Could Stress Contribute to Pain-Related Fear in Chronic Pain?

摘要: Learning to predict pain based on internal or external cues constitutes a fundamental and highly adaptive process aimed at self-protection. Pain-related fear is an essential component of this response, which formed by associative instrumental learning processes. In chronic pain, pain-related may become maladaptive, drive avoidance behaviors contribute symptom chronicity. Pavlovian conditioning has proven fruitful elucidate extinction involving aversive stimuli, including but studies in remain scarce. Stress demonstrably exerts differential effects emotional memory processes, not been transferred fear. Within perspective, we propose that stress could impaired processes call for interdisciplinary research. Specifically, suggest test the hypotheses that: (1) extinction-related phenomena inducing re-activation maladaptive (e.g., reinstatement, renewal) likely occur everyday life patients alter processing, impair perceptual discrimination favor overgeneralization; (2) acute prior during acquisition facilitate formation and/or consolidation memories; (3) after efficacy resulting greater reinstatement context-dependent renewal fear; (4) these be amplified due early adversity psychiatric comorbidity such depression anxiety with pain.