Competing Goals Attenuate Avoidance Behavior in the Context of Pain (original) (raw)

Current fear-avoidance models consider pain-related fear as a crucial factor in the development of chronic pain. Yet, 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 towards 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 on 50% (reward-US) of the trials, whereas the CSmovement 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.