Chronic pain is a significant problem for many Veterans, including new Veterans returning from Iraq and Afghanistan. It is also associated with a number of other significant problems, such as post-traumatic stress disorder and sleep problems. All of these can have significant negative effects of the quality of life of Veterans. Th current project seeks to help develop and evaluate two promising treatments that Veterans may find useful for helping them better manage chronic pain and its negative effects. Specifically, it s a randomized clinical trial comparing the efficacy of teaching skills in self-hypnosis and mindfulness meditation for reducing pain and improving the quality of life in Veterans. The project will also test hypotheses regarding how these treatment work by examining the meditating biological (e.g., brain activity measures), psychological (e.g., outcome expectancies), and social (e.g., therapeutic alliance) factors that could explain their effects. Potential moderators of treatment outcome (e.g., hypnotizability, baseline brain states) will also be examined. By better understanding the treatment effects of these interventions, as well as their mechanisms, and if the treatments are demonstrated to be effective as we anticipate they will be based on pilot and preliminary studies, Veterans will have more options for better managing chronic pain, and therefore maximizing the overall quality of their lives.
By increasing our understanding of the efficacy of two treatments that teach two specific pain management skills in samples of Veterans, the proposed project will benefit public health by providing an empirical basis for referring individuals with chronic pain to the most effective treatments. By increasing our understanding of the mechanisms by which these interventions have their beneficial effects, we will be better able to maximize the efficacy of pain treatments, by focusing on those mechanisms most responsible for treatment benefits. Moreover, such mechanism-based research can help translate research to practice by identifying treatment components that are most essential when adapting pain treatments for specific clinical settings.