No pain no gain? Pursuing a competing goal inhibits avoidance behavior

Abstract

This experiment investigated pain-related avoidance behaviour in a context of competing goals. Participants (N = 56) were presented trials of two different tasks of which one could produce pain. They were free to decide whether or not to perform trials of these tasks. In half of the participants a competing goal was activated by instructing them that they would receive a monetary reward corresponding to the number of pain task trials actually performed (competition group). In the other half of the participants no competing goal was installed (control group). Results showed that the competition group showed less frequent avoidance behaviour than the control group. Furthermore, the association between pain-related avoidance behaviour and fear of pain was smaller in the competition group than in the control group. The findings indicate that the emergence of pain-related avoidance behaviour depends upon the motivational context, and that the association between pain-related fear and avoidance is not stable. This study has implications for our understanding of disability, and points to the need to consider avoidance behaviour within a broad context of multiple, often competing, goals.

Competing Goals Attenuate Avoidance Behavior in the Context of Pain

“…This finding is however in line with other studies showing that introducing a monetary incentive does not necessarily result in a decrease in painrelated fear. 29,49 The current study extends available evidence for the inclusion of a motivational perspective on avoidance tendencies and behavior, wherein the dynamics of several−possibly conflicting−goals should be considered. Avoidance behavior is considered a relatively stable response driven by a fear-based motivation to prevent further injury.…”

“…9,18,29,54 However, the results of the current study show that avoidance can be influenced by the presence of concomitant, competing goals, such as the goal to retrieve a reward, even without changing pain-related fear itself. 23,40,44,47,49 Thus, avoidance behavior may vary from situation-to-situation, also even within individuals.…”

“…17,20,29,45,49,53,57 Recently, it has been suggested that pain-related fear should be considered within a motivational context. More specifically, the experience of pain might not only lead to the development of pain-related fear, but may also activate the goal to control or avoid (further) harm.…”

A Self-Regulation Perspective on Avoidance and Persistence Behavior in Chronic Pain

“…Both experimental studies and research in naturalistic settings are needed to test the validity of these ideas. For example, in previous studies it was found that the goal of obtaining a financial reward increased task persistence during experimental pain 66 , suppressed attention to pain-related cues 58 , and even reduced pain perception in high pain catastrophizers 59 . It would be interesting to extend this line of research by manipulating the type of motivation with which task goals are pursued.…”

“…Current models insufficiently address the question how patients try to function despite pain. In a recent experimental study, it was demonstrated that the decision to avoid or persist a pain-provoking task, is strongly affected by the motivational context 66 . Healthy volunteers were offered the choice to perform or avoid trials from a pain-provoking task.…”