Alike, But Not Quite: Comparing the Generalization of Pain-Related Fear and Pain-Related Avoidance

DOI

Pain-related fear and −avoidance crucially contribute to pain chronification. People with chronic pain may adopt costly avoidance strategies above and beyond what is necessary, aligning with experimental findings of excessive fear generalization to safe movements in these populations. Furthermore, recent evidence suggests that, when avoidance is costly, it can dissociate from fear. Here, we investigated whether concurrently measured pain-related fear and costly avoidance generalization correspond in one task. We also explored whether healthy participants avoid excessively despite associated costs, and if avoidance would decrease as a function of dissimilarity from a painassociated movement. In a robotic arm-reaching task, participants could avoid a low-cost, pain-associated movement trajectory (T+), by choosing a high-cost non-painful movement trajectory (T-), at opposite ends of a movement plane. Subsequently, in the absence of pain, we introduced three movement trajectories (G1-3) between T+ and T-, and one movement trajectory on the side of Topposite to T+ (G4), linearly increasing in costs from T+ to G4. Avoidance was operationalized as maximal deviation from T+, and as trajectory choice. Fear learning was measured using self-reported painexpectancy, pain-related fear, and startle eye-blink electromyography. Self-reports generalized, both decreasing with increasing distance from T+. In contrast, all generalization trajectories were chosen equally, suggesting that avoidance-costs and previous pain balanced each other out. No effects emerged in the electromyography. These results add to a growing body of literature showing that (pain-related) avoidance, especially when costly, can dissociate from fear, calling for a better understanding of the factors motivating, and mitigating, disabling avoidance. Perspective: This article presents a comparison of pain-related fear- and avoidance generalization, and an exploration of excessive avoidance in healthy participants. Our findings show that painrelated avoidance can dissociate from fear, especially when avoidance is costly, calling for a better understanding of the factors motivating and mitigating disabling avoidance.

Identifier
DOI https://doi.org/10.34894/R4BUBC
Related Identifier IsCitedBy https://doi.org/10.1016/j.jpain.2022.04.010
Metadata Access https://dataverse.nl/oai?verb=GetRecord&metadataPrefix=oai_datacite&identifier=doi:10.34894/R4BUBC
Provenance
Creator Glogan, Eveliina ORCID logo; Meulders, Michel ORCID logo; Pfeiffer, Leon ORCID logo; Vlaeyen, Johan W.S. ORCID logo; Meulders, Ann ORCID logo
Publisher DataverseNL
Contributor faculty data manager FPN; Meulders, Ann
Publication Year 2023
Rights info:eu-repo/semantics/restrictedAccess
OpenAccess false
Contact faculty data manager FPN (Maastricht University); Meulders, Ann (Maastricht University)
Representation
Resource Type behavioral data; Dataset
Format application/zip
Size 960885866
Version 1.0
Discipline Agriculture, Forestry, Horticulture, Aquaculture; Agriculture, Forestry, Horticulture, Aquaculture and Veterinary Medicine; Life Sciences; Social Sciences; Social and Behavioural Sciences; Soil Sciences