77 research outputs found

    Goal conflict in chronic pain : day reconstruction method

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    Background When suffering from chronic pain, attempts to control or avoid pain often compete with other daily activities. Engaging in one activity excludes engaging in another, equally valued activity, which is referred to as “goal conflict.” As yet, the presence and effects of goal conflicts in patients with chronic pain remain poorly understood. Methods This study systematically mapped the presence and experience of goal conflicts in patients with fibromyalgia compared to healthy controls. A total of 40 patients and 37 controls completed a semi-structured interview in which they first reconstructed the previous day, identified conflicts experienced during that day, and classified each of the conflicting goals in one of nine goal categories. Additionally, they assessed how they experienced the previous day and the reported conflicts. Results Results showed that patients did not experience more goal conflicts than healthy controls, but that they did differ in the type of conflicts experienced. Compared to controls, patients reported more conflicts related to pain, and fewer conflicts involving work-related, social or pleasure-related goals. Moreover, patients experienced conflicts as more aversive and more difficult to resolve than control participants. Discussion This study provides more insight in the dynamics of goal conflict in daily life, and indicates that patients experience conflict as more aversive than controls, and that conflict between pain control (and avoidance) and other valued activities is part of the life of patients

    The exploration-exploitation dilemma in pain:an experimental investigation

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    ABSTRACT: Daily life consists of a chain of decisions. Typically, individuals may choose to pursue what they already know (exploitation), or to search for other options (exploration). This exploration-exploitation dilemma is a topic of interest across multiple scientific fields. Here we propose that investigating how individuals solve this dilemma may improve our understanding of how individuals make behavioral decisions (e.g., avoidance) when facing pain. To this end, we present the data of three experiments in which healthy individuals were given the opportunity to choose between four different movements, with each movement being associated with different probabilities of receiving a painful outcome only (Experiment 1), or pain and/or a reward (Experiment 2). We also investigated whether participants stuck to their decisions when the contingencies between each movement and the painful/rewarding outcome changed during the task (Experiment 3). The key findings across all experiments are the following: First, after initial exploration, participants most often exploited the safest option. Second, participants weighted rewards more heavily than receiving pain. Lastly, after receiving a painful outcome, participants were more inclined to explore than to exploit a rewarding movement. We argue that by focusing more on how individuals in pain solve the exploration-exploitation dilemma is helpful in understanding behavioral decision-making in pain

    Cognitive behavioural therapy for tinnitus (Protocol)

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    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects and safety of CBT for tinnitus in adults

    Competing goals attenuate avoidance behavior in the context of pain

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    Current fear-avoidance models consider pain-related fear as a crucial factor in the development of chronic pain. However, pain-related fear often occurs in a context of multiple, competing goals. This study investigated whether pain-related fear and avoidance behavior are attenuated when individuals are faced with a pain avoidance goal and another valued but competing goal, operationalized as obtaining a monetary reward. Fifty-five healthy participants moved a joystick toward different targets. In the experimental condition, a movement to one target (conditioned stimulus [CS+]) was followed by a painful unconditioned stimulus (pain-US) and a rewarding unconditioned stimulus (reward-US) on 50% of the trials, whereas the other movement (nonreinforced conditioned stimulus [CS)) movement was not. In the control condition, the CS+ movement was followed by the pain-US only. Results showed that pain-related fear was elevated in response to the CS+ compared to the CS movement, but that it was not influenced by the reward-US. Interestingly, participants initiated a CS+ movement slower than a CS movement in the control condition but not in the experimental condition. Also, in choice trials, participants performed the CS+ movement more frequently in the experimental than in the control condition. These results suggest that the presence of a valued competing goal can attenuate avoidance behavior. Perspective: The current study provides experimental evidence that both pain and competing goals impact on behavioral decision making and avoidance behavior. These results provide experimental support for treatments of chronic pain that include an individual's pursuit of valuable daily life goals, rather than limiting focus to pain reduction only. (C) 2014 by the American Pain Societ
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