Observational Learning and Pain-Related Fear: An Experimental Study With Colored Cold Pressor Tasks

Abstract

The primary aim of the current study was to experimentally test whether pain-related fear can be acquired through observational learning, whether extinction occurs after actual exposure to the aversive stimulus, and whether pain-related fear was associated with increased pain ratings. During an observation phase, female volunteers watched a video showing models performing cold pressor tasks (CPT), of which the color served as a conditioned stimulus (CS). In a differential fear conditioning paradigm, each of two colors were either paired with models' painful (CS+) or neutral (CS-) facial expressions. Exposure consisted of participants performing CPTs of both colors (10°C). Self-reported fear of pain, and expected pain ratings were obtained after the observation period, while actual pain and avoidance measures were obtained during and after exposure. Results show that after observing another person performing the CPT associated with the painful faces, subjects report more fear of pain and expect more intense and unpleasant pain as compared to the CPT associated with the neutral faces. This effect of observational learning on pain-related fear persisted until after exposure.During and after exposure no stimulus type effect for pain ratings was found. This study provides preliminary evidence for observational learning of pain-related fear in humans.Observational learning and pain-related fear 3 Perspective:Fear of pain can be more disabling than pain itself, and is a risk factor for chronic pain.Knowledge about the acquisition of pain-related fear may help developing novel pain management programs. This study is one of the first to demonstrate the effects of observational learning on pain-related fear.

Negative Emotional Responses Elicited by the Anticipation of Pain in Others: Psychophysiological Evidence

“…The mean level of average and worst pain reported by the observed participants was The present findings corroborate previous findings on vicarious fear conditioning in humans 15,16,17,42,60,72,78 and suggest that seeing others in pain has a profound influence on observers 40 . Specifically, findings indicate that other's pain can serve as a sign of threat, resulting into fearful responses towards previously neutral stimuli.…”

“…Furthermore, it provides us with information about when others will likely experience pain and suffer. It is no surprise that studies on vicarious conditioning reveal that signals of pain in others elicit fear and anxiety in observers 40,42,60,78 . Several issues however deserve further scrutiny.…”

The experimental analysis of the interruptive, interfering, and identity-distorting effects of chronic pain

“…These findings support the idea that imagining the painful feared movement activates the memory representation of the movement-pain association, and in turn may trigger conditioned responses (Meulders & Vlaeyen, 2013b) (Meulders & Vlaeyen, 2013b) (Meulders & Vlaeyen, 2013b). It is therefore not surprising that pain-related fear can also be acquired indirectly, without having actually experienced the cue-pain association, for example through observation of others in pain (Helsen, Goubert, Peters, & Vlaeyen, 2011) (Goubert, Vlaeyen, Crombez, & Craig, 2011), or by virtue of symbolic representations of pain (Jepma & Wager, 2015), or the conceptual equivalence between stimuli, and their derived relationships with pain (Bennett, Meulders, Baeyens, & Vlaeyen, 2015).…”

Learning about pain through observation: the role of pain-related fear

“…Likewise, evidence that viewing another's pain engages the observers' own neural structures underscores the importance of examining the cognitive, affective, and behavioral responses to pain observation . However, despite the intuitive value of observational learning in pain processes, to our knowledge the current study is among the first (e.g., Helsen et al, 2011) to experimentally examine the modulation of observational learning by observer characteristics, with specific attention to observers' pain-related fear.…”

“…Given the relevance of pain-related fear to pain responses in the intrapersonal context ---e.g., attention to personal pain, pain appraisal, physical performance, disability Van Damme et al, 2010) ---surprisingly few studies have examined the impact of pain-related fear on observational learning responses (Helsen et al, 2011), including learning about the potential pain and harm value of physical activity.…”