Advertisement

Can Experimentally Induced Positive Affect Attenuate Generalization of Fear of Movement-Related Pain?

  • Nicole Geschwind
    Affiliations
    Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
    Search for articles by this author
  • Michel Meulders
    Affiliations
    Department of Informatics, Simulation and Modeling, KU Leuven, Belgium

    Research Group on Quantitative Psychology and Individual Differences, KU Leuven, Belgium
    Search for articles by this author
  • Madelon L. Peters
    Affiliations
    Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
    Search for articles by this author
  • Johan W.S. Vlaeyen
    Affiliations
    Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands

    Research Group on Health Psychology, KU Leuven, Belgium

    Center for Excellence on Generalization Research in Health and Psychopathology, KU Leuven, Belgium
    Search for articles by this author
  • Ann Meulders
    Correspondence
    Address reprint requests to Ann Meulders, PhD, Department of Psychology, University of Leuven, Tiensestraat 102, Box 3726, 3000 Leuven, Belgium.
    Affiliations
    Research Group on Health Psychology, KU Leuven, Belgium

    Center for Excellence on Generalization Research in Health and Psychopathology, KU Leuven, Belgium
    Search for articles by this author
Published:December 20, 2014DOI:https://doi.org/10.1016/j.jpain.2014.12.003

      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Asmundson G.J.
        • Norton P.J.
        • Veloso F.
        Anxiety sensitivity and fear of pain in patients with recurring headaches.
        Behav Res Ther. 1999; 37: 703-713
        • Boselie J.J.
        • Vancleef L.M.
        • Smeets T.
        • Peters M.L.
        Increasing optimism abolishes pain-induced impairments in executive task performance.
        Pain. 2014; 155: 334-340
        • Flor H.
        • Denke C.
        • Schaefer M.
        • Grusser S.
        Effect of sensory discrimination training on cortical reorganisation and phantom limb pain.
        Lancet. 2001; 357: 1763-1764
        • Fredrickson B.L.
        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
        • Fredrickson B.L.
        • Mancuso R.A.
        • Branigan C.
        • Tugade M.M.
        The undoing effect of positive emotions.
        Motiv Emot. 2000; 24: 237-258
        • Hanssen M.M.
        • Peters M.L.
        • Vlaeyen J.W.S.
        • Meevissen Y.M.C.
        • Vancleef L.M.G.
        Optimism lowers pain: Evidence of the causal status and underlying mechanisms.
        Pain. 2013; 154: 53-58
        • SAS Institute Inc
        SAS/STAT® 9.3 User's Guide.
        SAS Institute Inc, Cary, NC2011
        • Izard C.E.
        • Dougherty F.E.
        • Bloxom B.M.
        • Kotsch N.E.
        The Differential Emotions Scale: A Method of Measuring the Subjective Meaning of Experience of Discrete Emotions.
        Vanderbilt University, Department of Psychology, Nashville, TN1974
        • Jovanovic T.
        • Kazama A.
        • Bachevalier J.
        • Davis M.
        Impaired safety signal learning may be a biomarker of PTSD.
        Neuropharmacology. 2012; 62: 695-704
        • Kleinstäuber M.
        • Jasper K.
        • Schweda I.
        • Hiller W.
        • Andersson G.
        • Weise C.
        The role of fear-avoidance cognitions and behaviors in patients with chronic tinnitus.
        Cogn Behav Ther. 2013; 42: 84-99
        • Leeuw M.
        • Goossens M.E.
        • Linton S.J.
        • Crombez G.
        • Boersma K.
        • Vlaeyen J.W.
        The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence.
        J Behav Med. 2007; 30: 77-94
        • Leeuw M.
        • Goossens M.E.
        • van Breukelen G.J.
        • Boersma K.
        • Vlaeyen J.W.
        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
        • Lissek S.
        • Grillon C.
        Overgeneralization of conditioned fear in the anxiety disorders.
        J Psychol. 2010; 218: 146-148
        • Lissek S.
        • Pine D.S.
        • Grillon C.
        The strong situation: A potential impediment to studying the psychobiology and pharmacology of anxiety disorders.
        Biol Psychol. 2006; 72: 265-270
        • Lissek S.
        • Rabin S.
        • Heller R.E.
        • Lukenbaugh D.
        • Geraci M.
        • Pine D.S.
        • Grillon C.
        Overgeneralization of conditioned fear as a pathogenic marker of panic disorder.
        Am J Psychiatry. 2010; 167: 47-55
        • Lissek S.
        • Rabin S.J.
        • McDowell D.J.
        • Dvir S.
        • Bradford D.E.
        • Geraci M.
        • Pine D.S.
        • Grillon C.
        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
        • Meulders A.
        • Meulders M.
        • Vlaeyen J.W.S.
        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
        • Meulders A.
        • Vandebroek N.
        • Vervliet B.
        • Vlaeyen J.W.S.
        Generalization gradients in cued and contextual pain-related fear: An experimental study in healthy participants.
        Front Hum Neurosci. 2013; 7: 345
        • Meulders A.
        • Vansteenwegen D.
        • Vlaeyen J.W.S.
        The acquisition of fear of movement-related pain and associative learning: A novel pain-relevant human fear conditioning paradigm.
        Pain. 2011; 152: 2460-2469
        • Meulders A.
        • Vlaeyen J.W.S.
        The acquisition and generalization of cued and contextual pain-related fear: An experimental study using a voluntary movement paradigm.
        Pain. 2013; 154: 272-282
        • Mitchell R.L.C.
        • Phillips L.H.
        The psychological, neurochemical and functional neuroanatomical mediators of the effects of positive and negative mood on executive functions.
        Neuropsychologia. 2007; 45: 617
        • Peters M.L.
        • Flink I.K.
        • Boersma K.
        • Linton S.J.
        Manipulating optimism: Can imagining a best possible self be used to increase positive future expectancies?.
        J Positive Psychol. 2010; 5: 204-211
        • Schaefer A.
        • Nils F.
        • Sanchez X.
        • Philippot P.
        Assessing the effectiveness of a large database of emotion-eliciting films: A new tool for emotion researchers.
        Cogn Emot. 2010; 24: 1153-1172
        • Spruyt A.
        • Clarysse J.
        • Vansteenwegen D.
        • Baeyens F.
        • Hermans D.
        Affect 4.0: A free software package for implementing psychological and psychophysiological experiments.
        Exp Psychol. 2010; 57: 36
        • Sturgeon J.A.
        • Zautra A.J.
        Psychological resilience, pain catastrophizing, and positive emotions: Perspectives on comprehensive modeling of individual pain adaptation.
        Curr Pain Headache Rep. 2013; 17: 317
        • Verbeke G.
        • Molenberghs G.
        Linear Mixed Models for Longitudinal Data.
        Springer, New York2000
        • Vlaeyen J.W.
        • Linton S.J.
        Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art.
        Pain. 2000; 85: 317-332
        • Vlaeyen J.W.
        • Linton S.J.
        Fear-avoidance model of chronic musculoskeletal pain: 12 years on.
        Pain. 2012; 153: 1144-1147
        • Zautra A.J.
        • Fasman R.
        • Reich J.W.
        • Harakas P.
        • Johnson L.M.
        • Olmsted M.E.
        • Davis M.C.
        Fibromyalgia: Evidence for deficits in positive affect regulation.
        Psychosom Med. 2005; 67: 147-155
        • Zautra A.J.
        • Johnson L.M.
        • Davis M.C.
        Positive affect as a source of resilience for women in chronic pain.
        J Consult Clin Psychol. 2005; 73: 212-220