The effect of threat information on acquisition, extinction, and reinstatement of experimentally conditioned fear of movement-related pain

Pain Med. 2015 Dec;16(12):2302-15. doi: 10.1111/pme.12836. Epub 2015 Sep 11.

Abstract

Objective: The experiential acquisition of pain-related fear has been demonstrated by pairing a painful electrocutaneous stimulus pain-US; unconditioned pain stimulus) with one movement (CS+; conditioned stimulus) but not with another (CS-). However, it is expected that during acquisition through direct experience, pain-related fear can be intensified or weakened by verbally/visually transmitted information about the pain and its meaning.

Method: Participants received threatening information (US-inflation), safety information (US-deflation), or no information about the pain-US (US-same). Additionally, we measured return of fear after a reinstatement procedure: two unsignaled pain-USs were presented in the experimental groups, but not in the control groups.

Results: We replicated the acquisition and extinction of experimentally induced fear of movement-related pain in healthy subjects both in the verbal reports and the eye-blink startle measures. Two reinstating pain-US presentations led to a differential return of self-reported fear and a nondifferential return of fear in the eye-blink startle responses. Although, we failed to find an effect of verbal/visual information regarding the meaning of the pain-US on the acquisition, extinction, or reinstatement of pain-related fear, we did observe a pain sensitization effect over time suggesting that our threat manipulation induced an increase of perceived threat in all groups.

Conclusion: The results suggest that our threat manipulation might not have worked or that it was not sensitive enough to yield group-specific effects. We replicated acquisition, extinction, and return of experimentally conditioned fear of movement-related pain, but the threat manipulation failed to generate any additional effects.

Keywords: Anxiety; Avoidance Behavior; Behavior; Catastrophizing; Fear; Musculoskeletal; Psychology; Psychosocial factors.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Avoidance Learning*
  • Chronic Pain / diagnosis
  • Chronic Pain / psychology*
  • Chronic Pain / therapy*
  • Conditioning, Classical*
  • Cues
  • Extinction, Psychological*
  • Fear / psychology*
  • Female
  • Humans
  • Implosive Therapy / methods
  • Male
  • Movement
  • Transcutaneous Electric Nerve Stimulation / methods
  • Treatment Outcome
  • Young Adult