The goal of the present study is to compare different therapeutic strategies (according to habituation model vs. according to the inhibitory learning approach) during exposure to thermal pain in an experimental design.
Exposure therapy is effective for the treatment of individuals with chronic pain and high levels of fear-avoidance. Nevertheless, mechanisms of change for exposure treatment are not sufficiently investigated. According to the habituation model, the activation of a fear structure leads to a habituation of the initial physical response. Therefore, the therapeutic recommendation is to focus on the reduction of fear during exposure sessions. According to the inhibitory learning approach, however, exposure experiences compete with the original US-CS fear association. Therefore, the therapist should maximize the violation of negative expectancies. The present study intends to compare both strategies during the exposure to pain in an experimental design.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
139
Exposure instruction focuses on fear reduction during exposure sessions
Exposure instruction focuses on expectation violation during exposure sessions
Philipps University Marburg, Department of Clinical Psychology and Psychotherapy
Marburg, Germany
Pain tolerance
Determined by the temperature at which the participant stopped the heat stimulus
Time frame: 5 minutes prior and 5 minutes after three exposure practice trials
Pain intensity
Measured on an 11-point scale (0 = no pain; 10 = worst imaginable pain)
Time frame: 5 minutes prior and 5 minutes after three exposure practice trials
Pain quality
Measured on an 11-points scale (0 = bearable; 10 = unbearable)
Time frame: 5 minutes prior and 5 minutes after three exposure practice trials
Pain Catastrophizing Scale (PCS)
Pain catastrophizing thoughts (e.g. "I worry all the time about whether the pain will end.")
Time frame: 1-week prior and 10 minutes after three exposure practice trials
Pain Anxiety Symptom Scale (PASS)
Pain-related anxiety (e.g. "I worry when I am in pain.")
Time frame: 1-week prior and 10 minutes after three exposure practice trials
Pain Processing (Fragebogen zur Erfassung der Schmerzverarbeitung, FESV)
Cognitive pain coping strategies (e.g. "When I am in pain, I know several possibilities how to handle them.")
Time frame: 1-week prior and 10 minutes after three exposure practice trials
Psychophysiological activation
e.g. skin conductance responses, heart rate
Time frame: throughout the experiment (5 minutes prior, during and 10 minutes after three exposure practice trails
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