Behavioral Conceptualization and Treatment of Chronic Pain

J.W.S. Vlaeyen*, G. Crombez, T. Widiger, T.D. Cannon

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

40 Citations (Web of Science)
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Abstract

Pain is considered a hardwired signal of bodily disturbance belonging to a basic motivational system that urges the individual to act and to restore the body's integrity, rather than just a sensory and emotional experience. Given its eminent survival value, pain is a strong motivator for learning. Response to repeated pain increases when harm risks are high (sensitization) and decreases in the absence of such risks (habituation). Discovering relations between pain and other events provides the possibility to predict (Pavlovian conditioning) and control (operant conditioning) harmful events. Avoidance is adaptive in the short term but paradoxically may have detrimental long-term effects. Pain and pain-related responses compete with other demands in the environment. Exposure-based treatments share the aim of facilitating or restoring the pursuit of individual valued life goals in the face of persistent pain, and further improvements in pain treatment may require a paradigm shift toward more personalized approaches.
Original languageEnglish
Pages (from-to)187-212
Number of pages26
JournalAnnual Review of Clinical Psychology
Volume16
DOIs
Publication statusPublished - 1 Jan 2020

Keywords

  • behavior
  • central sensitization
  • chronic pain
  • conditioning
  • exposure in-vivo
  • fear avoidance
  • fear-avoidance model
  • goal conflict
  • graded exposure
  • learning
  • learning-theory
  • low-back-pain
  • motivation
  • movement-related pain
  • muscular responses
  • randomized controlled-trial
  • CENTRAL SENSITIZATION
  • MUSCULAR RESPONSES
  • MOVEMENT-RELATED PAIN
  • RANDOMIZED CONTROLLED-TRIAL
  • GOAL CONFLICT
  • LEARNING-THEORY
  • LOW-BACK-PAIN
  • FEAR-AVOIDANCE MODEL
  • GRADED EXPOSURE
  • EXPOSURE IN-VIVO

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