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Projects

Current projects
Warwick Study of Mental Defeat in Chronic Pain (WITHIN) 

Mental defeat is defined as the perceived loss of autonomy in the face of uncontrollable, traumatic events. Applied to the context of chronic pain this can be explained as a loss of identity and self in relation to repeated episodes of pain. This study follows on from previous work to apply an experimental, lab-based study to patients with chronic pain (previously done in pain-free, young adults). Additionally, a longitudinal sleep-tracking survey spanning across a 12-month period will collect data on how day-to-day lived experiences of pain impact health & quality of life.

Funder: Medical Research Council (MRC)

*Now recruiting people with chronic pain! Interested? Click here*

Warwick RECOVERS Study - Responding to COVID by Enhancing Resilience in Students

COVID-19 has presented varying levels of stress and uncertainty to society worldwide. The economic, social and psychological impact of the social distancing measures have added to the growing challenge of maintaining positive mental health and wellbeing. Previous research on the consequences of SARS epidemic in China has shown a significant and long-lasting psychosocial impact of the crisis (Mak et al., 2009). Within Warwick, discussions with subgroups of students staying on campus amid university closure have revealed a high level of anxiety and unease. It is unclear whether the levels of stress and uncertainty they experience is comparable to those normally associated with trauma, i.e., whether it can negatively affect important pillars of health (e.g., mood, sleep, physical activity), and whether it may aggravate psychiatric symptoms or extreme behaviour that warrant clinical attention. RECOVERS is a university-wide mental health screening and tracking study to try and answer these questions.

Funder: University of Warwick PVC (Research) COVID-19 Research Programme Award


Recently completed projects
Primary Care Treatment of Pain-related Insomnia: A Feasibility Study of a Hybrid Cognitive-Behavioural Approach

Chronic pain is often co-morbid with insomnia which can lessen people's ability to effectively deal with their pain and even exacerbate the pain itself. Current treatments however tend to focus solely on treating the pain, little help is available to treat insomnia apart from medications which show little evidence of being effective in the long-term. The current study therefore aims to trial, in a primary care setting, a new intervention designed to treat pain and sleep problems concurrently using a hybrid Cognitive-Behavioural approach.

Funder: National Institute for Health Research

The Effect of Mental Defeat on Pain Threshold, Pain Anticipation and Pain Ratings: An Experimental Study with Pain-Free, Young Adults.

Mental defeat is defined as the perceived loss of au-tonomy in the face of uncontrollable, traumatic events. Applied to the context of chronic pain this can be ex-plained as a loss of identity and self in relation to repeat-ed episodes of pain.

Previous research has demonstrated strong associative and predictive findings between mental defeat and relevant constructs captured in the immediate pain expe-rience and chronic pain. The current study investigates the potential of a causal relationship between these. It also serves as a pilot for the paradigm to be further refined and used in a chronic pain population to investi-gate the effects of activated mental defeat on pain thresh-old (PTh). Furthermore, this paradigm also has scope to in-corporate conditioned pain modulation (CPM) measures.
Funder: URSS (awarded to Natasha Kwol and Sarina Afzalishamsabad)

Poster - presented at the 10th Congress of the European Pain Federation, EFIC® 2017

Sleep and Daytime Physical Activity in People with Chronic Pain

People with chronic pain are reported to be physically less active than those without chronic pain in the general population. Numerous psychological factors have been associated with their relatively lower physical activity levels. The current study therefore aims (i) to investigate the effects of day-to-day variations in sleep quality on daytime physical activity in mixed chronic pain groups (e.g. fibromyalgia, back pain, arthritis, neck & shoulder pain etc); (ii) to investigate whether increase in daytime physical activity level will have an effect on pain regulation; (iii) to examine the daily psychophysiological variables (e.g. pain, mood, tiredness) that may interact with sleep to impact the regulation of daytime physical activity.

Funder: Ministry of Higher Education, Malaysia (PhD Scholarship awarded to Fatanah)

Poster - presented at the British Pain Society 50th Anniversary Scientific Meeting, May 2017

Effects of sleep changes on pain-related health outcomes in the general population: A systematic review of longitudinal studies with exploratory meta-analysis.

Emerging longitudinal research has highlighted poor sleep as a risk factor of a range of adverse health outcomes, including disabling pain conditions. In establishing the causal role of sleep in pain, it remains to be clarified whether sleep deterioration over time is a driver of pain onset and, importantly, whether sleep improvement over time can prevent or mitigate pain related outcomes.

A systematic literature search was performed using PubMed MEDLINE, Ovid EMBASE, and Proquest PsycINFO, to identify 16 longitudinal studies that evaluated the effect of sleep changes (simulating sleep deterioration, sleep stability or sleep improvement over time) on subsequent pain related outcomes in the general population.

Poster - presented at the British Pain Society 50th Anniversary Scientific Meeting, May 2017

Sleep disturbance and the experience of chronic pain

Chronic pain is a debilitating health problem and sleep impairment is one of the most common complaints in individuals suffering from chronic pain. The current study aims to identify the characteristics of sleep disturbance in two different chronic pain conditions (namely fibromyalgia and chronic back pain) compared with healthy pain-free individuals, and secondly, examine the association of these characteristics with subsequent pain responses and functioning performances.

The study will be carried out at the Sleep & Pain Laboratory where the participants will undergo two nights and two days of testing of sleep, pain & psychological functioning.

Investigating the Embodied Representation of Mental Defeat

Gestures can depict abstract concepts (for example, defeat) through metaphorical use of space and body. In fact, victory triggers upward body movements even in congenitally blind athletes. This suggests that the direction and location of gestures may be an important part of gestural representation of defeat. The aim of this study was to investigate embodied representations of mental defeat through the observation of how gestures depict defeat experiences

Funder: Experimental Psychology Society (to Professor Sotaro Kita)

Poster - presented by Priya Silverstein at the Warwick PGR Day, June 2016.

Development of the Pain-Related Beliefs and Attitudes about Sleep (PBAS) scale for the assessment and treatment of insomnia comorbid with chronic pain.

Maladaptive beliefs about the sleep-pain interaction are possible factors underlying perpetuation of sleep disturbances in chronic pain-related insomnia. However, there is currently no validated instrument that specifically assesses these beliefs.

We evaluated the psychometric and functional properties of a 10-item Pain-Related Beliefs and Attitudes about Sleep (PBAS) scale, designed to assess pain-related dysfunctional beliefs and attitudes about sleep among people with chronic pain.

Poster - presented at the 7th Quadrennial Congress of the World Sleep Federation, Istanbul



Understanding people's definition of sleep quality in good and poor sleepers: A quantitative approach using the Markov Chain Monte Carlo with people method

The judgment of sleep quality is subjective and varies between people. This experimental study is designed to quantitatively investigate the structural parameters of sleep quality using Markov Chain Monte Carlo with people method.

Funder: Ministry of Education, Malaysia (PhD Scholarship awarded to Fatanah)

Poster - presented at the 7th Quadrennial Congress of the World Sleep Federation, Istanbul



Pain inhibitory processes and sleep disruptions in healthy young adults.

Diffuse Noxious Inhibitory Control (DNIC) response/Conditioned Pain Modulation (CPM) is a clinical marker of impaired pain inhibitory processes in a range of chronic pain conditions. This study explored reliability and differences between two conditioning stimulus used to elicit DNIC responses and the influence of subjective poor sleep and sleep disruptions on DNIC responses.

Funder: University of Warwick Postgradute Research Fellowship (PhD scholarship awarded to Esther)

Poster - presented at the 9th European Congress on Pain 2015, Vienna

Poster - presented at the British Pain Society 50th Anniversary Scientific Meeting, May 2017



Nonpharmacological Treatments of Insomnia for Long-Term Painful Conditions: A Systematic Review and Meta-analysis of Patient-Reported Outcomes in Randomized Controlled Trials.

Insomnia is a debilitating comorbidity of chronic pain. This study evaluated the effect of nonpharmacological sleep treatments on patient-reported sleep quality, pain, and well-being in people with long-term cancer and non-cancer (e.g., back pain, arthritis, fibromyalgia) pain conditions.

Funder: Warwick Research Development Fund

Poster - presented at the 7th Quadrennial Congress of the World Sleep Federation, Istanbul



Sleep in patients with primary dystonia: A systematic review on the state of research and perspectives

Primary dystonia is the third most prevalent neurological movement disorder after essential tremor and Parkinson’s disease. It is characterised by involuntary muscle contractions accompanied by repetitive movement, abnormal posture and pain.

Non-motor symptoms of primary dystonia, including sleep disturbance, negatively impact on quality of life1. Given the increasingly evident link between pain and sleep and the emerging trend of hybrid intervention to tackle both issues simultaneously2, we systematically reviewed the state of research on sleep in primary dystonia

Funder: Dystonia Society and a European Sleep Research Society Travel Grant for Early Career Researcher (awarded to Elisabeth Hertenstein)

Poster - presented at the European Congress on Pain 2015, Vienna



Exploring the essential ingredients of a good night's sleep: A qualitative study with people with fibromyalgia, back pain, and healthy individuals without chronic pain

A good night's sleep is a rare luxury for many people with chronic pain. This qualitative study explored the parameters of subjective sleep quality in people with fibromyalgia, those with back pain and healthy individuals without chronic pain. A second objective was to identify the possible pathways through which appraisals of sleep quality might impact on subsequent engagement in physical and social activity.

Funder: Ministry of Education, Malaysia (PhD Scholarship awarded to Fatanah)

Poster - presented at the European Congress on Pain 2015, Vienna



Better sleep quality promotes next-day physical activity in chronic pain patients

Promoting physical activity is key to the management of chronic pain, but little is understood about the factors facilitating an individual’s engagement in physical activity on a day-to-day basis. This study examined the within-person effect of sleep on next day physical activity in patients with chronic pain and insomnia.

Funder : National Institute for Health Research, UK



The role of pain, physical disability and reduced social participation in insomnia onset in community dwelling older adults: A prospective cohort study

Most patients with chronic pain have insomnia that warrants clinical attention. This study examined the role of pain, physical disability, and reduced social participation in predicting and mediating insomnia onset in community dwelling older adults. Theories of pain-related insomnia identify activity dysregulation as a behavioural mechanism augmenting sleep disturbance. Participation in social and physical activities was hypothesised to be sleep promoting because engagement in activities generates sleep pressure and brings the exposure to light and stimulation that entrain the circadian rhythm.

Funder: The Medical Research Council, UK