Abstract:

Fear of pain (FOP), an experience associated with pain catastrophizing beliefs and interpretations of actual and potential pain as threat to body tissue, plays an important role in the development and maintenance of chronic pain. Recent evidence has found fear of pain can be acquired through associative learning, observational learning and verbal threat information. Acquired fear of pain can generalized new stimuli sharing features with original fear stimuli. Fortunately, fear of pain can be reduced successfully by extinction procedures including in vivo graded exposure to laboratory and “real-world” pain sensations. Brain regions including the amygdale, insula, and anterior cingulate cortex, are involved in the acquisition, extinction and reinstatement of FOP. Future research should investigate how FOP is reinstated and reconsolidated after its extinction neural mechanisms underpinning the phenomenon, and treatment implications to patients with chronic pain.

Key words: fear of pain, acquisition, generalization, extinction, pain-relevant fear conditioning paradigm