title: Between the Devil and the Deep Blue Sea: Avoidance-Avoidance Competition Increases Pain-Related Fear and Slows Decision-Making.
abstract: Successful adjustment to dynamic environments requires the simultaneous pursuit of multiple goals. However, the pursuit of multiple goals may bring about goal conflict. Despite evidence indicating that goal conflict can have a detrimental effect on subjective well-being, little is known about the effects of goal competition in the context of pain. This experiment investigated whether different types of goal competition increase pain-related fear and slow pain-related decision-making. Forty-six participants completed a cross-directional movement task in which they learned to associate movements in 1 direction (eg, left) with pain, and movements in the opposite direction (eg, right) with safety; and that movements in other directions (eg, up and down) were associated with reward and loss of reward, respectively. In the test phase, both phases were combined, creating different types of goal competition. The results showed that participants were most afraid of movements associated with 2 concurrent avoidance goals, and the least afraid of movements associated with approach-approach competition. Additionally, participants were slower in making a choice when presented with an avoidance-avoidance competition compared with approach-approach and avoidance-approach competition. These findings suggest that avoidance-avoidance competition increased fear and slowed decision-making compared with other types of competition.
  
  
  CONCLUSIONS
  This study provides experimental evidence for the differential effects of various goal conflicts on pain-related fear and decision-making. This knowledge may improve our understanding of patients' behavior when experiencing goal conflict and may contribute to improving treatments by addressing multiple goals patients are pursuing, and not just pain avoidance/reduction.
authors.affiliation: Health Psychology, University of Leuven, Leuven, Belgium; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium. Electronic address: Nathalie.claes@ppw.kuleuven.be.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Claes
authors.affiliation: Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium; Centre for Pain Research, The University of Bath, Bath, Somerset, United Kingdom.
authors.forename: Geert
authors.initials: G
authors.lastname: Crombez
authors.affiliation: Health Psychology, University of Leuven, Leuven, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Meulders
authors.affiliation: Health Psychology, University of Leuven, Leuven, Belgium; Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
authors.forename: Johan W S
authors.initials: JW
authors.lastname: Vlaeyen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001362:Avoidance Learning / Q000502:physiology*; D002755:Choice Behavior; D004558:Electric Stimulation / Q000009:adverse effects; D005239:Fear / Q000523:psychology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D009068:Movement; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000209:etiology / Q000523:psychology*; D010775:Photic Stimulation; D011930:Reaction Time; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Avoidance; goals; motivation; pain; reward