Approximately a quarter of injured Emergency Department (ED) patients and those with medical emergencies will develop clinically significant post-traumatic stress disorder (PTSD) symptoms, which are often comorbid with additional mental and physical health complaints. Our team focuses on the intersection between psychological health and physical pain, striving to bring awareness to the important role that psychological health can play in recovery from injury or illness.
We have explored methods to improve psychological screening of ED patients and to determine how early interventions can improve both mental and physical health outcomes immediately after injury. Through experience sampling and longitudinal assessment, we have characterized the dynamic relationships between posttraumatic stress symptoms, pain, and pain catastrophizing in the acute recovery period. Our work demonstrates that psychological symptoms and physical pain are closely intertwined in the days and weeks following injury, highlighting opportunities for integrated intervention.
Building on this foundation, we have examined the feasibility and efficacy of digital mental health tools in the acute care setting. We are also examining how social determinants of health impact pain and recovery among ED patients, and have explored the psychological health of emergency care workers during the COVID-19 pandemic. Together, we are developing a program of research that advances acute integrated healthcare to improve recovery from injury or illness.
Current Studies
- Tracking Acute Post-Injury Pain (TAPP)
Longitudinal cohort study to determine temporal associations between maladaptive psychological processes and the development of chronic pain among motor vehicle crash victims with traumatic musculoskeletal injury (K01 study funded by National Institute of Arthritis and Musculoskeletal Diseases)
- Pain-Related Disparities in Emergency Department Patients (PRIME)
Using a mixed-methods design, this project will investigate how intersectionality between a broad range of social determinants of health is associated with disparities in pain management among ED patients throughout Pennsylvania.
- Prehospital Analgesia Intervention trial (PAIN)
The Prehospital Analgesia INtervention trial (PAIN) is a 4 year (3-year enrollment) multicenter, prehospital, randomized, double-blind, clinical trial that will enroll approximately 1,136 patients at select LITES Network sites. The objective is to perform a prospective, interventional, randomized trial among prehospital trauma patients with compensated shock (SI>0.9) and an indication for pain management, comparing patient centered outcomes following prehospital administration of ketamine hydrochloride versus fentanyl citrate.
- DSUVIA Early Evaluation of Pain (DEEP)
Randomized, interventional trial of Emergency Department (ED) administration of DSUVIA (sufentanil) versus standard care pain management comparing pain treatment outcomes in injured patients with moderate to severe pain.
- NeuroImmunoEndocrine Interface: Exploring a Unifying Axis for Precision Care in Psychological Health & TBI (NEXUS)
Exploring how a person’s biology, stress, and resilience to stress can affect recovery after TBI and subsequent risk for psychological health conditions. These nuisances will be studied through blood protein and hormone levels, which naturally fluctuate with the body’s response to stress, as well as through the examination of an individual’s genetic composition. Anticipated results could provide a framework for personalized TBI and PH treatments based on an individual’s stress hormone levels.
Recent Work
- Is early psychological screening feasible in the Emergency Department?
We demonstrated the feasibility of screening injured ED patients for posttraumatic stress disorder and depression in the acute care setting, establishing a foundation for early identification and intervention. Academic Emergency Medicine, 2019
- How do posttraumatic stress symptoms relate to pain in the acute recovery period?
We used experience sampling over the first 14 days after injury to characterize daily associations between posttraumatic stress symptoms and pain, revealing dynamic relationships that inform timing of intervention. Academic Emergency Medicine, 2018
- What is the impact of subthreshold PTSD symptoms among frontline healthcare workers?
We examined the prevalence and health impairment associated with subthreshold PTSD symptoms among frontline healthcare workers during the COVID-19 pandemic, documenting significant functional impact even below diagnostic thresholds. Journal of Psychiatric Research, 2023
- Can a mobile app intervention reduce PTSD symptoms after motor vehicle crash?
We conducted a pilot randomized controlled trial of the PTSD Coach mobile app following motor vehicle crash-related injury, evaluating feasibility and preliminary efficacy of digital intervention in the acute care setting. Academic Emergency Medicine, 2020
- How do posttraumatic stress symptoms and pain catastrophizing evolve after injury?
We conducted longitudinal assessment of posttraumatic stress symptoms and pain catastrophizing after injury, characterizing trajectories and identifying predictors of poor psychological and pain outcomes. Rehabilitation Psychology, 2023
Investigators with this Research Interest
Assistant Professor of Emergency Medicine