Highlights
- •Observer self- and other-oriented goals affect emotion and motivation.
- •Approach versus avoidance motives differentially affect observer caregiving behavior.
- •Emotion regulation may facilitate optimal interpersonal pain dynamics.
Abstract
Emotional, motivational, and interpersonal dimensions are considered integral to pain
experience but have largely been examined separately. In this focus article, we argue
that an integrative theoretical account that acknowledges each of these elements is
a critical next step to capture the complexity and nuance of interpersonal pain dynamics
and to shape future research. The aim of this focus article is to provide a foundation
for such an account by drawing upon established insights from appraisal theory of
emotion, influential behavioral models, empathy/interpersonal pain research, and social
psychology literature to highlight conceptual relationships, potential mechanisms
of action, and avenues of inquiry that have not previously been examined in the context
of pain. Specifically, we highlight the interpersonal nature of pain and the conceptual
relationship between emotion and motivation in pain experience. We discuss an affective-motivational
tension between self- and other-oriented goals that can arise within the interpersonal
pain context, and how such dynamics may affect the nature and effectiveness of caregiving
behavior. We then describe the role of emotion regulation and strategies that may
facilitate optimal interpersonal pain dynamics and caregiving within a multiple goal
context. Finally, we outline a foundation for an integrative theoretical model and
directions for future research.
Perspective
Drawing upon insights from appraisal theory of emotion, empathy/interpersonal pain
research, influential behavioral models, and social psychology literature, this focus
article provides a foundation for an integrative affective-motivational account of
interpersonal pain dynamics as a basis for theoretical and clinical advancement.
Key words
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References
- The future of emotion regulation research: Capturing context.Perspect Psychol Sci. 2013; 8: 155-172
- Caregiver emotional availability, caregiver soothing behaviors, and infant pain during immunization.J Pediatr Psychol. 2015; 40: 1105-1114
- Their pain is not our pain: Brain and autonomic correlates of empathic resonance with the pain of same and different race individuals.Hum Brain Mapp. 2013; 34: 3168-3181
- Distress and empathy – 2 qualitatively distinct vicarious emotions with different motivational consequences.J Pers. 1978; 55: 19-33
- Regulatory flexibility: An individual differences perspective on coping and emotion regulation.Psychol Sci. 2013; 8: 591-612
- Suppression of anger and subsequent pain intensity and behavior among chronic low back pain patients: The role of symptom-specific physiological reactivity.J Behav Med. 2012; 35: 103-114
- Negative emotional responses elicited by the anticipation of pain in others: Psychophysiological evidence.J Pain. 2012; 13: 467-476
- Parents who catastrophize about their child’s pain prioritize attempts to control pain.Pain. 2012; 153: 1695-1701
- The role of relationship quality and perceived partner responses with pain and disability in those with back pain.Pain Med. 2012; 13: 204-214
- Catastrophizing delays the analgesic effect of distraction.Pain. 2010; 149: 202-207
- Marital functioning, chronic pain, and psychological distress.Pain. 2004; 107: 99-106
- Social interaction in pain: Reinforcing pain behaviors or building intimacy?.Pain. 2010; 149: 9-11
- Factor structure of the adult responses to children’s symptoms: Validation in children and adolescents with diverse chronic pain conditions.Clin J Pain. 2010; 26: 410-417
- Competing goals attenuate avoidance behaviour in the context of pain.J Pain. 2014; 15: 1120-1129
- Physiological arousal as a function of imagined, vicarious, and direct stress experiences.J Abnorm Psychol. 1968; 73: 513-520
- Fear-avoidance model of chronic pain: The next generation.Clin J Pain. 2012; 28: 475-483
- I suffer more from your pain when you act like me: Being imitated enhances affective responses to seeing someone else in pain.Cogn Affect Behav Neurosci. 2013; 13: 519-532
- The impact of being primed with social deception upon observer responses to other’s pain.Pain. 2013; 154: 221-226
- We discount the pain of others when pain has no medical explanation.Pain. 2012; 13: 1195-1205
- Putting the altruism back into altruism: The evolution of empathy.Annu Rev Psychol. 2008; 59: 279-300
- A social-neuroscience perspective on empathy.Curr Dir Psychol Sci. 2006; 15: 54-58
- The affective organization of parenting: Adaptive and maladaptive processes.Psychol Bull. 1991; 110: 3-25
- The affective structure of supportive parenting: Depressive symptoms, immediate emotions, and child-oriented motivation.Dev Psychol. 2004; 40: 1212-1227
- Pain demands attention: A cognitive-affective model of the interruptive function of pain.Psychol Bull. 1999; 125: 356-366
- Validating pain communication.Pain. 2015; 156: 215-219
- Approach-avoidance motivation and emotion: Convergence and divergence.Emot Rev. 2013; 5: 308-311
Fishbach A, Ferguson MJ: The goal construct in social psychology, in Kruglanski AW, Higgins ET (eds): Social Psychology: Handbook of Basic Principles. Guilford, NY, Guilford Press, 2007, pp 490-515
- Behavioural Methods in Chronic Pain and Illness.Mosby, St Louis1976
- The Laws of Emotion.Routhledge, New York2007
- Approach and avoidance behaviour in interpersonal relationships.Emot Rev. 2013; 5: 269-274
- Empathy predicts an experimental pain reduction during touch.J Pain. 2016; 17: 1049-1057
- Facing others in pain: The effects of empathy.Pain. 2005; 118: 285-288
- Distraction from chronic pain during a pain-inducing activity is associated with greater post-activity pain.Pain. 2004; 110: 220-227
- Pain demands attention from others: The approach/avoidance paradox.Pain. 2009; 143: 5-6
- Brain systems that mediate both emotion and cognition.Cogn Emot. 1990; 4: 269-288
- Emotion regulation: Conceptual foundations.in: Gross J.J. Handbook of Emotion Regulation. Guilford Press, New York2007: 3-20
- A biopsychosocial formulation of pain communication.Psychol Bull. 2011; 137: 910-939
- Self-regulation and chronic pain: The role of emotion.Cogn Ther Res. 2004; 28: 559-576
- Parenting goals as organizers of responses to parent-child disagreement.Dev Psychol. 1998; 34: 465-479
- I feel how you feel but not always: The empathic brain and its modulation.Curr Opin Neurobiol. 2008; 18: 153-158
- Approach and avoidance sexual motivation: Implications for personal and interpersonal well-being.Pers Rel. 2005; 12: 465-482
- Empathy examined through the neural mechanisms involved in imagining how I feel versus how you feel pain.Neuropsychologia. 2006; 44: 752-761
- The behavioral activation and inhibition systems: Implications for understanding and treating chronic pain.J Pain. 2016; 17: 529.e1-529.e18
- The development and preliminary validation of an instrument to assess patients’ attitudes toward pain.J Psychosom Res. 1987; 31: 393-400
- The effect of cognitive bias modification for interpretation (CBM-I) on avoidance of pain during an acute experimental pain task.Pain. 2014; 155: 1569-1576
- Pain catastrophizing, threat, and the informational value of mood: Task persistence during a painful finger pressing task.Pain. 2012; 153: 1410-1417
- The role of marital interaction in chronic pain and depressive symptom severity.J Psychosom Res. 1990; 34: 401-408
- Hypnosis and relaxation with pain patients: Evidence for effectiveness.Semin Pain Med. 2003; 1: 67-78
- Integrating dialectical behavior therapy and cognitive-behavioral couple therapy: A couples skills group for emotion dysregulation.Cogn Behav Pract. 2007; 14: 394-405
- Meta-analytic evidence for common and distinct neural networks associated with directly experienced pain and empathy for pain.Neuroimage. 2011; 54: 2492-2502
- Perspective taking is associated with specific facial responses during empathy for pain.Brain Res. 2008; 1227: 153-161
- Emotion, motivation, and anxiety. Brain mechanisms and psychophysiology.Biol Psychiatry. 1998; 44: 1248-1263
- Intimacy as an interpersonal process: The importance of self-disclosure, partner disclosure, and perceived partner responsiveness in interpersonal exchanges.J Pers Soc Psychol. 1998; 74: 1238-1251
- Emotion and Adaptation.Oxford University Press, New York1991
- The fear- avoidance model of musculoskeletal pain: Current state of scientific evidence.J Behav Med. 2007; 30: 77-94
- Pain affects spouses too: Personal experience with pain and catastrophizing as correlates of spouse distress.Pain. 2006; 126: 139-146
- Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress.J Pers Soc Psychol. 1979; 37: 688-714
- Perspective taking modulates event-related potentials to perceived pain.Neurosci Lett. 2010; 469: 328-332
- Empathy hurts: Compassion for another increases both sensory and affective components of pain perception.Pain. 2008; 136: 168-176
- Does empathy have a cost? Diverging psychological and physiological effects within families.Health Psychol. 2016; 35: 211-218
- Emotion regulation strategies and goals as predictors of older mothers’ and adult daughters’ helping-related subjective well-being.Psychol Aging. 2010; 25: 48-59
- When “don’t worry” communicates fear: Children’s perceptions of parental reassurance and distraction during a painful medical procedure.Pain. 2010; 150: 52-58
- Parental reassurance and pediatric procedural pain: A linguistic description.J Pain. 2007; 8: 95-101
- Psychometric evaluation and refinement of the pain response preference questionnaire.Pain Res Manage. 2014; 19: 42-48
- Pain terminology.in: Merskey H. Bogduk N. Classification of Chronic Pain. 2nd ed. IASP Press, Seattle1994: 209-214
- Learning resistance to pain and fear: Effects of overlearning, exposure, and rewarded exposure in context.J Exp Psychol. 1960; 60: 137-145
- Theories of emotion causation: A review.Cogn Emot. 2009; 23: 625-662
- Solicitousness and chronic pain: A critical review.Pain. 2002; 9: 7-27
- Chronic pain couples: Perceived marital interactions and pain behaviours.Pain. 2006; 123: 53-63
- Parents’ interpersonal distance and touch behaviour and child pain and distress during painful pediatric oncology procedures.J Nonverbal Behav. 2007; 31: 79-97
- On the mutual effects of pain and emotion: Facial pain expressions enhance pain perception and vice versa are perceived as more arousing when feeling pain.Pain. 2013; 154: 793-800
- The relationship between caregiver sensitivity and infant pain behaviors across the first year of life.Pain. 2011; 152: 2819-2826
- Assessing pain in infancy: The caregiver context.Pain Res Manage. 2009; 14: 27-32
- Chronic pain patient-spouse behavioral interactions predict patient disability.Pain. 1995; 63: 353-360
- Weighting pain avoidance and reward seeking: A neuroeconomical approach to pain.J Neurosci. 2010; 24: 4185-4186
- Nonpain goal pursuit inhibits attentional bias to pain.Pain. 2012; 153: 1180-1186
- Is there a potential role for attention bias modification in pain patients? Results of 2 randomised controlled trials.Pain. 2012; 153: 722-731
- Do parent protective responses mediate the relation between parent distress and child functional disability among children with chronic pain?.J Pediatr Psychol. 2011; 36: 1043-1051
- How humans integrate the prospects of pain and reward during choice.J Neurosci. 2009; 29: 14617-14626
- What do people want to feel and why? Pleasure and utility in emotion regulation.Curr Dir Psychol Sci. 2009; 18: 101-105
- Business or pleasure: Utilitarian versus hedonic considerations in emotion regulation.Emotion. 2007; 7: 546-554
- Cognitive dimensions of anger in chronic pain.Pain. 2012; 153: 515-517
- Keeping pain in mind: A motivational account of attention to pain.Neurosci Biobehav Rev. 2010; 34: 204-213
- Implicit associations between pain and self-schema in patients with chronic pain.Pain. 2013; 154: 2700-2706
- Relational consequences of personal goal pursuits.J Pers Soc Psychol. 2015; 106: 927-940
- The role of motivation in distracting attention away from pain: An experimental study.Pain. 2010; 149: 229-234
- Social modulation of facial pain display in high catastrophizing children: An observational study in schoolchildren and their parents.Pain. 2011; 152: 1591-1599
- Mothers’ and fathers’ responses to their child’s pain moderate the relationship between the child’s pain catastrophizing and disability.Pain. 2011; 152: 786-793
- The interpersonal function of pain: Conserving multiple resources.Pain. 2016; 157: 773-774
- The emotion regulatory function of parent attention to child pain and associated implications for parental pain control behaviour.Pain. 2014; 155: 1453-1463
- Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art.Pain. 2000; 85: 317-332
- Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation.Psychol Bull. 2012; 138: 775-808
- Mediators of change in acceptance and commitment therapy for pediatric chronic pain.Pain. 2011; 152: 2792-2801
- Facial expression of pain: An evolutionary account.Behav Brain Sci. 2002; 25: 439-488
- Unconscious affective processing and empathy: An investigation of subliminal priming on the detection of painful facial expressions.Pain. 2009; 143: 71-75
Article info
Publication history
Published online: April 07, 2017
Footnotes
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 by the American Pain Society