Optimizing Resilience In Orofacial Pain and Nociception
Condition: Temporomandibular Joint Disorder
MeSH terms: Joint Diseases; Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
Study type: Interventional

Summary: 
      The purpose of this study is to examine the effects of a hope-based intervention on clinical
      and experimental pain in individuals with temporomandibular disorder (TMD). To examine the
      effectiveness of this intervention, a two-arm randomized trial will be conducted with 50
      individuals, between the ages of 18 and 65, who have TMD.
    

Detailed description: 
      In recent years, there has been increasing interest in the contribution of positive
      psychological factors (e.g., optimism, pain acceptance, hope) to pain and pain-related
      coping. Although research supports the significance of these resilience factors in pain
      adaptation, psychological interventions based upon bolstering resilience have received far
      less attention. Emerging evidence supports the role of hope in psychosocial adjustment and
      enhancement of adaptive pain coping skills. Hope is considered to be a positive motivational
      state consisting of one's belief in their ability to generate routes to achieve goals
      (pathways) and initiation towards attaining these goals (agency). In the context of pain,
      increasing hope may promote augmentation of personal strengths to enhance development of
      meaningful goal pursuits and foster resilient outcomes. Enhancement of hopeful thinking and
      behavior may ultimately lead to the minimization of losses that are often associated with
      chronic pain. This experience may be also reflected physiologically, as increasing hope may
      confer biological benefits (e.g., decreased inflammation). Although hope-based interventions
      have been successfully applied in other clinical conditions (i.e., cancer), their utility in
      chronic pain disorders has not been examined.

      To examine the effectiveness of this approach, a two-arm randomized trial will be conducted
      with individuals who have TMD. In Study Arm 1, participants will receive hope-based therapy.
      In Study Arm 2, participants will receive pain education. Participants will attend 5 sessions
      over a period of 5 weeks. Two of these sessions will involve quantitative sensory pain
      testing; three sessions will include delivery of the treatment intervention. Pain outcomes
      will be measured at pre- and post-treatment.

      Aims:

        1. Examine the degree to which state and trait levels of hope are predictive of clinical
           pain, disability, affective distress, and experimental pain.

        2. Investigate the effects of a hope intervention, as compared to an education control
           group, on clinical and experimental pain in individuals with TMD.

        3. Identify psychosocial (e.g., hope, optimism, positive affect, catastrophizing),
           biological (e.g., inflammatory, endogenous opioid, neuroendocrine), and psychophysical
           factors associated with positive treatment response (i.e., reduction of clinical pain).
    

Intervention name(s): Hope Therapy; Pain Education
Intervention type(s): Behavioral; Other
Intervention description(s): Hope therapy is designed to address key components of hope theory through augmentation of hopeful thinking and enhancement of goal-directed activities. Training focuses on effective goal setting, mobilization of internal resources to reach goals, identification of resilience factors to formulate hopeful thinking, and enhancing maintenance of future goal development.; Pain Education is aimed to increase understanding of TMD symptomatology and etiology, as well as provide general education on pain, lifestyle management, and effective pain communication methods.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Temporomandibular Joint Disorder; TMD; Hope; Resilience; Cognitive Behavior Therapy