Executive functions deficits impair extinction of generalization of fear of movement‐related pain

Abstract

Low inhibitory capacity is not associated with slower generalization, but extinction of fear generalization. Fear elicited by a novel safe movement, situated outside the CS+/- continuum on the CS+ side, can be as strong as to the original stimulus predicting the pain-onset.

The relationship between fear generalization and pain modulation: an investigation in healthy participants

“…First, we successfully demonstrated a generalization gradient in pain-related fear and pain-US expectancy: ratings were highest in response to the CS+ and gradually decreased as GSs decreased in similarity to the CS+. These results were consistent with previous work (8,11,15), thus replicate the findings that the more proprioceptive similarity between a novel movement and the original painful movement, the more pain-related fear and expectancy it elicits. However, eyeblink startle responses were not in line with previous work as we were unable to test for a gradient due to the lack of differential responding to CSs during the generalization phase.…”

“…Pain-related fear can spread towards novel movements based on proprioceptive similarity to the original movement associated with pain (8,10,11) or movements belonging to the same conceptual category (e.g., function) (12,13), despite that they were never paired with pain (i.e., stimulus generalization). Typically, generalization gradients are observed: the greater the proprioceptive similarity between novel movements (i.e., generalization stimuli; GSs) and the original CS+, the more fear they elicit (8,11,14,15). This is an adaptive mechanism as generalization of fear enables individuals to extrapolate knowledge to similar potentially harmful stimuli without having to experience them (16).…”