This study is for people with chronic low back pain who may also be feeling discouraged,
frustrated, or depressed. This study is testing a new therapy that is designed to
specifically help these patients foster a better self-image. We hope this therapy will help
them feel less discouraged and depressed and, possibly, even help reduce their stress enough
that they may feel less pain.
Patients with chronic low back pain cope with numerous life challenges, including the
ability to work and decrements in physical and emotional well being. These changes impact
the patients' abilities to pursue and achieve not only important personal and professional
goals, but also make it difficult to maintain one's general standards of quality of daily
life with personal tasks.
This study aims to address the feelings and attitudes associated with these shortfalls which
frequently result in depression.
Eligible participants have been undergoing treatment for low back pain and have been
identified as depressed. Study participants are randomized into one of three arms:
Self System Therapy-Patients receive 12 sessions (90 Min) one-on-one with a specialized
treatment regimen designed to help patients foster a better self-image and re-evaluate their
life's goals in light of their new physical limitations. Modifications in goal
unavailability, goal activation, and goal accomplishments are key components in this therapy
delivered by a therapist.
Low Back Pain Education-Patients receive 12 sessions (90 min) of detailed information about
chronic low back pain, its causes and varied treatments, delivered by a research nurse.
Standard Care-Patients receive their routine medical care and serve as a treatment control
group. They receive the same follow up evaluations as the other two groups.
Measures- Before each of the 4 evaluations, 30 day diaries are completed which measure
daily pain coping, daily life events, daily mood and unpleasantness, and daily goal setting
Patients are evaluated at 4 times, before treatment, after treatment, and at a 6 month and
12 month intervals. An interview version of the Selves Questionnaire is used to measure
self-discrepancies. Pain behaviors are assessed by means of structured observation involving
videotaping. Other outcome measures include questionnaires for depression, psychosocial
disability, physical disability, and cognitive, affective, motivational, and physiological
areas of depressive symptomology.
- Male and females 18 years and older
- Low back pain for minimum of 6 months
- DSM-IV diagnosis of major depressive disorder or dysthymia as determined by SCID
interview, or meeting 18 or higher on Beck Depression Inventory.
- Diagnosis of schizophrenia, bipolar, organic brain syndrome, substance abuse within
past 5 years
- Hallucinations, delusions, or paranoid ideation
- Concurrent medical disorders that may cause depression or significantly affect
function (epilepsy, endocrine disease, COPD, diabetes), or intellectual impairment
based on clinical interview
- Inability to speak English; AND
- Patients with pending litigation or in the process of seeking disability benefits.