Daily functioning is an important aspect of chronic pain management, particularly for individuals living with complex regional pain syndrome (CRPS). Previous studies have established that emotional support from significant others is beneficial for chronic pain patients. However, emotional support can be discrepant from one’s preference and can also fluctuate. Thus, the present study investigates the role of instability in emotional support discrepancy on the daily functioning of patients with CRPS.

Participants consisted of 21 CRPS patients. Google Forms was used to obtain daily diary ratings over 15 days.The mean square of successive differences was calculated as an indicator of instability of emotional support discrepancy. Statistical analysis was conducted using hierarchical linear modeling.

Hierarchical linear modeling reveals that the moderating effect of instability in emotional support discrepancy on the relationship between daily pain severity daily activity avoidance (coefficient=0.01, t (292)=5.57, p<.001), activity interference (coefficient=0.01, t (292)=5.98, p<.001), distraction (coefficient=0.01, t (292)=5.10, p= .007) was statistically significant.

The results of this study suggest that instability in emotional support discrepancy reduces the buffering effect of emotional support.

Fear-avoidance model for pain suggests interpretation bias affects subsequent pain experience. However, limited research has been conducted on the role of interpretation bias in a subjective pain experience. The purpose of this study was to investigate the efficacy of interpretation bias modification for pain outcomes (i.e., pain intensity, threshold, and tolerance).

53 healthy university students were randomly assigned to either the training (n=28) or the control group (n=25). Interpretation bias and negative emotion were assessed before and after conducting the interpretation bias modification for pain (IBM-P). During a cold pressor task, pain outcomes were measured.

Results indicated that the training group showed significantly decreased interpretation bias and negative emotion than the control group after the IBM-P. Also, participants in the training group was found to have a greater pain threshold during the cold pressor task than those in the control group. Furthermore, the IBM-P effect on increased pain threshold was mediated by post-interpretational bias. Other pain outcomes and mediating effect of post-interpretational bias on the negative emotion were not significant.

Results highlight that interpretation bias is modifiable and plays an important role in pain outcomes. Thus, using IBM-P for pain patients can be a useful application to alleviate their pain outcomes. Future research should consider the precise role of interpretation bias that affects patient’s pain outcomes.

According to the fear-avoidance model, pain becomes chronic when it is related to fear and avoidance behavior. When a pain-related threat occurs, humans instinctively use avoidance behavior strategies. However, the support of significant others is likely to inhibit avoidance behavior even with the same pain-related threat stimulus. Thus, in this study, we examined the effects of pain-related threats and social support of romantic partner on avoidance behavior inhibition.

Participants consisted of 80 pairs of healthy undergraduate couples, and were randomly assigned to one of four group conditions in a 2×2 factorial design, with threat level (high/low) and social support (presence/absence) as factors.

The results of the experiment indicated a significant interaction between threat level and social support. Specifically, in the high-threat condition, when social support was provided, task delay time was significantly shorter than when no social support was provided. On the other hand, in the low-threat condition, the time delay difference between high- and low- social support group was not significant. Moreover, social support did not affect fear reduction.

These results indicate that avoidance behaviors, which are instinctive responses to pain, can be inhibited by social support. This result would enhance understanding of the factors that have not been described in the fear-avoidance model in the pain-chronicization process, and will help expand and improve the model. We also discuss possible limitations of the study and scope for further studies.

The purpose of this study was to examine the effects of monetary motivation on the relationship between pain-related fear and avoidance behavior.

Eighty healthy volunteers were randomly assigned to one of four groups in accordance with task conditions of pain-related fear (high or low) and monetary motivation (high or low).

The autonomic nervous system was more active in the high pain-related fear group than in the low pain-related fear group as the participants watched a video and performed a task. Also, pain-related fear and monetary motivation had a significant interaction effect on avoidance behavior. High monetary motivation was associated with a shorter delay time during task performance in the high pain-related fear group. No significant difference was observed in the delay time in the low pain-related fear group.

This study provides empirical evidence supporting the modified fear-avoidance model and experimentally proves the activation of the goal shielding mechanism.