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Threatening Social Context Facilitates Pain-Related Fear Learning

  • Kai Karos
    Correspondence
    Address reprint requests to Kai Karos, MSc, Department of Psychology, University of Leuven, Tiensestraat 102, Box 3726, 3000 Leuven, Belgium.
    Affiliations
    Research Group on Health Psychology, University of Leuven, Leuven, Belgium
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  • Ann Meulders
    Affiliations
    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
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  • Johan W.S. Vlaeyen
    Affiliations
    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
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Published:December 12, 2014DOI:https://doi.org/10.1016/j.jpain.2014.11.014

      Highlights

      • A threatening social context facilitates differential acquisition of pain-related fear.
      • The facilitation is evident in self-report and psychophysiological indices of fear.
      • A threatening social context leads to contextual fear.
      • Social context does not affect pain intensity ratings.

      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.

      Perspective

      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.

      Key words

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