While about 10% of patients presenting with acute low back pain (aLBP) will develop chronic low back pain (cLBP), they consume about 75% of LBP related health care expenses and constitute a major economic burden for society. The transition from acute to cLBP is associated with multiple risk factors, of which psychosocial risk factors have the greatest predictive power. This suggests an interaction between emotion, coping, and cognition (mind) and the physical experience of LBP (body). CAM modalities emphasizing the mind-body link, such as Mindfulness Based Stress Reduction, Feldenkrais, and Yoga, may modify these risk factors and help prevent cLBP. Clinicians currently do not have a simple, validated tool for identifying patients with aLBP at high risk for chronic pain and it is unclear whether (and, if so, which) CAM therapies can modify the risk profile and outcome in patients presenting with aLBP. Such information would aid in planning controlled trials of mind-body therapies for LBP, in identifying possible mechanisms of action of these therapies, and in targeting health care resources for cLBP prevention. The candidate will conduct 2 projects: (1) a prospective cohort study (n = 620) at Kaiser Permanente, Northern California (a) to develop and validate a brief prediction tool for primary care clinics and (b) to assess changes in risk factors over time and their association with changes in LBP outcomes; (2) an assessment of whether specific mind-body therapies alter the variables measured with the new prediction tool in randomized and observational studies. The candidate will pursue a structured educational program that includes coursework, mentoring, and supervision of these projects to develop the necessary skills in behavioral science, psychometric evaluation of measures, and clinical research implementation. The candidate's overall goal is to become an independent investigator conducting clinical research of mind-body approaches for the prevention of cLBP.
| Mehling, Wolf E; Ebell, Mark H; Avins, Andrew L et al. (2015) Clinical decision rule for primary care patient with acute low back pain at risk of developing chronic pain. Spine J 15:1577-86 |
| Mehling, W E; Avins, A L; Acree, M C et al. (2015) Can a back pain screening tool help classify patients with acute pain into risk levels for chronic pain? Eur J Pain 19:439-46 |
| Daubenmier, Jennifer; Sze, Jocelyn; Kerr, Catherine E et al. (2013) Follow your breath: respiratory interoceptive accuracy in experienced meditators. Psychophysiology 50:777-89 |
| Mehling, Wolf E; Gopisetty, Viranjini; Bartmess, Elizabeth et al. (2012) The prognosis of acute low back pain in primary care in the United States: a 2-year prospective cohort study. Spine (Phila Pa 1976) 37:678-84 |
| Mehling, Wolf E; Price, Cynthia; Daubenmier, Jennifer J et al. (2012) The Multidimensional Assessment of Interoceptive Awareness (MAIA). PLoS One 7:e48230 |
| Mehling, Wolf E; Gopisetty, Viranjini; Acree, Michael et al. (2011) Acute low back pain and primary care: how to define recovery and chronification? Spine (Phila Pa 1976) 36:2316-23 |
| Mehling, Wolf E; Gopisetty, Viranjini; Daubenmier, Jennifer et al. (2009) Body awareness: construct and self-report measures. PLoS One 4:e5614 |
| Mehling, Wolf E; Krause, Niklas (2007) Alexithymia and 7.5-year incidence of compensated low back pain in 1207 urban public transit operators. J Psychosom Res 62:667-74 |
