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Pavlov's Pain: the Effect of Classical Conditioning on Pain Perception and its Clinical Implications
Zhang, Libo1,2; Lu, Xuejing1,2; Bi, Yanzhi1,2; Hu, Li1,2,3
First AuthorZhang, Libo
2019-03-01
Source PublicationCURRENT PAIN AND HEADACHE REPORTS
Correspondent Emailxuejing lu(luxj@psych.ac.cn) ; li hu(huli@psych.ac.cn)
ISSN1531-3433
Subtypearticle
Volume23Issue:3Pages:12
Contribution Rank1
Abstract

Purpose of ReviewIt has been known for decades that classical conditioning influences pain perception. However, the precise relationship between conditioning and pain remains unclear. In addition, the clinical implications of their relationship are vastly underappreciated. Thus, we aim to (a) examine how conditioning increases or decreases pain sensitivity, (b) assess how conditioning contributes to the development and maintenance of chronic pain, and (c) explore strategies to utilize conditioning to optimize pain treatment.Recent FindingsWe first review studies regarding how classical conditioning alters pain perception with an emphasis on two phenomena where conditioning increases pain sensitivity (i.e., conditioned hyperalgesia) or decreases it (i.e., conditioned hypoalgesia). Specifically, we critically examine empirical studies about conditioned hyperalgesia and conditioned hypoalgesia, explore reasons why conditioning leads to these two seemingly opposite phenomena, and discuss the neural mechanisms behind them. We then highlight how conditioning contributes to the development and maintenance of chronic pain, and present neuroscientific evidence for maladaptive aversive conditioning in chronic pain patients. Moreover, we propose a framework for understanding how to exploit conditioning to optimize pain treatment, including minimizing conditioned hyperalgesia, maximizing conditioned hypoalgesia, and eliminating excessive fear and overgeneralization in chronic pain.SummaryClassical conditioning profoundly modulates the experience of pain and affects the development and maintenance of chronic pain. The relationship between them has far-reaching clinical implications in pain treatment. Further investigations should tackle crucial issues in previous studies, including the complex relationship between conditioning and explicit expectation, and a lack of relevant clinical studies. Resolving these issues, future research would advance our understanding of the nature of pain, help relieve the suffering of patients, and thus contribute to promoting human flourishing.

KeywordClassical conditioning Conditioned hyperalgesia Conditioned hypoalgesia Chronic pain Clinical implications
DOI10.1007/s11916-019-0766-0
Indexed BySCI
Language英语
Funding ProjectScientific Foundation project of Institute of Psychology, Chinese Academy of Sciences[KLMH2018ZG02] ; Informatization Special Project of Chinese Academy of Sciences[XXH13506-306] ; National Natural Science Foundation of China[31701000] ; National Natural Science Foundation of China[31822025] ; Scientific Foundation project of Institute of Psychology, Chinese Academy of Sciences[Y6CX021008] ; National Natural Science Foundation of China[31671141]
WOS Research AreaNeurosciences & Neurology
WOS SubjectClinical Neurology
WOS IDWOS:000460431100001
PublisherSPRINGER
WOS KeywordEXPOSURE IN-VIVO ; LOW-BACK-PAIN ; CHRONIC MUSCULOSKELETAL PAIN ; MOVEMENT-RELATED PAIN ; FEAR-AVOIDANCE MODEL ; PARTIAL-REINFORCEMENT ; NOCEBO HYPERALGESIA ; DECLARATIVE MEMORY ; LATENT INHIBITION ; NONCONSCIOUS ACTIVATION
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Document Type期刊论文
Identifierhttp://ir.psych.ac.cn/handle/311026/28603
Collection中国科学院心理健康重点实验室
Corresponding AuthorLu, Xuejing; Hu, Li
Affiliation1.Chinese Acad Sci, CAS Key Lab Mental Hlth, Inst Psychol, Beijing, Peoples R China
2.Univ Chinese Acad Sci, Dept Psychol, Beijing, Peoples R China
3.Guangzhou Med Univ, Affiliated Hosp 2, State Key Clin Specialty Pain Med, Dept Pain Management, Guangzhou, Guangdong, Peoples R China
Recommended Citation
GB/T 7714
Zhang, Libo,Lu, Xuejing,Bi, Yanzhi,et al. Pavlov's Pain: the Effect of Classical Conditioning on Pain Perception and its Clinical Implications[J]. CURRENT PAIN AND HEADACHE REPORTS,2019,23(3):12.
APA Zhang, Libo,Lu, Xuejing,Bi, Yanzhi,&Hu, Li.(2019).Pavlov's Pain: the Effect of Classical Conditioning on Pain Perception and its Clinical Implications.CURRENT PAIN AND HEADACHE REPORTS,23(3),12.
MLA Zhang, Libo,et al."Pavlov's Pain: the Effect of Classical Conditioning on Pain Perception and its Clinical Implications".CURRENT PAIN AND HEADACHE REPORTS 23.3(2019):12.
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