Reduced selective learning in patients with fibromyalgia vs healthy controls

Ann Meulders, Yannick Boddez, Fernando Blanco, Maaike Van Den Houte, Johan W S Vlaeyen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Impaired selective fear learning has been advanced as a core mechanism involved in excessive spreading of protective responses such as pain-related fear and avoidance leading to disability in chronic pain conditions. Using the litmus test for selective learning effects, the blocking procedure, we tested the hypothesis that patients with fibromyalgia (FM) show less selective threat learning than healthy controls (HCs). We introduce a novel selective learning task based around a clinical diary scenario. On a trial-by-trial basis, participants rated whether they expected certain situations (A, B, Z, and X) in the diary of a fictive FM patient would trigger pain in that patient. The procedure did not involve any experimental pain induction because the verbal outcomes "pain" or "no pain" were used. During the elemental acquisition phase, one situation was followed by "pain" (A+, eg, "Kim slept badly, and reports pain"), whereas another situation was followed by "no pain" (Z-, eg, "Kim was stressed, and reports no pain"). During the compound acquisition phase, another situation (X), referred to as the blocked stimulus, was presented in compound with a previously pain-eliciting situation and also paired with "pain" (AX+, eg, Kim slept badly" and "Kim has vacuumed," and reports pain). Simultaneously, a novel situation was introduced and also followed by "pain" (B+). Within-group comparisons showed blocking (ie, significant difference between B and X) in the HCs, but not in the patients with FM. This study is the first in directly assessing differences in selective learning between patients with FM and HCs using a blocking procedure.

Original languageEnglish
Pages (from-to)1268-1276
Number of pages9
JournalPain
Volume159
Issue number7
DOIs
Publication statusPublished - Jul 2018

Keywords

  • Blocking
  • Stimulus competition
  • Causal learning
  • Fibromyalgia
  • Pain expectancy
  • Chronic pain
  • HOSPITAL ANXIETY
  • CONDITIONED FEAR
  • PAIN
  • DEPRESSION
  • QUESTIONNAIRE
  • DEFICITS
  • ACQUISITION
  • VALIDATION
  • CRITERIA
  • SCALE
  • Fibromyalgia/psychology
  • Humans
  • Middle Aged
  • Male
  • Adult
  • Female
  • Learning/physiology
  • Neuropsychological Tests
  • Fear/psychology
  • Disabled Persons

Cite this

Meulders, Ann ; Boddez, Yannick ; Blanco, Fernando ; Van Den Houte, Maaike ; Vlaeyen, Johan W S. / Reduced selective learning in patients with fibromyalgia vs healthy controls. In: Pain. 2018 ; Vol. 159, No. 7. pp. 1268-1276.
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Reduced selective learning in patients with fibromyalgia vs healthy controls. / Meulders, Ann; Boddez, Yannick; Blanco, Fernando; Van Den Houte, Maaike; Vlaeyen, Johan W S.

In: Pain, Vol. 159, No. 7, 07.2018, p. 1268-1276.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Reduced selective learning in patients with fibromyalgia vs healthy controls

AU - Meulders, Ann

AU - Boddez, Yannick

AU - Blanco, Fernando

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AU - Vlaeyen, Johan W S

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AB - Impaired selective fear learning has been advanced as a core mechanism involved in excessive spreading of protective responses such as pain-related fear and avoidance leading to disability in chronic pain conditions. Using the litmus test for selective learning effects, the blocking procedure, we tested the hypothesis that patients with fibromyalgia (FM) show less selective threat learning than healthy controls (HCs). We introduce a novel selective learning task based around a clinical diary scenario. On a trial-by-trial basis, participants rated whether they expected certain situations (A, B, Z, and X) in the diary of a fictive FM patient would trigger pain in that patient. The procedure did not involve any experimental pain induction because the verbal outcomes "pain" or "no pain" were used. During the elemental acquisition phase, one situation was followed by "pain" (A+, eg, "Kim slept badly, and reports pain"), whereas another situation was followed by "no pain" (Z-, eg, "Kim was stressed, and reports no pain"). During the compound acquisition phase, another situation (X), referred to as the blocked stimulus, was presented in compound with a previously pain-eliciting situation and also paired with "pain" (AX+, eg, Kim slept badly" and "Kim has vacuumed," and reports pain). Simultaneously, a novel situation was introduced and also followed by "pain" (B+). Within-group comparisons showed blocking (ie, significant difference between B and X) in the HCs, but not in the patients with FM. This study is the first in directly assessing differences in selective learning between patients with FM and HCs using a blocking procedure.

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KW - Pain expectancy

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KW - CONDITIONED FEAR

KW - PAIN

KW - DEPRESSION

KW - QUESTIONNAIRE

KW - DEFICITS

KW - ACQUISITION

KW - VALIDATION

KW - CRITERIA

KW - SCALE

KW - Fibromyalgia/psychology

KW - Humans

KW - Middle Aged

KW - Male

KW - Adult

KW - Female

KW - Learning/physiology

KW - Neuropsychological Tests

KW - Fear/psychology

KW - Disabled Persons

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DO - 10.1097/j.pain.0000000000001207

M3 - Article

C2 - 29533384

VL - 159

SP - 1268

EP - 1276

JO - Pain

JF - Pain

SN - 0304-3959

IS - 7

ER -