Turning pain into cues for goal-directed behavior: Implementation intentions reduce escape-avoidance behavior on a painful task

Pain automatically elicits escape-avoidance behavior to avert bodily harm. In patients with chronic pain long-term escape-avoidance behavior may increase the risk of chronic disability. The aim of the presents study was to examine whether implementation intentions, reduce escape-avoidance behavior during painful tasks in healthy individuals. Implementation intentions are "if-then" self-statements associating situational cues with goal-directed behaviors. Seventy healthy participants performed a painful finger pressing task, preceded by either implementation intention instructions with pain or a non-pain cue as a cue for goal directed behavior, or control instructions. Escape-avoidance behavior was operationalized as both task duration and response rate. Inhibitory control was measured using the Stop Signal Task. The pain implementation intentions resulted in the highest task duration (p = .02), and thus less escape-avoidance behavior. Low inhibitory control was associated with shorter task duration (p = .03), and thus more escape-avoidance behavior. The non-pain implementation intentions resulted in the highest response rate, but only when inhibitory control was low (p = .04). Implementation intentions referring to pain or non-pain reduce escape-avoidance behavior on a painful task. It is worthwhile to examine whether individuals in pain and with low inhibitory control benefit from interventions that incorporate implementation intentions. PERSPECTIVE: This study is the first to show that forming implementation intentions reduce escape-avoidance behavior during pain and foster non-pain goal pursuit. The use of implementation intentions is indicated to be an intervention that could be of use in dealing with pain, particularly when inhibitory control is low.