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Summer 2018 Edition

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Pain, Depression and the Effect of Resilience in People with Spinal Cord Injury

Heather Taylor, PhD

Heather Taylor, PhD

Researchers at TIRR Memorial Hermann’s Spinal Cord Injury and Disability Research Center (SCIDR) have undertaken a longitudinal study examining the relations of pain and depression among women and men with spinal cord injury. The study, funded by the National Institute of Disability, Independent Living and Rehabilitation Research, seeks to identify ameliorating factors that may moderate the relation of pain on depression and improve quality of life.

“Pain and depression are common among people with SCI, and each has been associated with health complications, decreased independence, slower recovery and lower quality of life,” says Heather Taylor, PhD, principal investigator, director of spinal cord injury and disability research at TIRR Memorial Hermann and an Associate Professor at McGovern Medical School at UTHealth. “They often occur together, compounding the effect. We hope to determine the relationship of pain severity and pain interference to depression over time, to determine how pain’s impact is moderated by resilience and to evaluate how changes in pain and depression over time relate to satisfaction with life.”

The high prevalence of depression, psychological distress and psychological morbidity after spinal cord injury is well documented in the medical literature. “Research has long examined the risk factors and vulnerabilities leading to poor outcomes following injuries and disability onset. Recently resilience has gained greater attention as an ameliorating factor in SCI as we begin to document its potential buffering effects,” says Dr. Taylor. “But no known studies have conducted longitudinal evaluations of pain, depression and the moderating effect of resilience. We expect this study to inform future interventions designed to improve the lives of individuals with spinal cord injury.”

One particularly unique aspect of the study is the careful consideration of gender. “Because nearly 80 percent of people with SCI are male, studies often do not include a large enough sample of women to evaluate whether or not there are gender differences,” says Susan Robinson-Whelen, PhD, co-investigator of the study, a scientist at TIRR Memorial Hermann and an assistant professor of physical medicine and rehabilitation at Baylor College of Medicine. “In this study, we oversampled women, so approximately 40 percent of our study participants are women.”

The study has recruited a national sample of nearly 250 men and women with SCI who experience chronic pain. Study participants are followed over time, completing interviews and online surveys four times over the course of a year. In addition to Dr. Robinson-Whelen, co-investigators are Rosemary Hughes, PhD, senior research scientist at the University of Montana’s Rural Institute for Inclusive Communities and a research professor in the department of Psychology; Eva Widerstrom-Noga, DDS, PhD, Associate Professor at the University of Miami’s Miller School of Medicine; and statistician and measurement expert Paul Swank, PhD, president of Innovative Thinking, Inc. Members of SCIDR’s National Community Advisory Board, comprised of people with SCI, are key contributors to the project, providing input and oversight of study progress.

“Pain can have a huge impact on depression and recovery,” Dr. Taylor says. “If we can determine the role of resilience as a buffer and isolate its characteristics, we can develop interventions that will help people with SCI better cope with chronic pain."

The researchers will share baseline results soon, and longitudinal analyses will be shared when the study is completed in 2019. For more information, contact Dr. Taylor at heather.taylor@uth.tmc.edu.

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