patient population along with bright light therapy provided to patients exhibiting SBR disruption with significant sleep and mood symptoms.

Hypothesis 1: The IPSRT will be well tolerated and accepted by the patients

Hypothesis 2: Descriptive data will suggest improvement of SBR, CAR, and the pain-related symptoms and functioning.

Conditions

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Chronic Pain

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Pain Patients

40 Pain Patients will be screened for social and behavioral rhythms with no treatment involved. All patients will be evaluated an Actigraph by Philips for 8-days to assess sleep and activity.

Group Type NO_INTERVENTION

No interventions assigned to this group

Controls

40 Controls will be screened for social and behavioral rhythms with no treatment involved. All Controls will be evaluated an Actigraph by Philips for 8-days to assess sleep and activity.

Group Type NO_INTERVENTION

No interventions assigned to this group

Treatment

10 patients from the original 40 will receive Interpersonal Social Rhythms Psychotherapy and Bright Light Device therapy to improve social and behavioral rhythms.

Group Type EXPERIMENTAL

Interpersonal Social Rhythms Psychotherapy

Intervention Type BEHAVIORAL

The treatment involves 8-weeks of individual psychotherapy. Weekly sessions will be 60-minute long and will take place at the Pain Research Center. The treatment focuses on 1) the link between life events, pain severity, sleep disturbances, fatigue, and mood, 2) social and behavioral rhythms and sleep-wake disturbances, 3) identification and management of rhythm dysregulation and the triggers for it, 4) allowing and facilitating the mourning of the loss healthy self, 5) identification and appropriate management of symptoms.

Bright Light Device

Intervention Type OTHER

All patients will be provided with a bright light device (Re-Timer) and will be instructed to use it in the first 2-hours of the day (for a minimum of 30 minutes) throughout the 8-week treatment period.

Interventions

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Interpersonal Social Rhythms Psychotherapy

The treatment involves 8-weeks of individual psychotherapy. Weekly sessions will be 60-minute long and will take place at the Pain Research Center. The treatment focuses on 1) the link between life events, pain severity, sleep disturbances, fatigue, and mood, 2) social and behavioral rhythms and sleep-wake disturbances, 3) identification and management of rhythm dysregulation and the triggers for it, 4) allowing and facilitating the mourning of the loss healthy self, 5) identification and appropriate management of symptoms.

Intervention Type BEHAVIORAL

Bright Light Device

All patients will be provided with a bright light device (Re-Timer) and will be instructed to use it in the first 2-hours of the day (for a minimum of 30 minutes) throughout the 8-week treatment period.

Intervention Type OTHER

Other Intervention Names

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Re-Timer

Eligibility Criteria

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Inclusion Criteria

All participants (patients and controls):

* 18-65 years of age with
* reading/writing proficiency in English.

Aim 1:

Patients must:

* have had persistent pain for more than 1-year at a consistent body part or diffuse body pain (e.g., fibromyalgia) that is stable rather than progressive in nature
* report experiencing pain for more than 70% of the waking hours in any given week
* under current medical care by a physician for a pain diagnosis
* able remain stable on any of their medication (as prescribed) for the duration of the 8-day evaluation involved in Aim 1

Control subjects must:

* be pain-free for the past 1-year
* no prior treatment for a chronic pain condition
* in overall good health

Aim 2:

Patients must:

* have current symptoms of insomnia (Insomnia Severity Index (ISI), ISI\>8)
* have depression (Patient Health Questionnaire-9, PHQ-9\>10)
* exhibit significant circadian activity rhythm dysregulation during the 8-day evaluation (defined as Amplitude\<0.9)

Control subjects must:

* be pain-free for the past 1-year
* no prior treatment for a chronic pain condition
* in overall good health

Exclusion Criteria

Aim 1:

* patients/controls who underwent surgery in the last 6-months
* shift workers
* dementia
* current drug abuse/dependence
* receiving treatment in methadone clinic
* current cardiac conditions
* untreated sleep apnea
* untreated restless legs syndrome
* neurodegenerative disease
* bipolar disorder
* psychosis
* suicidal ideation
* have changed time-zones in the last 7 days
* experienced a significant life change in the last month (e.g., death in the family, loss of job, traumatic event)

Aim 2:

* patients/controls who underwent surgery in the last 6-months
* shift workers
* dementia
* current drug abuse/dependence
* receiving treatment in methadone clinic
* current cardiac conditions
* untreated sleep apnea
* untreated restless legs syndrome
* neurodegenerative disease
* bipolar disorder
* psychosis
* suicidal ideation
* have changed time-zones in the last 7 days
* experienced a significant life change in the last month (e.g., death in the family, loss of job, traumatic event)
* receiving psychotherapy
* significant photophobia
* chronic migraines
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Ariel Neikrug

Postdoctoral Fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ariel B Neikrug, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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University of Utah

Salt Lake City, Utah, United States

Site Status

Countries

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United States

Other Identifiers

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094507

Identifier Type: -

Identifier Source: org_study_id

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