Abstract
Fresh empirical evidence supports the notion that fear of movement-related pain can be acquired through associative learning. In the context of these findings, 2 ideas are appealing, yet uninvestigated. The first is that merely the intention to perform a painful movement acts as a covert conditioned stimulus (CS) inducing defensive fear responses (ie, gaining excitatory properties following Pavlovian acquisition). The second idea is that after extinction, fear of movement-related pain can easily be reinstated after unexpected painful stimuli (ie, reinstatement). In a voluntary differential conditioning movement paradigm with movements as CSs and a painful electrocutaneous stimulus as the unconditioned stimulus (pain-US), 2 groups were included (Experimental/Control). One movement (CS+) was followed by the pain-US and another movement (CS) was not during acquisition, while the CS+ was no longer reinforced during extinction. Next, the Experimental group received 2 reinstating pain-USs, whereas the Control group did not. The CS+ but not the CS evoked fear of movement-related pain in self-reports and eye-blink startles. Intriguingly, the mere intention to perform the painful movement produced higher eye-blink startle responses than the intention to perform the nonpainful movement. We also demonstrated nondifferential reinstatement in the verbal fear ratings in the Experimental group only. Perspective: This study demonstrates that the mere intention to perform a painful movement prior to the actual painful movement itself can come to elicit conditioned fear responses. These results suggest that actual movement may not be necessary to elicit pain-related fear responses, maintaining chronic pain-related fear, avoidance, and disability. (C) 2013 by the American Pain Society
Original language | English |
---|---|
Pages (from-to) | 412-423 |
Number of pages | 12 |
Journal | The Journal of Pain |
Volume | 14 |
Issue number | 4 |
DOIs | |
Publication status | Published - Apr 2013 |
Keywords
- Fear conditioning
- fear of movement-related pain
- motor intention
- reinstatement
- voluntary movement paradigm
- CHRONIC MUSCULOSKELETAL PAIN
- CONDITIONED FEAR
- BACK-PAIN
- AVOIDANCE MODEL
- REINSTATEMENT
- EXTINCTION
- PARADIGM
- STIMULUS
- CONTEXT
- INTERFERENCE