Highlights
- •Motivational aspects impact pain-related outcomes in healthy subjects.
- •Introducing a competing, approach-reward does not impact pain-related fear.
- •Presenting a competing, approach-reward goal attenuates avoidance behavior.
- •Avoidance behavior is associated with both pain-avoidance and approach-reward goals.
Abstract
Current fear-avoidance models consider pain-related fear as a crucial factor in the
development of chronic pain. However, pain-related fear often occurs in a context
of multiple, competing goals. This study investigated whether pain-related fear and
avoidance behavior are attenuated when individuals are faced with a pain avoidance
goal and another valued but competing goal, operationalized as obtaining a monetary
reward. Fifty-five healthy participants moved a joystick toward different targets.
In the experimental condition, a movement to one target (conditioned stimulus [CS+])
was followed by a painful unconditioned stimulus (pain-US) and a rewarding unconditioned
stimulus (reward-US) on 50% of the trials, whereas the other movement (nonreinforced
conditioned stimulus [CS−]) movement was not. In the control condition, the CS+ movement
was followed by the pain-US only. Results showed that pain-related fear was elevated
in response to the CS+ compared to the CS− movement, but that it was not influenced
by the reward-US. Interestingly, participants initiated a CS+ movement slower than
a CS− movement in the control condition but not in the experimental condition. Also,
in choice trials, participants performed the CS+ movement more frequently in the experimental
than in the control condition. These results suggest that the presence of a valued
competing goal can attenuate avoidance behavior.
Perspective
The current study provides experimental evidence that both pain and competing goals
impact on behavioral decision making and avoidance behavior. These results provide
experimental support for treatments of chronic pain that include an individual's pursuit
of valuable daily life goals, rather than limiting focus to pain reduction only.
Key words
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Article info
Publication history
Published online: August 22, 2014
Accepted:
August 6,
2014
Received in revised form:
July 17,
2014
Received:
April 7,
2014
Footnotes
The work was conducted at the University of Leuven, Belgium.
This study was supported by the research grant “Pain-Related Fear in Context: The Effects of Concomitant Non-pain Goals and Goal Conflicts on Fear Responding in the Context of Pain” funded by the Research Foundation–Flanders (Fonds Wetenschappelijk Onderzoek [FWO] Vlaanderen), Belgium, granted to G.C. and J.W.S.V. (grant ID: G091812N). The contribution of A.M. is supported by an EFIC-Grünenthal Research Grant (E-G-G ID: 169518451) and a postdoctoral research fellowship of the Research Foundation−Flanders (FWO Vlaanderen), Belgium (grant ID: 12E3714N).
The authors report no conflict of interest.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
