Highlights
- •Positive affect (PA) might be involved in resilience against chronic pain.
- •Stronger increases in PA are associated with steeper fear generalization gradients.
- •This is due to better fear inhibition in response to movements resembling the original safe movement.
- •Steeper generalization gradients are not associated with more spreading of fear inhibition in response to movements resembling the original painful movement.
- •PA may improve safety learning by promoting generalization from safe to novel movements.
Abstract
Recent experimental data show that associative learning processes are involved not
only in the acquisition but also in the spreading of pain-related fear. Clinical studies
suggest involvement of positive affect in resilience against chronic pain. Surprisingly,
the role of positive affect in associative learning in general, and in fear generalization
in particular, has received scant attention. In a voluntary movement paradigm, in
which one arm movement (reinforced conditioned stimulus [CS+]) was followed by a painful
stimulus and another was not (unreinforced conditioned stimulus [CS–]), we tested
generalization of fear inhibition in response to 5 novel but related generalization
movements (GSs; within-subjects) after either a positive affect induction or a control
exercise (Group = between-subjects) in healthy participants (N = 50). The GSs' similarity
with the original CS+ movement and CS– movement varied. Fear learning was assessed
via verbal ratings. Results indicated that there was an interaction between the increase
in positive affect and the linear generalization gradient. Stronger increases in positive
affect were associated with steeper generalization curves because of relatively lower
pain–unconditioned stimulus expectancy and less fear of stimuli more similar to the
CS–. There was no Group by Stimulus interaction. Results thus suggest that positive
affect may enhance safety learning through promoting generalization from known safe
movements to novel yet related movements. Improved safety learning may be a central
mechanism underlying the association between positive affect and increased resilience
against chronic pain.
Perspective
We investigated the extent to which positive affect influences the generalization
(ie, spreading) of pain-related fear inhibition in response to situations similar
to the original, pain-eliciting situation. Results suggest that increasing positive
affect in the acute pain stage may limit the spreading of pain-related fear, thereby
potentially inhibiting transition to chronic pain conditions.
Key words
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References
- Anxiety sensitivity and fear of pain in patients with recurring headaches.Behav Res Ther. 1999; 37: 703-713
- Increasing optimism abolishes pain-induced impairments in executive task performance.Pain. 2014; 155: 334-340
- Effect of sensory discrimination training on cortical reorganisation and phantom limb pain.Lancet. 2001; 357: 1763-1764
- The value of positive emotions: The emerging science of positive psychology is coming to understand why it's good to feel good.Am Sci. 2003; 91: 330-335
- The undoing effect of positive emotions.Motiv Emot. 2000; 24: 237-258
- Optimism lowers pain: Evidence of the causal status and underlying mechanisms.Pain. 2013; 154: 53-58
- SAS/STAT® 9.3 User's Guide.SAS Institute Inc, Cary, NC2011
- The Differential Emotions Scale: A Method of Measuring the Subjective Meaning of Experience of Discrete Emotions.Vanderbilt University, Department of Psychology, Nashville, TN1974
- Impaired safety signal learning may be a biomarker of PTSD.Neuropharmacology. 2012; 62: 695-704
- The role of fear-avoidance cognitions and behaviors in patients with chronic tinnitus.Cogn Behav Ther. 2013; 42: 84-99
- The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence.J Behav Med. 2007; 30: 77-94
- Measuring perceived harmfulness of physical activities in patients with chronic low back pain: The photograph series of daily activities-short electronic version.J Pain. 2007; 8: 840-849
- Overgeneralization of conditioned fear in the anxiety disorders.J Psychol. 2010; 218: 146-148
- The strong situation: A potential impediment to studying the psychobiology and pharmacology of anxiety disorders.Biol Psychol. 2006; 72: 265-270
- Overgeneralization of conditioned fear as a pathogenic marker of panic disorder.Am J Psychiatry. 2010; 167: 47-55
- Impaired discriminative fear-conditioning resulting from elevated fear responding to learned safety cues among individuals with panic disorder.Behav Res Ther. 2009; 47: 111-118
- Positive affect protects against deficient safety learning during extinction of fear of movement-related pain in healthy individuals scoring relatively high on trait anxiety.J Pain. 2014; 15: 632-644
- Generalization gradients in cued and contextual pain-related fear: An experimental study in healthy participants.Front Hum Neurosci. 2013; 7: 345
- The acquisition of fear of movement-related pain and associative learning: A novel pain-relevant human fear conditioning paradigm.Pain. 2011; 152: 2460-2469
- The acquisition and generalization of cued and contextual pain-related fear: An experimental study using a voluntary movement paradigm.Pain. 2013; 154: 272-282
- The psychological, neurochemical and functional neuroanatomical mediators of the effects of positive and negative mood on executive functions.Neuropsychologia. 2007; 45: 617
- Manipulating optimism: Can imagining a best possible self be used to increase positive future expectancies?.J Positive Psychol. 2010; 5: 204-211
- Assessing the effectiveness of a large database of emotion-eliciting films: A new tool for emotion researchers.Cogn Emot. 2010; 24: 1153-1172
- Affect 4.0: A free software package for implementing psychological and psychophysiological experiments.Exp Psychol. 2010; 57: 36
- Psychological resilience, pain catastrophizing, and positive emotions: Perspectives on comprehensive modeling of individual pain adaptation.Curr Pain Headache Rep. 2013; 17: 317
- Linear Mixed Models for Longitudinal Data.Springer, New York2000
- Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art.Pain. 2000; 85: 317-332
- Fear-avoidance model of chronic musculoskeletal pain: 12 years on.Pain. 2012; 153: 1144-1147
- Fibromyalgia: Evidence for deficits in positive affect regulation.Psychosom Med. 2005; 67: 147-155
- Positive affect as a source of resilience for women in chronic pain.J Consult Clin Psychol. 2005; 73: 212-220
Article info
Publication history
Published online: December 20, 2014
Accepted:
December 10,
2014
Received in revised form:
November 21,
2014
Received:
June 27,
2014
Footnotes
The authors thank Manou van der Walle for her assistance in the data collection and Jeroen Clarysse for his technical support.
A.M. is a postdoctoral researcher of the Research Foundation Flanders (FWO-Vlaanderen), Belgium (12E33714 N). The participation of N.G. was made possible by the Center for Excellence on Generalization research, KU Leuven, Belgium (GRIP*TT; KU Leuven grant PF/10/005). The study was also supported by the Odysseus Grant “The Psychology of Pain and Disability Research Program” funded by the Research Foundation Flanders (FWO-Vlaanderen), Belgium to J.W.S.V. (G090208N) and by an EFIC-Grünenthal Research Grant (E-G-G ID: 169518451) to A.M.
The authors report no conflict of interest.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
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© 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.
