An attentional perspective on differential fear conditioning in chronic pain: The informational value of safety cues. (September 2021)

• Record Type: Journal Article
• Authors: Koenig, Stephan; Körfer, Karoline; Lachnit, Harald; Glombiewski, Julia Anna
• Is Part Of: Behaviour research and therapy. Volume 144(2021)
• Publication Date: 2021-09
• Subjects: Chronic pain -- Fear conditioning -- Impaired safety learning -- Informational value -- Attention -- Eye movements; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2021.103917
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Differences in fear conditioning between individuals suffering from chronic pain and healthy controls may indicate a learning bias that contributes to the acquisition and persistence of chronic pain. However, evidence from lab-controlled conditioning studies is sparse and previous experiments have produced inconsistent findings. Twenty-five participants suffering from chronic back pain and twenty-five controls not reporting chronic pain took part in a differential fear conditioning experiment measuring attention (eye tracking) and autonomic arousal (pupil dilation and skin conductance) elicited by visual cues predicting the presence or absence of electric shock. In contrast to the healthy control group, participants with chronic pain did not acquire differential autonomic responding to cues of threat and safety and specifically failed to acquire any attentional preference for the safety cue over irrelevant contextual cues (while such preference was intact for the threat cue). We present simulations of a reinforcement learning model to show how the pattern of data can be explained by assuming that participants with chronic pain might have experienced less positive emotion (relief) when the electric shock was absent following safety cues. Our model shows how this assumption can explain both, reduced differential responding to cues of threat and safety as well as less selective attention to the safety cue. Highlights: Participants with chronic pain exhibit an impaired discrimination of cues of threat and safety in human fear conditioning. Elicited sympathetic arousal does not differ between cues of threat and safety. Eye tracking reveals no attentional preference for safety cues over irrelevant contextual cues. Computer simulations of a reinforcement learning model suggest less effective inhibitory conditioning.