Clinical Research Directory

The Role of Rumination and Worry in Pain and Functional Limitation in Knee Osteoarthritis

Knee osteoarthritis is a common degenerative joint disease in which pain severity often does not fully correspond with radiographic disease severity. Psychological processes such as rumination and worry may contribute to differences in pain perception and functional limitation among patients with similar structural disease burden. The purpose of this observational study is to investigate the relationships between radiographic osteoarthritis severity, pain severity, functional limitation, rumination, and worry in patients with knee osteoarthritis. Radiographic severity will be assessed using the Kellgren-Lawrence classification. Participants will complete the Penn State Worry Questionnaire, the Ruminative Thought Style Questionnaire, the Visual Analog Scale (VAS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The study aims to determine whether rumination and worry are associated with pain severity and functional impairment independently of radiographic osteoarthritis severity. Findings from this study may improve understanding of the biopsychosocial mechanisms underlying pain perception in knee osteoarthritis and may support the development of multidisciplinary treatment approaches that incorporate psychological factors into patient assessment and management.

Adaptive Coping Skills Training to Improve Psychological Distress Among Cardiorespiratory Failure Survivors

Conditions treated in intensive care units (ICUs) such as the acute respiratory distress syndrome (ARDS), congestive heart failure, COVID pneumonia, and sepsis are common. These can lead to high rates of depression, anxiety, and PTSD that worsen quality of life. Yet there are few effective strategies able to overcome barriers of limited access to mental health care. Even less is known about the experiences of patients from racially and ethnically minoritized populations because of they haven't been included well in past research. To address this problem, the investigators developed Blueprint, a mobile app that coaches people to use adaptive coping skills to self-manage their symptoms. The investigators found that it reduced depression symptoms and improved quality of life compared to placebo. To confirm these promising findings, the investigators are doing a formal test of Blueprint. The investigators will enroll 400 people who received ICU care from 4 hospitals (Duke, UCLA, Colorado, and Oregon). These patients will be randomized to receive either the Blueprint mobile app or a special Education Program mobile app the investigators developed. -both delivered through similar mobile app platforms. Our specific aims are to see which program improves symptoms better across 6 months of follow up. This project addresses national research priorities and could advance the field with a personalizable yet population-focused therapy that could be scaled broadly and efficiently to enhance mental health equity.