title: Threatening social context facilitates pain-related fear learning.
abstract: This study investigated the effects of a threatening and a safe social context on learning pain-related fear, a key factor in the development and maintenance of chronic pain. We measured self-reported pain intensity, pain expectancy, pain-related fear (verbal ratings and eyeblink startle responses), and behavioral measures of avoidance (movement-onset latency and duration) using an established differential voluntary movement fear conditioning paradigm. Participants (N = 42) performed different movements with a joystick: during fear acquisition, movement in one direction (CS+) was followed by a painful stimulus (pain-US) whereas movement in another direction (CS-) was not. For participants in the threat group, an angry face was continuously presented in the background during the task, whereas in the safe group, a happy face was presented. During the extinction phase the pain-US was omitted. As compared to the safe social context, a threatening social context led to increased contextual fear and facilitated differentiation between CS+ and CS- movements regarding self-reported pain expectancy, fear of pain, eyeblink startle responses, and movement-onset latency. In contrast, self-reported pain intensity was not affected by social context. These data support the modulation of pain-related fear by social context.
  
  
  CONCLUSIONS
  A threatening social context leads to stronger acquisition of (pain-related) fear and simultaneous contextual fear but does not affect pain intensity ratings. This knowledge may aid in the prevention of chronic pain and anxiety disorders and shows that social context might modulate pain-related fear without immediately affecting pain intensity itself.
authors.affiliation: Research Group on Health Psychology, University of Leuven, Leuven, Belgium. Electronic address: Kai.Karos@ppw.kuleuven.be.
authors.forename: Kai
authors.initials: K
authors.lastname: Karos
authors.affiliation: Research Group on Health Psychology, University of Leuven, Leuven, Belgium; Center for Excellence on Generalization Research in Health and Psychopathology, University of Leuven, Leuven, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Meulders
authors.affiliation: Research Group on Health Psychology, University of Leuven, Leuven, Belgium; Center for Excellence on Generalization Research in Health and Psychopathology, University of Leuven, Leuven, Belgium; Department of Clinical Psychological Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Johan W S
authors.initials: JW
authors.lastname: Vlaeyen
mesh_terms: D000293:Adolescent; D000328:Adult; D001767:Blinking; D003213:Conditioning, Psychological; D005145:Face; D005149:Facial Expression; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain; D010775:Photic Stimulation; D011581:Psychological Tests; D011597:Psychomotor Performance; D011930:Reaction Time; D013216:Reflex, Startle; D057566:Self Report; D012919:Social Behavior; D055815:Young Adult
keywords: Social context; contextual fear; fear conditioning; pain-related fear; preparedness; social threat