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Learning to fear pain after observing another's pain: An experimental study in schoolchildren.
Eur J Pain. 2020 04; 24(4):791-806.EJ

Abstract

BACKGROUND

Children of individuals with chronic pain have an increased vulnerability to experience pain problems, possibly through observation of pain in their parents. As pain-related fear (PRF) is a critical factor in the development and maintenance of chronic pain, the current experimental study examined the acquisition of PRF through observational learning and subsequent extinction after first-hand experience of the feared stimulus.

METHODS

Healthy children (8-16 years) observed either their mother or a stranger performing two cold pressor tasks (CPT) filled with coloured water. In a differential conditioning procedure, one colour (CS+) was combined with genuine painful facial expressions and the other colour (CS-) with neutral facial expressions. Following this observation phase, children performed both CPTs (10°C) themselves.

RESULTS

Children expected the CS+ to be more painful than the CS- and they reported being more afraid and hesitant to immerse in the CS+ compared to the CS-. Moreover, this fear was reflected in children's level of arousal in anticipation of CPT performance. This learned association extinguished after performing both CPTs. Effects were not moderated by whether the child observed their mother or a stranger, by the child's pain catastrophizing, trait PRF or trait anxiety. Remarkably, learning effects increased when the child perceived a larger difference between the model's painful and neutral facial expressions.

CONCLUSIONS

This study provides evidence for observational learning of PRF and subsequent extinction in schoolchildren. This acquisition of PRF by observing parental pain may contribute to vulnerabilities in children of parents with chronic pain.

SIGNIFICANCE

Children may acquire pain-related fear by observing pain in others and this learned fear can diminish after first-hand experience. Remarkably, observational learning did not depend on the children's relationship with the model, but it did depend on the intensity of pain that is perceived. A better understanding of the impact of observing (parental) pain may help clarify the intergenerational transmission of risk for pain and inform the development of preventive programs.

Authors+Show Affiliations

Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium. Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium.Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.Department of Psychology, University of Essex, Colchester, UK.Brain & Cognition, KU Leuven, Leuven, Belgium.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31886912

Citation

Van Lierde, Elke, et al. "Learning to Fear Pain After Observing Another's Pain: an Experimental Study in Schoolchildren." European Journal of Pain (London, England), vol. 24, no. 4, 2020, pp. 791-806.
Van Lierde E, Goubert L, Vervoort T, et al. Learning to fear pain after observing another's pain: An experimental study in schoolchildren. Eur J Pain. 2020;24(4):791-806.
Van Lierde, E., Goubert, L., Vervoort, T., Hughes, G., & Van den Bussche, E. (2020). Learning to fear pain after observing another's pain: An experimental study in schoolchildren. European Journal of Pain (London, England), 24(4), 791-806. https://doi.org/10.1002/ejp.1529
Van Lierde E, et al. Learning to Fear Pain After Observing Another's Pain: an Experimental Study in Schoolchildren. Eur J Pain. 2020;24(4):791-806. PubMed PMID: 31886912.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Learning to fear pain after observing another's pain: An experimental study in schoolchildren. AU - Van Lierde,Elke, AU - Goubert,Liesbet, AU - Vervoort,Tine, AU - Hughes,Gethin, AU - Van den Bussche,Eva, Y1 - 2020/01/22/ PY - 2019/05/09/received PY - 2019/11/14/revised PY - 2019/12/24/accepted PY - 2019/12/31/pubmed PY - 2020/11/21/medline PY - 2019/12/31/entrez SP - 791 EP - 806 JF - European journal of pain (London, England) JO - Eur J Pain VL - 24 IS - 4 N2 - BACKGROUND: Children of individuals with chronic pain have an increased vulnerability to experience pain problems, possibly through observation of pain in their parents. As pain-related fear (PRF) is a critical factor in the development and maintenance of chronic pain, the current experimental study examined the acquisition of PRF through observational learning and subsequent extinction after first-hand experience of the feared stimulus. METHODS: Healthy children (8-16 years) observed either their mother or a stranger performing two cold pressor tasks (CPT) filled with coloured water. In a differential conditioning procedure, one colour (CS+) was combined with genuine painful facial expressions and the other colour (CS-) with neutral facial expressions. Following this observation phase, children performed both CPTs (10°C) themselves. RESULTS: Children expected the CS+ to be more painful than the CS- and they reported being more afraid and hesitant to immerse in the CS+ compared to the CS-. Moreover, this fear was reflected in children's level of arousal in anticipation of CPT performance. This learned association extinguished after performing both CPTs. Effects were not moderated by whether the child observed their mother or a stranger, by the child's pain catastrophizing, trait PRF or trait anxiety. Remarkably, learning effects increased when the child perceived a larger difference between the model's painful and neutral facial expressions. CONCLUSIONS: This study provides evidence for observational learning of PRF and subsequent extinction in schoolchildren. This acquisition of PRF by observing parental pain may contribute to vulnerabilities in children of parents with chronic pain. SIGNIFICANCE: Children may acquire pain-related fear by observing pain in others and this learned fear can diminish after first-hand experience. Remarkably, observational learning did not depend on the children's relationship with the model, but it did depend on the intensity of pain that is perceived. A better understanding of the impact of observing (parental) pain may help clarify the intergenerational transmission of risk for pain and inform the development of preventive programs. SN - 1532-2149 UR - https://www.unboundmedicine.com/medline/citation/31886912/Learning_to_fear_pain_after_observing_another's_pain:_An_experimental_study_in_schoolchildren_ L2 - https://doi.org/10.1002/ejp.1529 DB - PRIME DP - Unbound Medicine ER -