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      Learning to predict and control harmful events: chronic pain and conditioning.

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      Pain

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          Abstract

          Pain is a biologically relevant signal and response to bodily threat, associated with the urge to restore the integrity of the body. Immediate protective responses include increased arousal, selective attention, escape, and facial expressions, followed by recuperative avoidance and safety-seeking behaviors. To facilitate early and effective protection against future bodily threat or injury, learning takes place rapidly. Learning is the observable change in behavior due to events in the internal and external environmental and includes nonassociative (habituation and sensitization) and associative learning (Pavlovian and operant conditioning). Once acquired, these knowledge representations remain stored in memory and may generalize to perceptually or functionally similar events. Moreover, these processes are not just a consequence of pain; they may directly influence pain perception. In contrast to the rapid acquisition of learned responses, their extinction is slow, fragile, context dependent and only occurs through inhibitory processes. Here, we review features of associative forms of learning in humans that contribute to pain, pain-related distress, and disability and discuss promising future directions. Although conditioning has a long and honorable history, a conditioning perspective still might open new windows on novel treatment modalities that facilitate the well-being of individuals with chronic pain.

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          Author and article information

          Journal
          Pain
          Pain
          1872-6623
          0304-3959
          Apr 2015
          : 156 Suppl 1
          Affiliations
          [1 ] aResearch Group Health Psychology, University of Leuven, KU Leuven, Belgium bCenter of Excellence on Generalization Research in Ill Health and Psychopathology, University of Leuven, KU Leuven, Belgium cDepartment of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands.
          Article
          00006396-201504001-00012
          10.1097/j.pain.0000000000000107
          25789440
          023857d8-d84a-4470-afc8-74d766dfd728
          History

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