title: Can experimentally induced positive affect attenuate generalization of fear of movement-related pain?
abstract: Recent experimental data show that associative learning processes are involved not only in the acquisition but also in the spreading of pain-related fear. Clinical studies suggest involvement of positive affect in resilience against chronic pain. Surprisingly, the role of positive affect in associative learning in general, and in fear generalization in particular, has received scant attention. In a voluntary movement paradigm, in which one arm movement (reinforced conditioned stimulus [CS+]) was followed by a painful stimulus and another was not (unreinforced conditioned stimulus [CS-]), we tested generalization of fear inhibition in response to 5 novel but related generalization movements (GSs; within-subjects) after either a positive affect induction or a control exercise (Group = between-subjects) in healthy participants (N = 50). The GSs' similarity with the original CS+ movement and CS- movement varied. Fear learning was assessed via verbal ratings. Results indicated that there was an interaction between the increase in positive affect and the linear generalization gradient. Stronger increases in positive affect were associated with steeper generalization curves because of relatively lower pain-unconditioned stimulus expectancy and less fear of stimuli more similar to the CS-. There was no Group by Stimulus interaction. Results thus suggest that positive affect may enhance safety learning through promoting generalization from known safe movements to novel yet related movements. Improved safety learning may be a central mechanism underlying the association between positive affect and increased resilience against chronic pain.
  
  
  CONCLUSIONS
  We investigated the extent to which positive affect influences the generalization (ie, spreading) of pain-related fear inhibition in response to situations similar to the original, pain-eliciting situation. Results suggest that increasing positive affect in the acute pain stage may limit the spreading of pain-related fear, thereby potentially inhibiting transition to chronic pain conditions.
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Geschwind
authors.affiliation: Department of Informatics, Simulation and Modeling, KU Leuven, Belgium; Research Group on Quantitative Psychology and Individual Differences, KU Leuven, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Meulders
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
authors.forename: Madelon L
authors.initials: ML
authors.lastname: Peters
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands; Research Group on Health Psychology, KU Leuven, Belgium; Center for Excellence on Generalization Research in Health and Psychopathology, KU Leuven, Belgium.
authors.forename: Johan W S
authors.initials: JW
authors.lastname: Vlaeyen
authors.affiliation: Research Group on Health Psychology, KU Leuven, Belgium; Center for Excellence on Generalization Research in Health and Psychopathology, KU Leuven, Belgium. Electronic address: ann.meulders@ppw.kuleuven.be.
authors.forename: Ann
authors.initials: A
authors.lastname: Meulders
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D003213:Conditioning, Psychological; D004558:Electric Stimulation / Q000009:adverse effects; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007858:Learning; D009068:Movement; D059226:Nociceptive Pain / Q000523:psychology*; D011581:Psychological Tests; D012044:Regression Analysis; D057566:Self Report; D014163:Transfer, Psychology; D055815:Young Adult
keywords: Fear of movement-related pain; best positive self; fear generalization; positive affect; safety signal; voluntary movement paradigm