Chronic pain is a common and debilitating condition. One in five people in the Australian community have been found to experience chronic pain at any one time. Although there is no evidence of a consistent increase in rates of chronic pain, the rate of permanent disability has increased dramatically in recent decades. This has contributed to the growing cost of chronic pain. For example, back pain is the most common reason for filing workers' compensation claims and leads to loss of 101.8 millio ....Chronic pain is a common and debilitating condition. One in five people in the Australian community have been found to experience chronic pain at any one time. Although there is no evidence of a consistent increase in rates of chronic pain, the rate of permanent disability has increased dramatically in recent decades. This has contributed to the growing cost of chronic pain. For example, back pain is the most common reason for filing workers' compensation claims and leads to loss of 101.8 million workdays annually. The annual costs of medical care for back pain alone have been estimated at $AUD50 billion in the US and $10 billion in Australia. Not only is chronic pain a considerable economic burden, it is also a considerable personal burden to patients. Pain is one of the strongest predictors of poor quality of life and has consistently been found to be associated with high rates of depression. Although there is a large body of research that investigates what factors are associated with chronic pain, there is surprisingly little research that investigates the mechanisms that cause chronicity. Theories of chronic pain suggest that psychological characteristics increase the propensity for people to develop chronic pain. Specifically, theories argue that those people who tend to be fearful of pain will over-attend to painful sensations and avoid pain-provoking activities and as a result are at risk of developing chronic pain. This study will test those theories. If it is found that over-attending to pain does predispose patients to develop chronic pain, this will have important implications for preventing the development of chronic pain. These findings could help to devise early interventions to prevent chronicity and thereby reduce the economic burden to health services and the emotional burden to patients in terms of reduced quality of life.Read moreRead less
Selective Attention And Fear Avoidance In The Maintenance And Management Of Pain Associated With Rheumatoid Arthritis
Funder
National Health and Medical Research Council
Funding Amount
$195,660.00
Summary
Despite advances in the treatment of RA, the condition continues to have a chronic course for the majority of patients. Research has established that the way in which people think about pain and illness influences their responses to symptoms. In turn, these factors can impinge on quality of life and disability. For people with chronic pain problems, those who are fearful of pain and concentrate on symptoms have a poorer outcome in the long-term. In RA, striking a balance between rest and exercis ....Despite advances in the treatment of RA, the condition continues to have a chronic course for the majority of patients. Research has established that the way in which people think about pain and illness influences their responses to symptoms. In turn, these factors can impinge on quality of life and disability. For people with chronic pain problems, those who are fearful of pain and concentrate on symptoms have a poorer outcome in the long-term. In RA, striking a balance between rest and exercise is thought to be crucial. As such, ignoring the pain can lead to overactivity and subsequent joint damage and may be as unhelpful as underactivity. This project aims to investigate the relationship between people's fear of pain and the degree to which they attend to pain. It is suggested that those with very high or very low levels of fear towards the pain will either over-attend or under-attend to pain in comparison to healthy controls and patients with a moderate level of fear. Optimum levels of fear avoidance are expected to be associated with less disability and improved joint function. These findings have implications for the management of RA. Psychological treatments for patients with RA have been found to be effective in reducing pain, disability and improving mood. Treatments usually focus on a combination of changing people's attitudes and behaviours. However, whether strategies that aim to change attitudes or those targeting behaviour are more successful or have specific treatment effects is unknown. The present project will compare a treatment targeting behaviours associated with RA and encouraging a balanace between rest and exercise, with a treatment targeting patient's beliefs about the illness. It is expected that the treatments will have specific effects, which may better allow tailoring of psychological management to patient's individual needs.Read moreRead less
Long Noncoding RNA In Space And Time, And The Regulation Of Fear Extinction
Funder
National Health and Medical Research Council
Funding Amount
$1,012,245.00
Summary
Most of our genome is made up noncoding RNA; however, nothing is known about why a special class of noncoding RNA would be expressed in synapses, and how this affects learning and memory related to neuropsychiatric disorders. Understanding the fundamental molecular machinery underlying the formation of fear extinction memory will enable the development of new treatment approaches for anxiety-related disorders that are characterised by memory deficits.
A Window Of Vulnerability: Impaired Fear Inhibition In Adolescent Rats
Funder
National Health and Medical Research Council
Funding Amount
$335,849.00
Summary
Adolescence is a period of increased vulnerability to anxiety disorders. The brain undergoes substantial maturation during adolescence, particularly the prefrontal cortex (PFC), a region critical for inhibiting fear. This project examines why fear inhibition is impaired in adolescents and compares the neural mechanisms mediating treatments that enhance fear reduction in adolescence. This research adds new knowledge about novel approaches for early interventions for adolescent anxiety.
A core feature of clinical anxiety is the inability to learn about safety and suppress fear. Impaired safety learning underpins excessive fear responding, overgeneralisation of fear, as well as treatment resistance in clinical anxiety. Very little is known about the brain mechanisms for learned safety. This project maps and manipulates these mechanisms to lay the basic science foundation for the next generation of treatments of anxiety.
Disorders of fear and anxiety impose significant burdens on individual sufferers, their families, and communities. This project studies the brain mechanisms of fear and anxiety, with special focus on the role of the prefrontal cortex. It tests the novel hypothesis that prefrontal cortex is part of a neural pathway critical for regulating fear learning and ensuring that fear learning is adaptively guided by past experience. In the absence of this pathway, fear learning is maladaptive and excessiv ....Disorders of fear and anxiety impose significant burdens on individual sufferers, their families, and communities. This project studies the brain mechanisms of fear and anxiety, with special focus on the role of the prefrontal cortex. It tests the novel hypothesis that prefrontal cortex is part of a neural pathway critical for regulating fear learning and ensuring that fear learning is adaptively guided by past experience. In the absence of this pathway, fear learning is maladaptive and excessive relative to the danger posed by a situation.Read moreRead less
Developmental Differences In The Role Of The Medial Prefrontal Cortex In Fear Regulation
Funder
National Health and Medical Research Council
Funding Amount
$354,481.00
Summary
This project explores the neural circuitry involved in fear expression early in life, and how early life experiences can affect this circuitry. A better understanding of the neural circuitry underlying fear regulation across development is essential given that the majority of anxiety disorders first appear in childhood or early adolescence.
Exploring DNA Methylation As A Mechanism For Long-term Memory For Fear Extinction
Funder
National Health and Medical Research Council
Funding Amount
$415,322.00
Summary
Traumatic experiences are well remembered. In some cases, fear-related memories become debilitating and require therapeutic intervention to diminish the impact of these kinds of memories on daily living. Such therapies engage a process of inhibitory learning called fear extinction. Since anxiety disorders are particularly sensitive to relapse even after extensive exposure therapy, a deeper understanding of the extinction process is crucial if we are to develop more effective treatment protocols ....Traumatic experiences are well remembered. In some cases, fear-related memories become debilitating and require therapeutic intervention to diminish the impact of these kinds of memories on daily living. Such therapies engage a process of inhibitory learning called fear extinction. Since anxiety disorders are particularly sensitive to relapse even after extensive exposure therapy, a deeper understanding of the extinction process is crucial if we are to develop more effective treatment protocols for a variety of anxiety disorders.Read moreRead less
Disorder in the circuits that process emotional stimuli are central in the pathogenesis of anxiety disorders. In this grant we will study the circuits that are inolved in fear learnng. Our results will provide the background to developing more effective therapies for a range of anxiety related disorders such as generalised anxiety and post traumatic stress disorder.