Coping with and attention to pain from
a self-regulation perspective
Stefaan Van Damme
Ghent University
Department of Experimental-Clinical and Health Psychology
[email protected]
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
How to cope with pain?
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
(Vlaeyen & Linton, 2000)
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
(Source: Hasenbring, Rusu & Hallner)
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Self-regulation
IDEAL SELF
be pain-free
avoid painevoking
activities
take
painkillers
be social
go out with
friends
be caring
engage in
football club
be successful
play with
the kids
work hard
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Investigating the relations between pain
control and other goals
(Lauwerier et al., in prep)
+ how necessary is pain
control to attain other goals?
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Results (N= 73 chronic pain patients)
Pain control interferes with
other goals
Pain control facilitates other
goals
Pain control is necessary to
attain other goals
% patients scoring 4
(often) or 5 (very often)
50
80
60
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Interference
Acceptance
Facilitation
Problem solving
Pain control
= necessary
Distress
Pain catastrophizing
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012




Aim: investigating role of contextual goals in avoidanceendurance behaviour
Participants: 56 undergraduate students
Procedure: Random presentation of trials from a painrelated task and a neutral task
Participants free choice to perform or avoid trials
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
LOW TASK
MOTIVATION GROUP
PAIN TASK
HIGH TASK
MOTIVATION GROUP
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Correlation with
FEAR OF PAIN
STIMULUS
Number of pain trials performed
p < .05
r = -0.23 (ns)
30
High
Motivation
r = -0.67 (p < .001)
20
Low
Motivation
*
10
0
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Van Damme et al., 2010, Neurosci Biobehav Rev
Legrain et al., 2009, Pain
GOALS
avoidance
endurance
pain and
pain-related
information
non-painrelated
information
hypervigilance
hypovigilance
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
GOAL TO AVOID PAIN
 Sample: 41 undergraduate students
 Attentional bias task: visual search paradigm in
which one of the stimuli is a pain cue
 One group instructed to avoid pain, the other
group not
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Even stronger attentional bias
in “pain
avoidance
group”
Experimental
group
1800
1800
1700
1700
1600
1600
1500
1500
1400
valid
1300
invalid
1200
baseline
1100
Mean RT
Mean RT
Typical attentional bias in
“no painControl
avoidance
groupgroup”
1400
valid
1300
invalid
1200
baseline
1100
1000
1000
900
900
800
800
3
5
7
3
5
7
Goal to avoid pain enhances attentional
bias to pain-related stimuli!
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
NON-PAIN GOAL
 Sample: 58 undergraduate students
 Attentional bias task: spatial cueing task in which
one cue is predictive of a pain stimulus
 One group receives monetary reward for
engaging in additional task, the other group not
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Typical attentional
bias to pain
SUPPRESSION OF
ATTENTIONAL
BIAS TO PAIN
SHIELDING GOAL
FROM PAIN
INTERFERENCE?
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012
Conclusions
1. Pain behaviour and coping should
be understood within a goalregulation perspective
2. Strong activation of the goal to
avoid/control pain increases disability and
distress, and promotes hypervigilance
3. Strong activation of non-pain goal
increases task persistence and suppresses
attention to pain-related information
S. Van Damme – SIG Pain Mind Movement – Nottwil 2012