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Pain-avoidance versus reward-seeking: an experimental investigation

(2015) PAIN. 156(8). p.1449-1457
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Abstract
According to fear-avoidance models, a catastrophic interpretation of a painful experience may give rise to pain-related fear and avoidance, leading to the development and maintenance of chronic pain problems in the long term. However, little is known about how exactly motivation and goal prioritization play a role in the development of pain-related fear. This study investigates these processes in healthy volunteers using an experimental context with multiple, competing goals. In a differential human fear-conditioning paradigm, 57 participants performed joystick movements. In the control condition, one movement (conditioned stimulus; CS+) was followed by a painful electrocutaneous unconditioned stimulus (pain-US) in 50% of the trials, whereas another movement (nonreinforced conditioned stimulus; CS-) was not. In the experimental condition, a reward in the form of lottery tickets (reward-US) accompanied the presentation of the pain-US. Participants were classified into 3 groups, as a function of the goal, they reported to be the most important: (1) pain-avoidance, (2) reward-seeking, and (3) both goals being equally important. Results indicated that neither the reward co-occurring with pain nor the prioritized goal modulated pain-related fear. However, during subsequent choice trials, participants selected the painful movement more often when the reward was presented compared with the context in which the reward was absent. The latter effect was dependent on goal prioritization, with more frequent selections in the reward-seeking group, and the least selections in the pain-avoidance group. Taken together, these results underscore the importance of competing goals and goal prioritization in the attenuation of avoidance behavior.
Keywords
CHRONIC MUSCULOSKELETAL PAIN, MOVEMENT-RELATED PAIN, FEAR-AVOIDANCE, GOAL-PURSUIT, EFFECT SIZE, BACK-PAIN, MODEL, ACQUISITION, PARADIGM, BEHAVIOR, Pain-related fear, Avoidance, Motivation, Goal competition, Goal importance, Reward, Pain

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Citation

Please use this url to cite or link to this publication:

MLA
Claes, Nathalie, Geert Crombez, and Johan Vlaeyen. “Pain-avoidance Versus Reward-seeking: An Experimental Investigation.” PAIN 156.8 (2015): 1449–1457. Print.
APA
Claes, Nathalie, Crombez, G., & Vlaeyen, J. (2015). Pain-avoidance versus reward-seeking: an experimental investigation. PAIN, 156(8), 1449–1457.
Chicago author-date
Claes, Nathalie, Geert Crombez, and Johan Vlaeyen. 2015. “Pain-avoidance Versus Reward-seeking: An Experimental Investigation.” Pain 156 (8): 1449–1457.
Chicago author-date (all authors)
Claes, Nathalie, Geert Crombez, and Johan Vlaeyen. 2015. “Pain-avoidance Versus Reward-seeking: An Experimental Investigation.” Pain 156 (8): 1449–1457.
Vancouver
1.
Claes N, Crombez G, Vlaeyen J. Pain-avoidance versus reward-seeking: an experimental investigation. PAIN. 2015;156(8):1449–57.
IEEE
[1]
N. Claes, G. Crombez, and J. Vlaeyen, “Pain-avoidance versus reward-seeking: an experimental investigation,” PAIN, vol. 156, no. 8, pp. 1449–1457, 2015.
@article{5840959,
  abstract     = {According to fear-avoidance models, a catastrophic interpretation of a painful experience may give rise to pain-related fear and avoidance, leading to the development and maintenance of chronic pain problems in the long term. However, little is known about how exactly motivation and goal prioritization play a role in the development of pain-related fear. This study investigates these processes in healthy volunteers using an experimental context with multiple, competing goals. In a differential human fear-conditioning paradigm, 57 participants performed joystick movements. In the control condition, one movement (conditioned stimulus; CS+) was followed by a painful electrocutaneous unconditioned stimulus (pain-US) in 50% of the trials, whereas another movement (nonreinforced conditioned stimulus; CS-) was not. In the experimental condition, a reward in the form of lottery tickets (reward-US) accompanied the presentation of the pain-US. Participants were classified into 3 groups, as a function of the goal, they reported to be the most important: (1) pain-avoidance, (2) reward-seeking, and (3) both goals being equally important. Results indicated that neither the reward co-occurring with pain nor the prioritized goal modulated pain-related fear. However, during subsequent choice trials, participants selected the painful movement more often when the reward was presented compared with the context in which the reward was absent. The latter effect was dependent on goal prioritization, with more frequent selections in the reward-seeking group, and the least selections in the pain-avoidance group. Taken together, these results underscore the importance of competing goals and goal prioritization in the attenuation of avoidance behavior.},
  author       = {Claes, Nathalie and Crombez, Geert and Vlaeyen, Johan},
  issn         = {0304-3959},
  journal      = {PAIN},
  keywords     = {CHRONIC MUSCULOSKELETAL PAIN,MOVEMENT-RELATED PAIN,FEAR-AVOIDANCE,GOAL-PURSUIT,EFFECT SIZE,BACK-PAIN,MODEL,ACQUISITION,PARADIGM,BEHAVIOR,Pain-related fear,Avoidance,Motivation,Goal competition,Goal importance,Reward,Pain},
  language     = {eng},
  number       = {8},
  pages        = {1449--1457},
  title        = {Pain-avoidance versus reward-seeking: an experimental investigation},
  url          = {http://dx.doi.org/10.1097/j.pain.0000000000000116},
  volume       = {156},
  year         = {2015},
}

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