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Biased Intensity Judgements of Visceral Sensations After Learning to Fear Visceral Stimuli: A Drift Diffusion Approach

  • Jonas Zaman
    Correspondence
    Address reprint requests to Jonas Zaman, MSc, PhD, Health Psychology, KU Leuven, Tiensestraat 102, 3080 Leuven, Belgium.
    Affiliations
    Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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  • Victoria J. Madden
    Affiliations
    Sansom Institute for Health Research, The University of South Australia, Adelaide, Australia and Department of Psychiatry and Mental Health and Department of Anaesthesia and Perioperative Medicine, University of Cape Town, South Africa
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  • Julie Iven
    Affiliations
    Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
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  • Katja Wiech
    Affiliations
    Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom

    Nuffield Department of Clinical Neurosciences, Nuffield Division Anaesthetics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
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  • Nathalie Weltens
    Affiliations
    Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
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  • Huynh Giao Ly
    Affiliations
    Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
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  • Johan W.S. Vlaeyen
    Affiliations
    Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium

    Department Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
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  • Lukas Van Oudenhove
    Affiliations
    Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium

    Consultation-Liaison Psychiatry, University Psychiatric Centre, KU Leuven, Leuven, Belgium
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  • Ilse Van Diest
    Affiliations
    Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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      Highlights

      • Fear learning to a nonpainful visceral sensation was established.
      • Decision-making underlying intensity judgments of visceral sensations was modelled.
      • Fear learning induced a bias in the perceptual decision-making process.
      • Decision-making was biased towards perceiving visceral sensations as more intense.

      Abstract

      A growing body of research has identified fear of visceral sensations as a potential mechanism in the development and maintenance of visceral pain disorders. However, the extent to which such learned fear affects visceroception remains unclear. To address this question, we used a differential fear conditioning paradigm with nonpainful esophageal balloon distensions of 2 different intensities as conditioning stimuli (CSs). The experiment comprised of preacquisition, acquisition, and postacquisition phases during which participants categorized the CSs with respect to their intensity. The CS+ was always followed by a painful electrical stimulus (unconditioned stimulus) during the acquisition phase and in 60% of the trials during postacquisition. The second stimulus (CS−) was never associated with pain. Analyses of galvanic skin and startle eyeblink responses as physiological markers of successful conditioning showed increased fear responses to the CS+ compared with the CS−, but only in the group with the low-intensity stimulus as CS+. Computational modeling of response times and response accuracies revealed that differential fear learning affected perceptual decision-making about the intensities of visceral sensations such that sensations were more likely to be categorized as more intense. These results suggest that associative learning might indeed contribute to visceral hypersensitivity in functional gastrointestinal disorders.

      Perspective

      This study shows that associative fear learning biases intensity judgements of visceral sensations toward perceiving such sensations as more intense. Learning-induced alterations in visceroception might therefore contribute to the development or maintenance of visceral pain.

      Key words

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