Intensive Treatment for Chronic Pain and Posttraumatic Stress Disorder (PTSD)

Study Overview
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Brief Summary
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This study is investigating the efficacy of an intensive (3 week) integrated treatment for Veterans with both pain and PTSD.

Detailed Description
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Objectives: The primary objective of this study is to evaluate the efficacy of an intensive integrated treatment for Veterans with comorbid chronic pain and posttraumatic stress disorder (PTSD). A secondary objective is to examine potential mechanisms of action that might account for improvements in pain or PTSD. Third, exploratory analyses will be conducted to assess the relationship between participation in treatment and cognitive functioning. It is hypothesized that 1) participants receiving the intensive treatment (PT) will report significantly greater decreases in symptoms of pain and PTSD from pre-treatment to post-treatment when compared to participants randomized to a standard care (SC) condition, and 2) participants receiving PT will show greater maintenance of change on measures of pain and PTSD at 3 months following the completion of treatment when compared to participants randomized to the SC condition.

Official Title
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Intensive Treatment of Chronic Pain and PTSD for OEF/OIF Veterans

Conditions
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Stress Disorders, Post-Traumatic

Intervention / Treatment
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* Behavioral: Intensive Treatment
* Behavioral: Treatment as Usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients will be eligible to participate if they have constant pain of at least three months duration with a neurologic or musculoskeletal etiology. Patients must also meet diagnostic criteria for PTSD. Exclusion Criteria: Patients with life threatening or acute physical illness, current alcohol or substance abuse, current psychosis or suicidal ideation, and individuals seeking pain treatment such as surgical interventions will be excluded.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intensive Treatment<br>Intensive 3 week treatment for pain and PTSD. This includes elements of Cognitive Processing Therapy and CBT for Chronic Pain | Behavioral: Intensive Treatment<br>* Participants randomized to the Intensive Treatment condition will attend 6 bi-weekly outpatient therapy sessions conducted in an individual format of 90 minutes in duration.<br>|
| Experimental: Treatment as Usual<br>Treatment as Usual. Participants are eligible for all treatment services as needed except for treatment of pain or PTSD | Behavioral: Treatment as Usual<br>* Treatment as Usual.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| McGill Pain Questionnaire | McGill Pain Questionnaire (MPQ; Melzack, 1975): is a self-report questionnaire consisting of 102 words separated into three major classes; the sensory, affective, and evaluative aspects of pain. Respondents are asked to circle the word that best describes their pain. The stability, reliability, and validity of the MPQ have been established (Reading, Everitt, & Sledmere, 1982). The MPQ total score ranges from 0 to 78 with higher values indicating more significant pain. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Psychology, Pain, Veterans, Stress Disorders, Post-Traumatic