JENNIFER A. HAYTHORNTHWAITE, PhD
Professor of Psychiatry & Behavioral Sciences
Dr. Haythornthwaite, PhD received her Ph.D. in Clinical Psychology from the State University of New York at Stony Brook and then completed a clinical internship at the West Haven VA Medical Center and a research fellowship at the National Institute on Aging. Her work has focused on the study and treatment of the psychosocial aspects of pain, particularly the impact of negative emotions and pain coping strategies on pain and pain-related disability. The relevance of depression to chronic pain is clinically significant beyond its effects on pain and pain-related outcomes, as suicide rates are elevated in chronic pain. Her work has demonstrated that depression, sleep disturbance, and pain catastrophizing each contribute to elevated risk for suicidal ideation in patients who are experiencing chronic pain. In collaboration with sleep experts, she has investigated the common report that pain disrupts sleep, finding that sleep disturbance may actually contribute to increased pain sensitivity. Another influential psychosocial factor - pain catastrophizing - has long been known to be a maladaptive coping strategy in patients with chronic pain, and her work has shown its predictive influence on pain
beyond the effects of depressive symptoms. Pain catastrophizing has trait-like features and often does not change with the resolution of acute pain, is associated with an elevated inflammatory response to acute pain stimulation, and is associated with indices of central sensitization. These neurobiological processes – elevated cytokine response to stress/pain and sensitization of the nervous system to painful stimulation – are the focus of her current work, as these may be mechanisms by which catastrophizing incurs risk for persistent pain.
Dr. Haythornthwaite’s work also tests treatments using randomized clinical trials of both pharmacological and psychological treatments for persistent pain. An early collaboration demonstrated beneficial effects of opioid treatment in post-herpetic neuralgia and had a tremendous impact in the field of neuropathic pain, contributing to the re-conceptualization of clinical guidelines. Patients showed significant variability in opioid responsiveness and post-herpetic neuralgia patients who were less pain sensitive (using laboratory stimulation techniques) reported the greatest reduction in pain with opioid therapy, a finding that was specific to opioids and not observed with response to tricyclic antidepressant. This variability in treatment response is an important line of investigation for future projects. Her current work is testing the effects of cognitive behavioral and mindfulness treatments on neurobiological outcomes in migraine, focusing on brain function and structure, and temporomandibular joint disorder, focusing on cytokine reactivity and pain modulatory processes. As part of the HEAL initiative at NIH, she is working with a team of investigators at Hopkins to examine the effects of conservative and interventional approaches to managing pain due to knee osteoarthritis, called the SKOAP trial.
Dr. Haythornthwaite has served in leadership positions at Johns Hopkins University and in the American Pain Society and has worked with a number of groups to enhance the mentoring of early career clinicians and investigators. She speaks frequently to both mentors and mentees at various academic institutions about strategies to improve mentoring relationships and is currently leading a new program at Hopkins focused on enhancing the mentoring of students in the graduate biomedical education program.