<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04438746</url>
  </required_header>
  <id_info>
    <org_study_id>#20-002</org_study_id>
    <nct_id>NCT04438746</nct_id>
  </id_info>
  <brief_title>Chronic Pain, Opioids, and Anger Treatment</brief_title>
  <official_title>Alleviating Pain and Opioid Dependence Through Anger Management: A Pilot Study</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>The University of Texas at San Antonio</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>The University of Texas at San Antonio</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The current US opioid epidemic is a pressing public health concern. Links between opioid&#xD;
      misuse and mortality are well-known; nearly 70% of all drug overdose deaths in 2017 were&#xD;
      attributable to opioids. Given their pain-relieving properties, opioids have been widely used&#xD;
      in the chronic pain population who are also susceptible to misuse of these analgesics.. In&#xD;
      chronic pain patients with anger, the pain as well as opioid use may be aggravated. For&#xD;
      example, suppression of anger has been linked with increased pain sensitivity in experiments,&#xD;
      while anger-hostility scores and internalized anger predict pain severity variance and pain&#xD;
      intensity, respectively. Anger is also linked with drug use/abuse, including opioids. The&#xD;
      goal of this research is to implement a state-of-the-art program for anger regulation in&#xD;
      chronic pain patients., Called Cognitive Behavioral Affective Therapy (CBAT), this program is&#xD;
      evaluated on multiple measures of anger, sensory versus affective measures of pain, and&#xD;
      measures of opioid misuse. CBAT is expected to reduce anger, and thereby produce reduction in&#xD;
      pain as well as shift attitudes away from opioid misuse..&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Participants will be recruited by electronic announcements and IRB approved recruitment&#xD;
      flyers in local pain clinics and pain support groups. These ads and flyers will contain&#xD;
      relevant info (e.g., study email address and GoogleVoice number) for prospective participants&#xD;
      to contact study staff with any questions about participation. Interested participants will&#xD;
      be screened by an RA on the phone using the following steps: 1) RA will obtain verbal consent&#xD;
      upon explaining study participation and answering any questions participants may have; 2)&#xD;
      Once informed consent is obtained, RA will use participants preferred email address to send&#xD;
      potential participant a link to the Qualtrics screening questionnaire; 3) RA will then&#xD;
      briefly orient participant to Qualtrics; and 3) RA will complete the screening process with&#xD;
      participant on the phone to determine and inform participant of their eligibility to&#xD;
      participate.&#xD;
&#xD;
      Consent and Screening: Participants will first go through the informed consent procedure,&#xD;
      where they will be told about the purpose of the study, expectations of them as participants,&#xD;
      etc. Informed consent is expected to take no more than 5 minutes. They will then be asked to&#xD;
      complete a screening questionnaire which is expected to take no more than 3 minutes. Eligible&#xD;
      participants will be randomly assigned to one of two groups: 1) Control and 2) CBAT. Both&#xD;
      control group and experimental group participants will be required to complete 2 pre-recorded&#xD;
      sessions per week lasting 1 hour each (total of 8 hours) over the course of 4 weeks.&#xD;
&#xD;
      Online Sessions and Surveys: After questionnaires (including measures of pain and opioid use,&#xD;
      the Anger Parameters Scale) have been administered at pre-treatment, the first session will&#xD;
      serve as orientation to self-monitoring anger levels between sessions. If a participant has&#xD;
      no anger on a given day, no monitoring is necessary. Following this, control group&#xD;
      participants self-monitor their anger and watch pre-recorded sessions on emotions in general.&#xD;
      The treatment group will be actively trained in anger regulation skills within the framework&#xD;
      of CBAT. These participants will proceed from a week of anger prevention to a week of&#xD;
      intervention to a week of postvention. During the prevention phase, an individually-tailored&#xD;
      behavior contract against anger will be signed by each paParticipants will work with&#xD;
      investigators over email to draft and electronically sign their contracts. RAs will review&#xD;
      participant progress toward fulfillment of contracts during weekly check-in phone calls to&#xD;
      participants. Participants will also engage in behavioral rehearsal of anger-provoking&#xD;
      situations and learn about stimulus control for discriminating and avoiding situations that&#xD;
      are likely to culminate in anger.&#xD;
&#xD;
      In the Intervention phase, participants will be introduced to techniques for regulating anger&#xD;
      that could not be prevented. These include thought-stopping, distraction, and cognitive&#xD;
      reappraisal..&#xD;
&#xD;
      In the postvention phase, participants will be trained in techniques for ameliorating&#xD;
      residual anger. These include expressive writing and verbal disclosure. Gestalt therapy empty&#xD;
      chair dialogue will be used for overcoming unresolved anger.&#xD;
&#xD;
      At the conclusion of the 4 weeks of anger self-regulation training, the same questionnaires&#xD;
      relating to anger, pain, and opioid misuse and beliefs will be assessed in both groups. This&#xD;
      post-treatment set of questionnaires is expected to take no more than 20 minutes.&#xD;
&#xD;
      Finally, a follow-up session (2 hours) will be held for both groups one month after&#xD;
      post-treatment. Anger, pain, and opioid use measures will be re-administered (taking no more&#xD;
      than 20 minutes). All participants will receive a brief booster session to reinforce&#xD;
      effective anger regulation techniques. The same pre- and post-treatment questionnaires&#xD;
      mentioned above will be re-administered at this point in the study.&#xD;
&#xD;
      Phone Calls and Knowledge Tests: To ensure that participants are paying attention to the&#xD;
      online videos, RAs will contact them weekly and administer a brief, multiple choice knowledge&#xD;
      test over the phone. Participants who score less than 50% in any given week will be dropped&#xD;
      from the study. During that same phone call, RAs will check in with participants to ensure&#xD;
      that there are no problems with their participation in the study and that the participants&#xD;
      are not in any emotional distress. Phone calls are anticipated to last approximately 10&#xD;
      minutes, for a total time of 50 minutes over the span of the study (4 weeks of either&#xD;
      treatment or control and the 1-month follow up). Total participant time commitment over the&#xD;
      course of the study is approximately 12 hours.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Active, not recruiting</overall_status>
  <start_date type="Actual">July 1, 2020</start_date>
  <completion_date type="Anticipated">January 1, 2023</completion_date>
  <primary_completion_date type="Actual">January 1, 2022</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change in pain medication dosage and frequency of use at one month</measure>
    <time_frame>One month</time_frame>
    <description>Participants are asked what pain medication they are using and at what dosage and frequency. Open-ended question.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in pain medication dosage and frequency of use at one month follow-up</measure>
    <time_frame>One month after end of intervention</time_frame>
    <description>Participants are asked what pain medication they are using and at what dosage and frequency. Open-ended question.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in attitudes/beliefs surrounding pain medication at one month</measure>
    <time_frame>One month</time_frame>
    <description>Assessed using the Pain Medication Beliefs Questionnaire (Schieffer et al., 2005), a five-item instrument measuring beliefs about one's response to, relief from, and potential addiction to pain medication</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in attitudes/beliefs surrounding pain medication at one month follow-up</measure>
    <time_frame>One month after end of intervention</time_frame>
    <description>Assessed using the Pain Medication Beliefs Questionnaire (Schieffer et al., 2005), a five-item instrument measuring beliefs about one's response to, relief from, and potential addiction to pain medication</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in opioid misuse at one month</measure>
    <time_frame>One month</time_frame>
    <description>Measured with the Current Opioid Misuse Measure (Butler et al., 2007), a 17-item instrument assessing signs and symptoms of drug misuse, emotional/psychiatric problems due to misuse, evidence of lying about drug use, and other domains</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in opioid misuse at one month follow-up</measure>
    <time_frame>One month after end of intervention</time_frame>
    <description>Measured with the Current Opioid Misuse Measure (Butler et al., 2007), a 17-item instrument assessing signs and symptoms of drug misuse, emotional/psychiatric problems due to misuse, evidence of lying about drug use, and other domains</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in anger parameters at one month</measure>
    <time_frame>One month</time_frame>
    <description>The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold (Fernandez et al., 2014). Scores can range from 0-120 and higher scores imply more maladaptive anger.&#xD;
The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in anger parameters at one month follow-up</measure>
    <time_frame>One month after end of intervention</time_frame>
    <description>The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold (Fernandez et al., 2014). Scores can range from 0-120 and higher scores imply more maladaptive anger.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in anger expression style at one month</measure>
    <time_frame>One month</time_frame>
    <description>Measured with the Anger Expression Scale (Fernandez, 2008). The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in anger expression style at one month follow-up</measure>
    <time_frame>One month after end of intervention</time_frame>
    <description>Measured with the Anger Expression Scale (Fernandez, 2008). The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in chronic pain ratings at one month</measure>
    <time_frame>One month</time_frame>
    <description>Single item measured on a scale from 0-10</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in chronic pain ratings at one month follow up</measure>
    <time_frame>One month after end of intervention</time_frame>
    <description>Single item measured on a scale from 0-10</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in emotional response to chronic pain at one month</measure>
    <time_frame>One month</time_frame>
    <description>Single item measured on a scale from &quot;a little unpleasant&quot; to &quot;extremely distressing&quot;</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in emotional response to chronic pain at one month follow-up</measure>
    <time_frame>One month after end of intervention</time_frame>
    <description>Single item measured on a scale from &quot;a little unpleasant&quot; to &quot;extremely distressing&quot;</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">51</enrollment>
  <condition>Anger</condition>
  <condition>Opioid Use</condition>
  <condition>Chronic Pain</condition>
  <arm_group>
    <arm_group_label>Group receiving CBAT</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
  </arm_group>
  <arm_group>
    <arm_group_label>Group receiving general emotion training</arm_group_label>
    <arm_group_type>Placebo Comparator</arm_group_type>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Emotion discussion</intervention_name>
    <description>General discussion of emotions; no therapy or training is offered</description>
    <arm_group_label>Group receiving general emotion training</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Cognitive Behavioral Affective Therapy</intervention_name>
    <description>Active training in regulating anger</description>
    <arm_group_label>Group receiving CBAT</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  taking opioid pain relievers for at least 3 months in the past 12 months&#xD;
&#xD;
          -  maladaptive levels of anger as measured by STAXI-2&#xD;
&#xD;
          -  without psychiatric co-morbidity (e.g., major depression, substance use disorder,&#xD;
             etc.)&#xD;
&#xD;
          -  not undergoing current psychological/psychiatric treatment&#xD;
&#xD;
          -  speak English.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        -&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>65 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Ephrem Fernandez, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of Texas at San Antonio</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>University of Texas at San Antonio</name>
      <address>
        <city>San Antonio</city>
        <state>Texas</state>
        <zip>78249</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <verification_date>May 2022</verification_date>
  <study_first_submitted>May 28, 2020</study_first_submitted>
  <study_first_submitted_qc>June 17, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">June 19, 2020</study_first_posted>
  <last_update_submitted>May 18, 2022</last_update_submitted>
  <last_update_submitted_qc>May 18, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">May 20, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>The University of Texas at San Antonio</investigator_affiliation>
    <investigator_full_name>Ephrem Fernandez</investigator_full_name>
    <investigator_title>Professor, Psychology</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Chronic Pain</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04438746
org study id: #20-002
nct id: NCT04438746
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The current US opioid epidemic is a pressing public health concern. Links between opioid
      misuse and mortality are well-known; nearly 70% of all drug overdose deaths in 2017 were
      attributable to opioids. Given their pain-relieving properties, opioids have been widely used
      in the chronic pain population who are also susceptible to misuse of these analgesics.. In
      chronic pain patients with anger, the pain as well as opioid use may be aggravated. For
      example, suppression of anger has been linked with increased pain sensitivity in experiments,
      while anger-hostility scores and internalized anger predict pain severity variance and pain
      intensity, respectively. Anger is also linked with drug use/abuse, including opioids. The
      goal of this research is to implement a state-of-the-art program for anger regulation in
      chronic pain patients., Called Cognitive Behavioral Affective Therapy (CBAT), this program is
      evaluated on multiple measures of anger, sensory versus affective measures of pain, and
      measures of opioid misuse. CBAT is expected to reduce anger, and thereby produce reduction in
      pain as well as shift attitudes away from opioid misuse..
Participants will be recruited by electronic announcements and IRB approved recruitment
      flyers in local pain clinics and pain support groups. These ads and flyers will contain
      relevant info (e.g., study email address and GoogleVoice number) for prospective participants
      to contact study staff with any questions about participation. Interested participants will
      be screened by an RA on the phone using the following steps: 1) RA will obtain verbal consent
      upon explaining study participation and answering any questions participants may have; 2)
      Once informed consent is obtained, RA will use participants preferred email address to send
      potential participant a link to the Qualtrics screening questionnaire; 3) RA will then
      briefly orient participant to Qualtrics; and 3) RA will complete the screening process with
      participant on the phone to determine and inform participant of their eligibility to
      participate.

      Consent and Screening: Participants will first go through the informed consent procedure,
      where they will be told about the purpose of the study, expectations of them as participants,
      etc. Informed consent is expected to take no more than 5 minutes. They will then be asked to
      complete a screening questionnaire which is expected to take no more than 3 minutes. Eligible
      participants will be randomly assigned to one of two groups: 1) Control and 2) CBAT. Both
      control group and experimental group participants will be required to complete 2 pre-recorded
      sessions per week lasting 1 hour each (total of 8 hours) over the course of 4 weeks.

      Online Sessions and Surveys: After questionnaires (including measures of pain and opioid use,
      the Anger Parameters Scale) have been administered at pre-treatment, the first session will
      serve as orientation to self-monitoring anger levels between sessions. If a participant has
      no anger on a given day, no monitoring is necessary. Following this, control group
      participants self-monitor their anger and watch pre-recorded sessions on emotions in general.
      The treatment group will be actively trained in anger regulation skills within the framework
      of CBAT. These participants will proceed from a week of anger prevention to a week of
      intervention to a week of postvention. During the prevention phase, an individually-tailored
      behavior contract against anger will be signed by each paParticipants will work with
      investigators over email to draft and electronically sign their contracts. RAs will review
      participant progress toward fulfillment of contracts during weekly check-in phone calls to
      participants. Participants will also engage in behavioral rehearsal of anger-provoking
      situations and learn about stimulus control for discriminating and avoiding situations that
      are likely to culminate in anger.

      In the Intervention phase, participants will be introduced to techniques for regulating anger
      that could not be prevented. These include thought-stopping, distraction, and cognitive
      reappraisal..

      In the postvention phase, participants will be trained in techniques for ameliorating
      residual anger. These include expressive writing and verbal disclosure. Gestalt therapy empty
      chair dialogue will be used for overcoming unresolved anger.

      At the conclusion of the 4 weeks of anger self-regulation training, the same questionnaires
      relating to anger, pain, and opioid misuse and beliefs will be assessed in both groups. This
      post-treatment set of questionnaires is expected to take no more than 20 minutes.

      Finally, a follow-up session (2 hours) will be held for both groups one month after
      post-treatment. Anger, pain, and opioid use measures will be re-administered (taking no more
      than 20 minutes). All participants will receive a brief booster session to reinforce
      effective anger regulation techniques. The same pre- and post-treatment questionnaires
      mentioned above will be re-administered at this point in the study.

      Phone Calls and Knowledge Tests: To ensure that participants are paying attention to the
      online videos, RAs will contact them weekly and administer a brief, multiple choice knowledge
      test over the phone. Participants who score less than 50% in any given week will be dropped
      from the study. During that same phone call, RAs will check in with participants to ensure
      that there are no problems with their participation in the study and that the participants
      are not in any emotional distress. Phone calls are anticipated to last approximately 10
      minutes, for a total time of 50 minutes over the span of the study (4 weeks of either
      treatment or control and the 1-month follow up). Total participant time commitment over the
      course of the study is approximately 12 hours.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Change in pain medication dosage and frequency of use at one month
time frame: One month
description: Participants are asked what pain medication they are using and at what dosage and frequency. Open-ended question.
measure: Change in pain medication dosage and frequency of use at one month follow-up
time frame: One month after end of intervention
description: Participants are asked what pain medication they are using and at what dosage and frequency. Open-ended question.
measure: Change in attitudes/beliefs surrounding pain medication at one month
time frame: One month
description: Assessed using the Pain Medication Beliefs Questionnaire (Schieffer et al., 2005), a five-item instrument measuring beliefs about one's response to, relief from, and potential addiction to pain medication
measure: Change in attitudes/beliefs surrounding pain medication at one month follow-up
time frame: One month after end of intervention
description: Assessed using the Pain Medication Beliefs Questionnaire (Schieffer et al., 2005), a five-item instrument measuring beliefs about one's response to, relief from, and potential addiction to pain medication
measure: Change in opioid misuse at one month
time frame: One month
description: Measured with the Current Opioid Misuse Measure (Butler et al., 2007), a 17-item instrument assessing signs and symptoms of drug misuse, emotional/psychiatric problems due to misuse, evidence of lying about drug use, and other domains
measure: Change in opioid misuse at one month follow-up
time frame: One month after end of intervention
description: Measured with the Current Opioid Misuse Measure (Butler et al., 2007), a 17-item instrument assessing signs and symptoms of drug misuse, emotional/psychiatric problems due to misuse, evidence of lying about drug use, and other domains
measure: Change in anger parameters at one month
time frame: One month
description: The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold (Fernandez et al., 2014). Scores can range from 0-120 and higher scores imply more maladaptive anger.
The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.
measure: Change in anger parameters at one month follow-up
time frame: One month after end of intervention
description: The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold (Fernandez et al., 2014). Scores can range from 0-120 and higher scores imply more maladaptive anger.
measure: Change in anger expression style at one month
time frame: One month
description: Measured with the Anger Expression Scale (Fernandez, 2008). The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
measure: Change in anger expression style at one month follow-up
time frame: One month after end of intervention
description: Measured with the Anger Expression Scale (Fernandez, 2008). The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
measure: Change in chronic pain ratings at one month
time frame: One month
description: Single item measured on a scale from 0-10
measure: Change in chronic pain ratings at one month follow up
time frame: One month after end of intervention
description: Single item measured on a scale from 0-10
measure: Change in emotional response to chronic pain at one month
time frame: One month
description: Single item measured on a scale from "a little unpleasant" to "extremely distressing"
measure: Change in emotional response to chronic pain at one month follow-up
time frame: One month after end of intervention
description: Single item measured on a scale from "a little unpleasant" to "extremely distressing"
arm group label: Group receiving CBAT
arm group type: Experimental
arm group label: Group receiving general emotion training
arm group type: Placebo Comparator
intervention type: Behavioral
intervention name: Emotion discussion
description: General discussion of emotions; no therapy or training is offered
arm group label: Group receiving general emotion training
intervention type: Behavioral
intervention name: Cognitive Behavioral Affective Therapy
description: Active training in regulating anger
arm group label: Group receiving CBAT
criteria: 
gender: All
minimum age: 18 Years
maximum age: 65 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Ephrem Fernandez, PhD
role: Principal Investigator
affiliation: University of Texas at San Antonio
facility: 
country: United States
responsible party type: Principal Investigator
investigator affiliation: The University of Texas at San Antonio
investigator full name: Ephrem Fernandez
investigator title: Professor, Psychology
mesh term: Chronic Pain