Kai Karos

Competing goals attenuate avoidance behavior in the context of pain

UNLABELLED Current fear-avoidance models consider pain-related fear as a crucial factor in the development of chronic pain. However, pain-related fear often occurs in a context of multiple, competing goals. This study investigated whether pain-related fear and avoidance behavior are attenuated when individuals are faced with a pain avoidance goal and another valued but competing goal, operationalized as obtaining a monetary reward. Fifty-five healthy participants moved a joystick toward different targets. In the experimental condition, a movement to one target (conditioned stimulus [CS+]) was followed by a painful unconditioned stimulus (pain-US) and a rewarding unconditioned stimulus (reward-US) on 50% of the trials, whereas the other movement (nonreinforced conditioned stimulus [CS-]) movement was not. In the control condition, the CS+ movement was followed by the pain-US only. Results showed that pain-related fear was elevated in response to the CS+ compared to the CS- movement, but that it was not influenced by the reward-US. Interestingly, participants initiated a CS+ movement slower than a CS- movement in the control condition but not in the experimental condition. Also, in choice trials, participants performed the CS+ movement more frequently in the experimental than in the control condition. These results suggest that the presence of a valued competing goal can attenuate avoidance behavior. PERSPECTIVE The current study provides experimental evidence that both pain and competing goals impact on behavioral decision making and avoidance behavior. These results provide experimental support for treatments of chronic pain that include an individuals pursuit of valuable daily life goals, rather than limiting focus to pain reduction only.

Expand Your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality

This study tested Expand Your Horizon, a programme designed to improve body image by training women to focus on the functionality of their body using structured writing assignments. Eighty-one women (Mage=22.77) with a negative body image were randomised to the Expand Your Horizon programme or to an active control programme. Appearance satisfaction, functionality satisfaction, body appreciation, and self-objectification were measured at pretest, posttest, and one-week follow-up. Following the intervention, participants in the Expand Your Horizon programme experienced greater appearance satisfaction, functionality satisfaction, and body appreciation, and lower levels of self-objectification, compared to participants in the control programme. Partial eta-squared effect sizes were of small to medium magnitude. This study is the first to show that focusing on body functionality can improve body image and reduce self-objectification in women with a negative body image. These findings provide support for addressing body functionality in programmes designed to improve body image.

Threatening Social Context Facilitates Pain-Related Fear Learning

UNLABELLED This study investigated the effects of a threatening and a safe social context on learning pain-related fear, a key factor in the development and maintenance of chronic pain. We measured self-reported pain intensity, pain expectancy, pain-related fear (verbal ratings and eyeblink startle responses), and behavioral measures of avoidance (movement-onset latency and duration) using an established differential voluntary movement fear conditioning paradigm. Participants (N = 42) performed different movements with a joystick: during fear acquisition, movement in one direction (CS+) was followed by a painful stimulus (pain-US) whereas movement in another direction (CS-) was not. For participants in the threat group, an angry face was continuously presented in the background during the task, whereas in the safe group, a happy face was presented. During the extinction phase the pain-US was omitted. As compared to the safe social context, a threatening social context led to increased contextual fear and facilitated differentiation between CS+ and CS- movements regarding self-reported pain expectancy, fear of pain, eyeblink startle responses, and movement-onset latency. In contrast, self-reported pain intensity was not affected by social context. These data support the modulation of pain-related fear by social context. PERSPECTIVE A threatening social context leads to stronger acquisition of (pain-related) fear and simultaneous contextual fear but does not affect pain intensity ratings. This knowledge may aid in the prevention of chronic pain and anxiety disorders and shows that social context might modulate pain-related fear without immediately affecting pain intensity itself.

The Influence of Social Threat on Pain, Aggression, and Empathy in Women

Only one published study has investigated the effect of a threatening social context on the perception and expression of pain, showing that social threat leads to increased pain reports but reduced nonverbal pain expression. The current study aimed to replicate and extend these findings to further explore the effects of a threatening social context. Healthy, female participants (N = 71) received 10 electrocutaneous stimuli delivered by a confederate. They were led to believe that the confederate was requested to administer 10 painful stimuli (control group) or that the confederate deliberately chose to deliver 10 painful stimuli when given the choice to deliver between 1 to 10 painful stimuli (social threat group). Self-reported pain intensity, unpleasantness, threat value of pain, and painful facial expression were assessed. Additionally, empathy and aggression toward the confederate were investigated. Social threat did not affect painful facial expression or self-reported pain intensity, but led to increased aggression toward the confederate. Moreover, perceived social threat predicted the threat value of pain and reduced empathy toward the confederate. We were not able to replicate the previously reported dissociation between pain reports and pain expression as a result of social threat. However, social threat was associated with an increased threat value of pain, increased aggression, and reduced empathy. PERSPECTIVE A threatening social context affects how threatening pain is perceived and has interpersonal consequences such as increased aggression and reduced empathy, thereby creating a double burden on the individual suffering from pain.

Fear of pain changes movement: Motor behaviour following the acquisition of pain-related fear

According to current fear‐avoidance models, changes in motor behaviour (e.g. avoidance) are a key component in the development and maintenance of chronic pain complaints. Yet, experimental research assessing actual behavioural changes following painful events is relatively sparse. This study investigated the effects of pain anticipation on changes in motor behaviour using a fear conditioning paradigm and robot‐generated standardized movement trajectories of the upper extremities.

Parental emotion and pain control behaviour when faced with childʼs pain: the emotion regulatory role of parental pain-related attention-set shifting and heart rate variability

Abstract This study investigated the moderating role of parental pain-related attention-set shifting and heart rate variability (HRV) for parental distress and pain control behaviour when faced with their childs pain. Participants were 54 schoolchildren and one of their parents. Parental HRV was assessed at study commencement followed by a cued-switching task indexing parental ability to flexibly shift attention between pain-related and neutral attentional sets. In a subsequent phase, parents observed their child perform a cold-pressor task [CPT], allowing for assessment of parental pain control behavior (indexed by latency to stop their childs CPT performance) and parental distress—assessed through self-report following observation of child CPT performance. Findings indicated that parental facilitated attentional shifting (ie, engage) towards a pain-related attentional set contributed to higher levels of pain control behaviour when faced with increasing levels of child facial display of pain. Pain control behaviour among parents who demonstrated impeded attentional shifting to a pain-related attentional set was equally pronounced regardless of low or high levels of child pain expression. Parental ability to shift attention away (ie, disengage) from a pain-related set to a neutral set did not impact findings. Results further indicated that although high levels of parental HRV buffer the impact of child facial pain display on parental emotional distress and pain control behaviour, low levels of HRV constitute a risk factor for higher levels of parental distress and pain control behaviour when faced with increased child facial pain display. Theoretical/clinical implications and further research directions are discussed.

On the Overlap Between Physical and Social Pain

When asked to name their most negative life events, people often cite an event of loss such as the dissolution of a valued relationship or the death of a loved one. Curiously, such events are often experienced and described as painful. Curiously, the overlap between physical pain and distressing social experiences does not end there. This chapter explores a growing body of social neuroscience and experimental laboratory research that demonstrates a fascinating, dynamic interplay between distressing social experiences such as exclusion and ostracism, and the experience of physical pain.

Where We’ve Been, Where We’re at, Where Do We Go from Here?

The goal of this volume has been to bring together “state-of-the-science” narrative reviews of major directions in the study of social and interpersonal dimensions of pain. This final chapter takes a broad overview of the field, placing the individual contributions in context. It begins with a historical overview, situating the field of social/interpersonal influences on pain within the evolution of ideas about the psychology of pain. Key conceptual and empirical contributions arising from the individual chapters are identified. In the final section, important gaps in our knowledge are identified and directions for future research that we think have the potential to be very fruitful are given. Particular emphasis is placed on the value of expanding the domain of inquiry to incorporate social influences at a macro level.

When, How, and Why Do We Express Pain?

The experience of pain is typically accompanied by various verbal and nonverbal behavioral expressions that help to inform our social environment about our pain. These expressions range from verbal reports (e.g., “I feel pain in my shoulder that is quite strong”) to nonverbal expressions, like moaning and facial grimacing. Depending on the situational context, however, as well as on previous learning experiences, personality traits and our affective state, the way we express pain can vary substantially. In the present chapter we give an in-depth overview of the complex psychosocial factors that affect when, how and why we express pain.