Department of Psychology I, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany.
Sci Rep. 2023 Aug 23;13(1):13799. doi: 10.1038/s41598-023-40789-z.
Pain-associated approach and avoidance behaviours are critically involved in the development and maintenance of chronic pain. Empirical research suggests a key role of operant learning mechanisms, and first experimental paradigms were developed for their investigation within a controlled laboratory setting. We introduce a new Virtual Reality paradigm to the study of pain-related behaviour and investigate pain experiences on multiple dimensions. The paradigm evaluates the effects of three-tiered heat-pain stimuli applied contingent versus non-contingent with three types of arm movements in naturalistic virtual sceneries. Behaviour, self-reported pain-related fear, pain expectancy and electrodermal activity were assessed in 42 healthy participants during an acquisition phase (contingent movement-pain association) and a modification phase (no contingent movement-pain association). Pain-associated approach behaviour, as measured by arm movements followed by a severe heat stimulus, quickly decreased in-line with the arm movement-pain contingency. Slower effects were observed in fear of movement-related pain and pain expectancy ratings. During the subsequent modification phase, the removal of the pain contingencies modified all three indices. In both phases, skin conductance responses resemble the pattern observed for approach behaviour, while skin conductance levels equal the pattern observed for the self-ratings. Our findings highlight a fast reduction in approach behaviour in the face of acute pain and inform about accompanying psychological and physiological processes. We discuss strength and limitations of our paradigm for future investigations with the ultimate goal of gaining a comprehensive understanding of the mechanisms involved in chronic pain development, maintenance, and its therapy.
疼痛相关的趋近和回避行为在慢性疼痛的发展和维持中起着至关重要的作用。实证研究表明操作性学习机制起着关键作用,并且首先开发了实验范式来在受控的实验室环境中研究这些机制。我们引入了一种新的虚拟现实范式来研究与疼痛相关的行为,并在自然虚拟场景中评估多种维度的疼痛体验。该范式评估了在三个层次的热疼痛刺激下,与三种手臂运动 contingent(有条件的)与 non-contingent(无条件的)应用的效果。在获得阶段(有条件的运动-疼痛关联)和修改阶段(无有条件的运动-疼痛关联),42 名健康参与者的行为、与疼痛相关的恐惧的自我报告、疼痛预期和皮肤电活动被评估。在手臂运动后紧随强烈的热刺激,与手臂运动-疼痛关联相一致,疼痛相关的趋近行为迅速减少。在运动相关疼痛恐惧和疼痛预期评分方面观察到较慢的影响。在随后的修改阶段,消除疼痛关联会改变所有三个指标。在这两个阶段,皮肤电反应与趋近行为的模式相似,而皮肤电水平与自我评分的模式相同。我们的研究结果强调了在急性疼痛面前,趋近行为的快速减少,并提供了伴随的心理和生理过程的信息。我们讨论了我们的范式在未来研究中的优势和局限性,最终目的是全面了解慢性疼痛发展、维持及其治疗中涉及的机制。