title: Pain in context: Cues predicting a reward decrease fear of movement related pain and avoidance behavior.
abstract: Previous research shows that goal-directed behavior might be modulated by cues that predict (dis)similar outcomes. However, the literature investigating this modulation with pain outcomes is scarce. Therefore, this experiment investigated whether environmental cues predicting pain or reward modulate defensive pain responding. Forty-eight healthy participants completed a joystick movement task with two different movement orientations. Performing one movement was associated with a painful stimulus, whereas performance of another movement was associated with reward, i.e. lottery tickets. In a subsequent task, participants learned to associate three different cues withpain, reward, or neither of the two. Next, these cues were integrated in the movement task. This study demonstrates that in general, aversive cues enhance and appetitive cues reduce pain-related fear. Furthermore, we found that incongruence between the outcomes predicted by the movement and the cue results in more oscillatory behavior, i.e., participants were more willing to perform a painful movement when a cue predicting reward was simultaneously presented, and vice versa. Similarly, when given a choice, participants preferred to perform the reward movement, unless there was an incongruence between the outcomes predicted by the movements and cues. Taken together, these results provide experimental evidence that environmental cues are capable of modulating pain-related fear and avoidance behavior.
authors.affiliation: Research Group Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium; Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Belgium. Electronic address: Nathalie.claes@kuleuven.be.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Claes
authors.affiliation: Research Group Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium; Center for Excellence on Generalization Research in Health and Psychopathology, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium; Department of Clinical Psychological Science, Maastricht University, The Netherlands.
authors.forename: Johan W S
authors.initials: JWS
authors.lastname: Vlaeyen
authors.affiliation: Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Belgium; Centre for Pain Research, University of Bath, United Kingdom.
authors.forename: Geert
authors.initials: G
authors.lastname: Crombez
mesh_terms: D001362:Avoidance Learning; D002755:Choice Behavior; D003214:Conditioning, Classical; D003216:Conditioning, Operant; D003463:Cues; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement; D010146:Pain / Q000523:psychology*; D012201:Reward; D055815:Young Adult
keywords: Classical conditioning; Fear; Instrumental learning; Pain