Putu Gita Nadinda , Antoinette I.M. van Laarhoven , Johan W.S. Vlaeyen , Madelon L. Peters , Andrea W.M. Evers
{"title":"I expect therefore I avoid? The effects of negative expectancy learning on pain and pain-related avoidance behavior","authors":"Putu Gita Nadinda , Antoinette I.M. van Laarhoven , Johan W.S. Vlaeyen , Madelon L. Peters , Andrea W.M. Evers","doi":"10.1016/j.jpain.2025.105506","DOIUrl":null,"url":null,"abstract":"<div><div>Expectancies and avoidance behavior are key factors influencing pain perception and its maintenance, but few empirical studies have investigated their relationship. Thus, two separate studies with a two-fold primary aim were conducted. The first part of the primary aim was to investigate whether negative expectancies lead to hyperalgesia. The second part of the primary aim was to investigate whether negative expectancies lead to more costly pain avoidance. The studies included a total of 116 and 98 participants respectively. In both studies, participants were randomly assigned to either the experimental or the control group. Pain expectancies were induced verbally and via conditioning, and avoidance was measured through a novel pain avoidance task in which participants could choose between avoiding a more painful stimulus by playing a difficult game or enduring a more painful stimulus by playing an easy game. In Study 2, adjustments were made to the conditioning procedure and the novel pain avoidance task based on the results of Study 1. Both studies demonstrated that negative expectancies led to hyperalgesia, indicating that the negative expectancy paradigm produces robust effects. However, negative expectancies did not lead to more pain avoidance suggesting that other factors may be at play in avoiding more pain. Further studies are needed to fully unravel the interplay between expectancies and avoidance in pain.</div></div><div><h3>Perspective</h3><div>This article found that negative expectancies can lead to hyperalgesia but not necessarily to more pain avoidance behavior in individuals without chronic pain. Findings from this article support the ample studies indicating that expectancies provide a strong target for pain treatment.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105506"},"PeriodicalIF":4.0000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1526590025007333","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Expectancies and avoidance behavior are key factors influencing pain perception and its maintenance, but few empirical studies have investigated their relationship. Thus, two separate studies with a two-fold primary aim were conducted. The first part of the primary aim was to investigate whether negative expectancies lead to hyperalgesia. The second part of the primary aim was to investigate whether negative expectancies lead to more costly pain avoidance. The studies included a total of 116 and 98 participants respectively. In both studies, participants were randomly assigned to either the experimental or the control group. Pain expectancies were induced verbally and via conditioning, and avoidance was measured through a novel pain avoidance task in which participants could choose between avoiding a more painful stimulus by playing a difficult game or enduring a more painful stimulus by playing an easy game. In Study 2, adjustments were made to the conditioning procedure and the novel pain avoidance task based on the results of Study 1. Both studies demonstrated that negative expectancies led to hyperalgesia, indicating that the negative expectancy paradigm produces robust effects. However, negative expectancies did not lead to more pain avoidance suggesting that other factors may be at play in avoiding more pain. Further studies are needed to fully unravel the interplay between expectancies and avoidance in pain.
Perspective
This article found that negative expectancies can lead to hyperalgesia but not necessarily to more pain avoidance behavior in individuals without chronic pain. Findings from this article support the ample studies indicating that expectancies provide a strong target for pain treatment.
期刊介绍:
The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.