Psychosocial mechanisms of chronic pain

Lead Research Organisation: University of Bath
Department Name: Psychology

Abstract

(i) Aims and objectives
Pain that lasts a long time (is chronic) takes apart lives, relationships and families. Although biological signals can help understand why pain happens, they do not fully account for the experiences people have, or why pain develops the way it does. Psychological and social factors, such as thoughts and feelings, personal relationships, and lifestyle, can also affect chronic pain. However, we do not yet know which of these psychological and social mechanisms are most important, or how they combine with biological signals to affect chronic pain. Our aim is to determine the psychosocial mechanisms underpinning chronic pain. Our objective is to create a clearer account of how, and in what way, psychosocial factors (interacting with biology) affect pain: what makes chronic pain start, keep going, get better or get worse. In doing so, we will also identify ways to prevent chronic pain from happening, and reduce the negative effects that pain can have on people's lives.

(ii) Data to be collected
We will focus on how people think and feel about pain, how others affect their pain, and consider the wider social and environmental influences on pain. These psychosocial mechanisms will in turn be described in the context of physiological and biomedical dimensions of chronic pain. Our planned work involves people with pain at each stage to ensure our work is guided by the way pain affects people's lives. We will start by exploring the existing evidence, to identify what matters most, including what measures and methods best reflect lived experience. We will ask people with pain which of these factors matter most, and test them in existing large datasets. We will run new studies on the psychological and social factors that hold greatest promise. We will explore how the way people think and behave contributes to pain, and observe how people live their lives with pain. We will study the ways people adapt to live well with pain, and identify the part played in chronic pain by the factors we are interested in.

(iii) Benefits of the consortium
A consortium approach allows us to think big. It gives us a rare opportunity to change how we think about pain and how we research it. To achieve these ambitious goals, we need to bring together expertise from different scientific disciplines, alongside people with pain, and in a way that has not previously been possible. The Advanced Pain Discovery Platform (APDP) not only allows us to do this, but also offers us an unprecedented prospect of working consistently at a conceptual level, to generate data and test ideas. It also allows for cross-consortium working, to stimulate and evaluate new ideas and spot opportunities for future pain research and discovery.

(iv) Legacy and/or sustainability of the network
Our primary contribution will be to identify the psychological and social factors that are most important for understanding pain. We will develop new ways to study pain, new measures of pain and its impacts, and most importantly identify key psychosocial mechanisms of pain, showing how they work alongside biology to promote or limit pain. We will provide guidance about these psychosocial mechanisms, and place this resource within the APDP, for use by the wider interdisciplinary pain research community, including those who wish to incorporate psychosocial factors in medical-epidemiological, clinical, or human genotyping studies. Through our work, and the partnerships that generated it, we will open new, broad avenues of pain research that will develop better ways to help people to live well with less pain.

Technical Summary

The challenge we address is identifying the most promising psychosocial mechanisms underpinning chronic pain, and making them accessible to biomedical research.

Our vision is to deliver a transformational contribution to pain science and practice. Our aim is to deliver robust, diverse, and meaningful psychosocial content on the platform for rich phenotyping and behavioural classification. Our objectives are to define the psychosocial pathway(s) to development and maintenance of chronic pain; to identify multidimensional factors that maintain or exacerbate pain across the lifespan; and to identify modifiable psychosocial factors that can prevent or disrupt the pathway to chronic pain.

Working together, people with chronic pain and world-leading behavioural scientists will repurpose existing datasets and run quantitative and qualitative studies to collect new data. Our interdisciplinary consortium, across 8 universities and a wider collaborator network, creates synergies across group disciplines, and is consolidated through work structures, membership, governance, and advisory groups.

We have embedded people with pain in this consortium from its inception to ensure what matters most to those with pain is reflected in our goals, objectives and work plans. From our PPI Network we will establish work development groups for each research team, and a Consortium Public Advisory Group to oversee and guide. Through the consortium we seek to harness the UK's expertise in psychosocial and biomedical research. The scale of the consortium provides an unprecedented opportunity to draw together the psychosocial and the biomedical to make real progress towards improving the lives of those living with pain.

Our primary contribution, and legacy, will be to identify and classify robust candidate psychosocial mechanisms, with guidance about best methods and measures, to inform novel targets for research, prevention, and treatment.

Publications

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