2004-05 WSU Undergraduate Research Grant Application

Revised May 2004

Cover Sheet

___ The Effects of Thermal Biofeedback on Pain Perception in Endometriosis_____

Project Title (10 words or less)

Dollar Amount Requested from Undergraduate Research Funds: ____$300___________

_____ Stone, Kirsten_______________________________________________

Student Name (last, first)

_____880315262________________________________________________________

Student ID #

_____24 Credits, 14 Pending__ ____ Spring 2005_______________

Total Number of Credits Completed Anticipated Graduation (term/year) *

(* funds may NOT be spent after graduation)

_____ Fowler, Lauren_____________________________________________________

Faculty Mentor Name (last, first)

__ Psychology Department, College of Social and Behavioral Sciences, 1202_______

Faculty Mentor Department, Mail Code, and College

This project __X__ DOES ____ DOES NOT require review by the WSU Institutional Review Board for Human Subjects or the WSU Animal Care and Use Committee.

__________________________________ _________________

Student Signature Date

__________________________________ _________________

Project Mentor Signature Date

_________________ _________________

Campus Mail Code Phone Extension

__________________________________ _________________

Undergraduate Research Committee Representative Date

__________________________________ _________________

Faculty Mentor Department Chair Date

BUDGET ITEM	Department or College Funds	Outside Agency Funds	Personal Funds	Undergrad. Research Funds	GRAND TOTAL
Materials *	EHP 30			CalmLink $300	$300
Equipment *	Computer Equipment
Travel to gather data			Self-Provided
Travel to present results (must have proof of acceptance)
Stipend: Hrs @ $10/hr Benefits @ 8.5% Total
GRAND TOTAL				$300	$300

NOTE – Equipment and left-over materials purchased with this grant will remain the property of WSU

Project Description

Endometriosis is a gynecological disease, which is estimated to affect up to 20% of the female population, which includes between 4 to 10 million women in the United States alone (Hawkins, 2003). The predominant symptom, reported by an astounding 70% of sufferers, is chronic pelvic pain, which can often be disabling (Hawkins, 2003), as tissues similar to that in the uterus begin to grow outside of it, vascularize, and begin to become innervated as well (Berkley, 2004). This could account for much of the pain associated with the disease.

Biofeedback, a technique under investigation for the treatment of chronic pain, including that due to endometriosis, is based on the premise that as stress levels rise, autonomic arousal increases, which also causes an increase in pain perception (Hawkins, 2003). The use of biofeedback equipment consists of visual or auditory signals which let the subject know when they have successfully or unsuccessfully raised or lowered their levels of physiological arousal. They can learn to consciously alter things which are normally involuntary, such as heart rate, hand temperature, brain waves, muscle tension or perspiration (Alexander, 1995). In this study, the method in question will be thermal biofeedback. It has been shown that thermal biofeedback, raising hand temperature, works by vasodilation, through adrenergic mechanisms, and is an effective, valid and reliable method for treating a number of chronic conditions (Freedman, 1991). Recently, a study specifically designed for endometriosis had promising results, supporting the hypothesis that biofeedback could be useful, but due to the small sample size, more research is warranted (Hawkins, 2003). It may be the concept of the control the woman feels over the symptoms of the disease which may contribute to the success of biofeedback (Hawkins, 2003).

I will be the primary researcher for this project, working in conjunction with Dr. Lauren Fowler and the Psychology Department. I have had experience in conducting an experiment and analyzing results from class work, from the courses in Statistics and Research Methods, as well as working with another Professor in data collection for their research in the Psychology Department. This proposed study originated with me, was designed in conjunction with Dr. Fowler, and arose out of personal interest in endometriosis and its associated pain. I watched many of my aunts and cousins suffer from it before being diagnosed with it myself two years ago. Thermal biofeedback techniques would supply women with tools to help them relieve their pain, in any situation and at any time, once mastered, rather than relying on invasive surgeries and often ineffective medicinal treatments. The product of this research will be a presentation at the WSU Undergraduate Research Symposium, and hopefully presentations at regional and national conferences as well, and, depending on the funding and number of participants, even publish the results in a scholarly journal. As I am planning on going on to Graduate School, I feel this will be a valuable experience for me to conduct my own research project as my Senior Thesis, and the research experience will be important for getting into a Graduate program in Psychology.

Project Methods and Timeline

Participants will be volunteers over the age of 18 who will be recruited from local doctors, flyers on the University campus, and online support groups. The study will be a pre-test-post-test design, and will begin with a pilot study in the Fall of 2004, and the final study will commence in the Spring of 2005. Each part will take approximately four weeks to complete. Initially, a pain scale, the Endometriosis Health Profile Questionnaire (EHP-30)[designed specifically for endometriosis, with demonstrated reliability and validity, and also sensitive to change, making it useful for measuring levels of pain before and after treatment (Jones, 2004)] will be administered to all subjects, to assess their pre-biofeedback pain levels. The participants will be trained in the biofeedback techniques, with the researcher interacting with them to provide instruction. The same pain scale will be administered again upon completion of the training to assess the level of pain reduction. The study has received IRB approval. All equipment used will be completely non-invasive, and participants will be treated in accordance with APA ethical standards.

The biofeedback training will be facilitated by the computer biofeedback program called CalmLink; temperature sensors will be attached on the outside to the middle finger on the subjects’ dominant hands, which will aid in pre- and post-biofeedback hand temperatures, as well as providing the interface for learning the techniques. By consciously raising their hand temperatures, they will see the “feedback” on the computer screen, either in the form of a graph which will rise or fall according to their temperature, with a target temperature identified, or in the form of a game, similar to the game “Pac-Man,” except as the subject relaxes and raises their hand temperature, the game slows down and becomes easier to play. Thermal biofeedback has been shown to be effective in treating many gynecologic conditions, including primary dysmenorrhea (Hart, 1981) and premenstrual tension syndrome (Mathew, 1979). In this proposed study, a scale specifically designed for endometriosis (EHP-30) will be coupled with the treatment specifically for reducing the pain associated with endometriosis.

Project Budget

The proposed budget for this project is required for the computer biofeedback program and thermal temperature interface called CalmLink ($300), which will be used for the thermal biofeedback training and data collection. All other supplies will be provided by the Psychology Department, Dr. Fowler, and myself.

References

Alexander, C. J. & Steefel, L. (1995). Biofeedback: listen to the body. RN, 58(8), 51- 53.

Berkley, K. J. et al. (2004). Innervation of ectopic endometrium in a rat model of endometriosis. Proceedings of the National Academy of Sciences of the United States of America, 101(30), 11094-11098.

Freedman, R. R. (1991). Physiological mechanisms of temperature biofeedback. Biofeedback and Self Regulation, 16(2), 95-115.

Hart, A. D. et al. (1981). A comparison of skin temperature and EMG training for primary dysmenorrhea. Biofeedback and Self Regulation, 6(3), 367-373.

Hawkins, R. S., Hart, A. D. (2003). The use of thermal biofeedback in the treatment of pain associated with endometriosis: preliminary findings. Applied Psychophysiology and Biofeedback, 28(4), 279-289.

Jones, G. et al. (2004). Evaluating the responsiveness of the endometriosis health profile: The EHP-30. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 13(3), 705-713.

Mathew, R. J. et al. (1979). Skin temperature control for premenstrual tension syndrome: A pilot study. American Journal of Clinical Biofeedback, 2(1), 7-10.