Social & Behavioral Rhythms in Chronic Pain
Condition: Chronic Pain
MeSH terms: Chronic Pain
Study type: Interventional

Summary: 
      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: 
      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.
    

Intervention name(s): Interpersonal Social Rhythms Psychotherapy; Bright Light Device
Intervention type(s): Behavioral; Other
Intervention description(s): 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.; 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.
Other intervention name(s): Re-Timer
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Screening