Rational

  1. Chronic pain muscelosceletar pain

  • burden of chronic pain
    • highly debilitating condition (avoidance of pain inducing situations leading to)
    • functional disability
    • etc
  • (despite this little is known about the development maintentance of pain reated avoidance behavior)

  1. pain related fear

  • cognitive models propose pain related fear which causes avoidance behavior to play a key role in the development and maintenance of chronic pain.
    • As such catastrophic misinterpretation of pain as a sing of bodily harm (can only put this if I talked about adaptability of pain)

Questionaires

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Fear of pain questionnaire (FPQ)

Multidimensional experimental avoidance questionnaire (MEAQ)

Pain catastrophizing scale (PCS)

--> can lead to fear of pain and fear of pain to avoidance

High sensitive person scale (HSP)

Intolerance of uncertainty scale (IUS)

Pain anxiety symptom scale (PASS)

STAI

PANAS

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  1. pain related fear

  • cognitive models propose that catastrophic misinterpretations of pain as a sign of bodily harm may cause pain related fear and avoidance behavior to play a key role in the development and maintenance of chronic pain.
  • As such catastrophic misinterpretation of pain as a sing of bodily harm (can only put this if I talked about adaptability of pain)

  1. Pain = Adaptive

  1. Chronic pain = maladaptive

  • if acute pain experienced too long it looses its fuction of protecting the body from harm
  • this can have debilitating consequences
    • list burden cumulating in functiona disability

  1. Cognitive models

  • cognitive models implicate pain related fear (prf) and the resulting avoidance behavior in the development and maintenance of the condition.


    • (Specifically, catastrophic misinterpretations of Nociceptive pain as bodily harm may lead to prf which causes the avoidance behavior. This avoidance behavior in turn then helps to maintain the condition as an absence of the pain is interpreted as a direct consequence of the avoidance behavior and thus reinforcing it based on pavlovian conditioning principles (but isnt this more operant conditioning negative reinforcement lol?)

  • yet little research has been done to investigate the issue (development, maintenance and mechanism) in a systematic manner.

  1. Study

  • we aim to begin this systematic investigating by focusing on the extinction and renewal of fear-related avoidance behavior in a pavlovian fear conditioning paradigm

Chronic pain

conditioning could explain the maining loop #

cognitive models

conditioning

extinction

renewal

design