I expect therefore I avoid? The effects of negative expectancy learning on pain and pain-related avoidance behavior

IF 4 2区 医学 Q1 CLINICAL NEUROLOGY
Putu Gita Nadinda , Antoinette I.M. van Laarhoven , Johan W.S. Vlaeyen , Madelon L. Peters , Andrea W.M. Evers
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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.
我期待所以我避免?负性期望学习对疼痛及疼痛相关回避行为的影响。
期望和回避行为是影响疼痛感知及其维持的关键因素,但很少有实证研究探讨它们之间的关系。因此,进行了两项具有双重主要目的的独立研究。第一部分的主要目的是调查是否负面预期导致痛觉过敏。第二部分的主要目的是调查消极预期是否会导致更昂贵的疼痛避免。这些研究分别包括116名和98名参与者。在这两项研究中,参与者被随机分配到实验组或对照组。通过语言和条件反射诱导疼痛预期,通过一项新的疼痛回避任务来测量回避,在这项任务中,参与者可以选择通过玩一个困难的游戏来避免更痛苦的刺激,或者通过玩一个简单的游戏来忍受更痛苦的刺激。在研究2中,根据研究1的结果对条件反射程序和新的疼痛回避任务进行了调整。两项研究都表明,消极期望导致痛觉过敏,表明消极期望范式产生了强有力的影响。然而,消极的预期并没有导致更多的疼痛逃避,这表明其他因素可能在避免更多的疼痛中起作用。需要进一步的研究来充分揭示预期和回避疼痛之间的相互作用。观点:这篇文章发现,在没有慢性疼痛的个体中,负面预期会导致痛觉过敏,但不一定会导致更多的疼痛回避行为。这篇文章的发现支持了大量的研究,表明预期为疼痛治疗提供了一个强有力的目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Pain
Journal of Pain 医学-临床神经学
CiteScore
6.30
自引率
7.50%
发文量
441
审稿时长
42 days
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.
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