When Do We Not Face Our Fears? Investigating the Boundary Conditions of Costly Pain-Related Avoidance Generalization

DOI

Excessive generalization of fear and avoidance are hallmark symptoms of chronic pain disability, yet research focusing on the mechanisms underlying generalization of avoidance specifically, is scarce. Two experiments investigated the boundary conditions of costly painrelated avoidance generalization in healthy participants who learned to avoid pain by performing increasingly effortful (in terms of deviation and force) arm-movements using a robot-arm (acquisition). During generalization, novel, but similar arm-movements, without pain, were tested. Experiment 1 (N = 64) aimed to facilitate generalization to these movements by reducing visual contextual changes between acquisition and generalization, whereas Experiment 2 (N = 70) aimed to prevent extinction by increasing pain uncertainty. Both experiments showed generalization of pain-expectancies and pain-related fear. However, Experiment 2 was the first and only to also demonstrate generalization of avoidance, ie, choosing the novel effortful armmovements in the absence of pain. These results suggest that uncertainty about the occurrence of pain may delay recovery, due to reduced disconfirmation of threat beliefs when exploring, resulting in persistent avoidance. Perspective: This article demonstrates generalization of instrumentally acquired costly painrelated avoidance in healthy people under conditions of uncertainty. The results suggest that targeting pain-related uncertainty may be a useful tool for clinicians adopting a psychological approach to treating excessive pain-related avoidance in chronic pain.

Identifier
DOI https://doi.org/10.34894/YEIRRD
Related Identifier IsCitedBy https://doi.org/10.1016/j.jpain.2021.03.149
Metadata Access https://dataverse.nl/oai?verb=GetRecord&metadataPrefix=oai_datacite&identifier=doi:10.34894/YEIRRD
Provenance
Creator Glogan, Eveliina ORCID logo; Kristof Vandael (ORCID: 0000-0003-0476-270X); Gatzounis, Rena 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 42023659
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