Experimental Health Psychology, Department of Clinical Psychological Science, Maastricht University, the Netherlands.
Experimental Health Psychology, Department of Clinical Psychological Science, Maastricht University, the Netherlands; Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium.
J Behav Ther Exp Psychiatry. 2021 Mar;70:101622. doi: 10.1016/j.jbtep.2020.101622. Epub 2020 Oct 24.
Contingency learning, i.e. learning that a cue predicts the presence (or absence) of an event, is central to the formation of beliefs regarding painfulness of body postures. Such beliefs may spread to safe cues due to compromised learning (e.g., excessive generalization, impaired safety learning), prompting avoidance and leading to disability. Despite its importance, compromised learning about low back pain is underinvestigated. We propose a low back pain scenario contingency learning task for the investigation of back pain-related learning.
Sixty healthy participants viewed pictures of an avatar in various back postures, and for each posture gave pain-expectancy judgments and viewed the verbal outcome (pain/no pain) for a fictive back pain patient. During acquisition, one posture was followed by pain (conditioned stimulus; CS+), whereas another was not (CS-). During generalization, unreinforced novel intermediate back postures (generalization stimuli; GSs) were tested. During extinction, only the CSs were presented, not followed by pain. During generalization of extinction, only the GSs were presented, not followed by pain.
Participants expected pain more for the CS + than the CS- (differential acquisition) and generalized their pain-expectancy to the GS most similar to the CS+ (generalization). During extinction, pain-expectancy for the CS + decreased and generalized to the GS most similar to the CS+ (generalization of extinction).
Future research should investigate generalizability of findings to clinical samples and consider the role of pre-existing pain threat beliefs.
This task is an easily applicable, non-invasive way to investigate the formation of back pain-related threat beliefs.
偶然性学习，即学习线索预测事件的出现（或不存在），是形成对身体姿势疼痛程度的信念的核心。由于学习受损（例如过度泛化、安全性学习受损），这种信念可能会传播到安全线索，从而引发回避行为，导致残疾。尽管其重要性，但对低背痛的学习受损仍研究不足。我们提出了一种低背痛情景偶然性学习任务，用于研究与背痛相关的学习。
60 名健康参与者观看了各种背部姿势的化身图片，并为每个姿势给出了疼痛预期判断，并为虚构的背痛患者查看了口头结果（疼痛/无疼痛）。在获得阶段，一种姿势后会出现疼痛（条件刺激；CS+），而另一种姿势则不会（CS-）。在泛化阶段，未受强化的新中间背部姿势（泛化刺激；GSs）进行了测试。在消退阶段，只呈现 CS，不伴随疼痛。在消退的泛化阶段，只呈现 GS，不伴随疼痛。
与 CS-相比，参与者对 CS+的疼痛预期更高（差异获得），并将其疼痛预期泛化到与 CS+最相似的 GS（泛化）。在消退阶段，CS+的疼痛预期降低，并泛化到与 CS+最相似的 GS（消退的泛化）。
未来的研究应该调查这些发现对临床样本的可推广性，并考虑预先存在的疼痛威胁信念的作用。
该任务是一种简单适用、非侵入性的方法，可以研究与背痛相关的威胁信念的形成。
