Chronic pain is serious problem for many persons with spinal cord injury, and one for which few effective treatments have been found. Research indicates that hypnotic analgesia may benefit persons with chronic pain, including those with SCI-related pain, yet there have been no controlled trials to determine whether hypnotic analgesia is effective beyond the effects of a credible control condition. Moreover, there remain many unanswered questions concerning the mechanisms of hypnotic analgesia. The proposed research will (1) test the effectiveness of a hypnotic intervention against a no-treatment baseline period and against a control intervention using a prospective randomized controlled design, (2) examine several predictors, moderators, and mediators of hypnotic analgesia, and (3) result in a treatment manual that will describe procedures for hypnotic analgesia treatment for this population. 134 persons with SCl-related neuropathic pain will be randomly assigned to either hypnotic analgesia or a control treatment. Pain intensity will be assessed before a 2-month baseline, at pretreatment, at posttreatment, and at 3-, 6-, 9- and 12-months follow-up. Secondary outcome measures (observed pain behavior, pain affect, activity level and pain interference) and four potential process variables (perceived treatment credibility, motivation to respond, hypnotic responsiveness, and physiological relaxation) will also be assessed. We will determine whether hypnotic analgesia reduces pain and its negative impact on persons with SCI relative to a credible control condition, and also determine the long-term effects of this treatment. We will also determine the extent to which treatment outcome is related to perceived treatment credibility, motivation, and hypnotic responsiveness, and moderated by degree of physiological relaxation achieved during treatment. If hypnotic analgesia is shown to have beneficial effects over and above the placebo intervention, the treatment manual developed for the study will be made available to researchers and clinicians to be used as a basis for further research (replications and extensions) and to provide guidelines for the application of hypnotic analgesia to persons with SCI-related neuropathic pain.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD042838-05
Application #
7098863
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Shinowara, Nancy
Project Start
2002-08-01
Project End
2008-07-31
Budget Start
2006-08-01
Budget End
2008-07-31
Support Year
5
Fiscal Year
2006
Total Cost
$233,159
Indirect Cost
Name
University of Washington
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Jensen, Mark P; Barber, Joseph; Romano, Joan M et al. (2009) Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal-cord injury. Int J Clin Exp Hypn 57:239-68
Jensen, Mark P; Barber, Joseph; Romano, Joan M et al. (2009) A comparison of self-hypnosis versus progressive muscle relaxation in patients with multiple sclerosis and chronic pain. Int J Clin Exp Hypn 57:198-221
Jensen, Mark P; Barber, Joseph; Hanley, Marisol A et al. (2008) Long-term outcome of hypnotic-analgesia treatment for chronic pain in persons with disabilities. Int J Clin Exp Hypn 56:156-69
Jensen, Mark P; McArthur, Kristin D; Barber, Joseph et al. (2006) Satisfaction with, and the beneficial side effects of, hypnotic analgesia. Int J Clin Exp Hypn 54:432-47
Jensen, Mark P; Hanley, Marisol A; Engel, Joyce M et al. (2005) Hypnotic analgesia for chronic pain in persons with disabilities: a case series. Int J Clin Exp Hypn 53:198-228
Patterson, David R; Jensen, Mark P (2003) Hypnosis and clinical pain. Psychol Bull 129:495-521