Mini symposium on pain and suffering

Transcription

1 Mini symposium on pain and suffering in the honor of Prof. Dr. Geert Crombez (UGent) Francqui Chair* Leuven, May 13 th :00 10:30 Welcome and short introduction 10:30 11:00 Presentation 1: Dimitri Van Ryckeghem (UGent) Attentional control of pain: a search towards predictors and underlying mechanisms 11:00 11:30 Presentation 2: Marjolein Hanssen (UM) Optimism as a resiliency for chronic pain: cognitive behavioral pathways of resilience 11:30 12:00 Coffee break 12:00 12:30 Presentation 3: Rena Gatzounis (KUL) Task interruptions in the context of pain 12:30 13:00 Presentation 4: Emelien Lauwerier (UGent) Coping with chronic pain: a matter of holding on or letting go? An empirical investigation of different selfregulatory mechanisms 13:00 14:30 Lunch and interactive poster session Scientific program Abstracts Venue 14:30 15:00 Presentation 5: Nele Vandebroek (KUL) Anxious, more anxious, terrified: An experiment on pain-related fear generalization 15:00 15:30 Presentation 6: Lize De Coster (UGent) The influence of being imitated on empathy for pain 15:30 16:00 Coffee break 16:00 17:00 Closing lecture by Prof. Dr. Geert Crombez Some personal thoughts on future challenges * The Francqui Chair is organized under the auspices of the K.U.Leuven Center of Excellence Generalization Research in Ill health and Psychopathology (GRIPP*TT), which is a consortium of the Research Group on Health Psychology and the Centre of Learning Psychology and Experimental Psychopathology. 1

2 Abstracts oral presentations (chronologically) 1. ATTENTIONAL CONTROL OF PAIN: A SEARCH TOWARDS PREDICTORS AND UNDERLYING MECHANISMS DIMITRI VAN RYCKEGHEM (UGENT) Research has shown that pain involuntary draws attention. Important to investigate however is whether the involuntary capture of attention by pain can be overruled. To investigate which variables help to inhibit the involuntary capture of attention by pain and to shield the voluntary directed attention, we made use of two approaches. First, we investigated which individual differences may relate to more involuntary capture of attention by pain. It was hypothesized that the presence of an attentional bias towards painrelated information would decrease participants ability to overrule this automatic capture of attention by pain. This was investigated in an experiment in which both attentional control (distraction paradigm) and pain-related attentional bias (exogenous cueing paradigm/ dot probe paradigm) were examined. Second, we investigated which task characteristics may be important to reduce involuntary attentional capture by pain. We hypothesized that the presence of pain features should be minimized in a participant s attentional set by reducing the overlapping perceptual features of pain and the focal task (e.g. spatial location, perceptual modality). This was investigated in two successive experiments in which both the location (spatially congruent/ spatially incongruent) and the modality (somatosensory relevant/ auditory relevant) relevant to perform the task well were manipulated. Additionally, the array of pain features that were task-relevant and consequently present in a persons attentional set were manipulated by using specific cues. Results of these studies will be presented and discussed. 2. OPTIMISM AS A RESILIENCY FOR CHRONIC PAIN: COGNITIVE BEHAVIORAL PATHWAYS OF RESILIENCE MARJOLEIN HANSSEN (UM) Dispositional optimism has repeatedly been associated with general physical and psychological well-being. Over the last decade, evidence has accumulated that optimism may also be an important construct to take into consideration in pain research. Not only do optimistic people seem to cope better with pain, they also seem to be less sensitive to the experience of pain. However, it is yet unclear which working mechanism(s) underlie these associations. In this talk, first I will present evidence pointing at the possible protective role of optimism for chronic pain. Second, I will propose mechanisms for the explanation of the relation between optimism and pain. I will hereby focus on certain mechanisms that have been studied by our research group and I will present results on expectancy and goal-directed coping as proposed mediating factors. Last but not least, I will shortly focus on the clinical implications of the study of optimism as a resiliency for chronic pain. Not only do interventions aimed at inducing optimism seem promising, an optimistic approach to life can provide an example that we can learn from. 3. TASK INTERRUPTIONS IN THE CONTEXT OF PAIN RENA GATZOUNIS (KUL) Task interruptions, defined as the suspension of a task with the intention to resume it later, are known to disrupt performance. There are two main reasons for which they are assumed to play an important role in a pain context. Firstly, interrupting one s task pursuit in order to engage in protective behaviors seems to be a prominent natural reaction to pain (Eccleston & Crombez, 1999). Secondly, interruptions are used in pain management in the form of 2

3 pacing. Despite the lack of experimental research in the field of pain, task interruptions have been extensively studied in the fields of aviation, driving and ergonomics. This research is largely guided by theoretical models focusing on the role of memory in task resumption, such as the goal activation theory (Altmann & Trafton, 2002). In this presentation, a recently started PhD research project, which aims at the understanding of interruptions in the context of pain and the alleviation of their (hypothesized) negative effects on task performance, by taking an experimental approach, will be introduced. The general outline of the project and the approach taken in the first experiment will be described. Altmann, E. M., & Trafton, J. G. (2002). Memory for goals. An activation-based model. Cognitive Science, 26, Eccleston, C., & Crombez, G. (1999). Pain demands attention. A cognitiveaffective model of the interruptive function of pain. Psychological Bulletin, 125, COPING WITH CHRONIC PAIN: A MATTER OF HOLDING ON OR LETTING GO? AN EMPIRICAL INVESTIGATION OF DIFFERENT SELF- REGULATORY MECHANISMS EMELIEN LAUWERIER (UGENT) Self-regulation models identified two different coping responses in patients with chronic pain. Patients can either be motivated to diminish the impact of pain by controlling or solving pain or to disengage from attempts to control pain and adjust to the pain problem. In situations where it is impossible to have actual control over pain, such as is mostly the case in chronic pain, adjustment to a life with pain and to the restrictions brought about by pain has already been shown beneficial. Still, seeking pain relief seems to be a central feature of chronic pain patienthood. Many patients can be found to be stuck in problem solving attempts that are essentially misdirected (Eccleston & Crombez, 2007). In the present lecture, we will give a brief theoretical overview of self-regulatory mechanisms involved in coping with chronic pain. Within our perspective, coping with chronic pain is recast as attempts to pursue valued goals that are blocked by pain. Further on, we will present the audience with a selected number of research studies in this respect. 5. ANXIOUS, MORE ANXIOUS, TERRIFIED: AN EXPERIMENT ON PAIN- RELATED FEAR GENERALIZATION NELE VANDEBROEK (KUL) Many objects or situations that individuals encounter in life are unlikely to recur in exactly the same form and context. Thus, generalizing learning experiences from one situation to another is crucial to change behavior accordingly. When confronted with danger for example, generalization of fear allows the organism to rapidly adapt behaviour when faced with a novel threatening cue that is related to, or that resembles a previously learned threat. However, fear generalization may become dysfunctional when non-threatening cues are treated as harmful based on their similarity to a known threat, as is the case in many anxiety disorders. Reaching to date, there is substantial evidence for the influence of pain-related fear on the development and maintenance of chronic pain. However, experimental research examining the role of fear generalization in the context of pain has only received scant attention. This is surprising since cross-sectional studies have shown that chronic back pain patients tend to overgeneralize negative pain experiences, and that overgeneralization is associated with disability. I will propose a study, using a pain-related fear conditioning paradigm, demonstrating that individuals show a larger fear response to stimuli that share perceptual features with a painful stimulus. In future research, we will replicate this paradigm in an fmri setting to elucidate the neural substrates underlying pain-related fear generalization. 3

4 6. THE INFLUENCE OF BEING IMITATED ON EMPATHY FOR PAIN LIZE DE COSTER (UGENT) Social psychological research suggests that being imitated leads to prosocial behaviour (e.g. Chartrand & Bargh, 1999), while pain perception studies indicate that pain-related brain representations become activated in the observer when viewing another person in pain (e.g. Singer et al., 2004). The aim of this study is to investigate whether being imitated can modulate such empathy for pain. To this end, we developed an experimental approach combining a simple imitation task with a pain perception task: Participants have to carry out an index or a middle finger movement that is either imitated by a previously videotaped hand presented on a monitor (imitation block) or not (nonimitation block), while the hand on the video receives painful stimulation at the end of each block. We predict that being imitated leads to stronger empathy for pain than not being imitated, due to a selfother confusion mechanism. Using behavioral questionnaires and autonomic responses as indices for the strength of activation of the pain matrix, results suggest that being imitated compared to not being imitated has an influence both on explicit and implicit measures of empathy for pain. In the near future, we plan to further investigate this question using functional MRI and TMS. 4

5 Venue Mini symposium on pain and suffering : Huis Van t Sestich Naamsestraat 69 room HOGS B-3000 Leuven Public transportation (bus from NMBS station Leuven): Line 2 Kessel-Lo / Heverlee (every 7-8 minutes) Travel time around 12 minutes Closing lecture by Prof. Dr. Geert Crombez Psychological Institute Tiensestraat 102 room PSI B-3000 Leuven Leuven 5