title: The effect of threat information on acquisition, extinction, and reinstatement of experimentally conditioned fear of movement-related pain.
abstract: OBJECTIVE
  The experiential acquisition of pain-related fear has been demonstrated by pairing a painful electrocutaneous stimulus pain-US; unconditioned pain stimulus) with one movement (CS+; conditioned stimulus) but not with another (CS-). However, it is expected that during acquisition through direct experience, pain-related fear can be intensified or weakened by verbally/visually transmitted information about the pain and its meaning.
  
  
  METHODS
  Participants received threatening information (US-inflation), safety information (US-deflation), or no information about the pain-US (US-same). Additionally, we measured return of fear after a reinstatement procedure: two unsignaled pain-USs were presented in the experimental groups, but not in the control groups.
  
  
  RESULTS
  We replicated the acquisition and extinction of experimentally induced fear of movement-related pain in healthy subjects both in the verbal reports and the eye-blink startle measures. Two reinstating pain-US presentations led to a differential return of self-reported fear and a nondifferential return of fear in the eye-blink startle responses. Although, we failed to find an effect of verbal/visual information regarding the meaning of the pain-US on the acquisition, extinction, or reinstatement of pain-related fear, we did observe a pain sensitization effect over time suggesting that our threat manipulation induced an increase of perceived threat in all groups.
  
  
  CONCLUSIONS
  The results suggest that our threat manipulation might not have worked or that it was not sensitive enough to yield group-specific effects. We replicated acquisition, extinction, and return of experimentally conditioned fear of movement-related pain, but the threat manipulation failed to generate any additional effects.
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.|Department of Rehabilitation Medicine, University Medical Centre Maastricht, Maastricht, The Netherlands.
authors.forename: Marlies
authors.initials: M
authors.lastname: den Hollander
authors.affiliation: Research Group Health Psychology, University of Leuven, Leuven, Belgium.|Centre 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: Department of Rehabilitation Medicine, University Medical Centre Maastricht, Maastricht, The Netherlands.
authors.forename: Marluuke
authors.initials: M
authors.lastname: Jakobs
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.|Research Group Health Psychology, University of Leuven, Leuven, Belgium.|Centre for Excellence on Generalization Research in Health and Psychopathology, University of Leuven, Leuven, Belgium.
authors.forename: Johan W S
authors.initials: JW
authors.lastname: Vlaeyen
mesh_terms: D000293:Adolescent; D001362:Avoidance Learning; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D003214:Conditioning, Classical; D003463:Cues; D005108:Extinction, Psychological; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods; D008297:Male; D009068:Movement; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anxiety; Avoidance Behavior; Behavior; Catastrophizing; Fear; Musculoskeletal; Psychology; Psychosocial factors