• Jonas Zaman, Victoria J Madden, Julie Iven, Katja Wiech, Nathalie Weltens, Huynh Giao Ly, VlaeyenJohan W SJWSHealth Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Department Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands., Lukas Van Oudenhove, and Ilse Van Diest.
• Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium. Electronic address: jonas.zaman@kuleuven.be.
• J Pain. 2017 Oct 1; 18 (10): 1197-1208.

AbstractA growing body of research has identified fear of visceral sensations as a potential mechanism in the development and maintenance of visceral pain disorders. However, the extent to which such learned fear affects visceroception remains unclear. To address this question, we used a differential fear conditioning paradigm with nonpainful esophageal balloon distensions of 2 different intensities as conditioning stimuli (CSs). The experiment comprised of preacquisition, acquisition, and postacquisition phases during which participants categorized the CSs with respect to their intensity. The CS+ was always followed by a painful electrical stimulus (unconditioned stimulus) during the acquisition phase and in 60% of the trials during postacquisition. The second stimulus (CS-) was never associated with pain. Analyses of galvanic skin and startle eyeblink responses as physiological markers of successful conditioning showed increased fear responses to the CS+ compared with the CS-, but only in the group with the low-intensity stimulus as CS+. Computational modeling of response times and response accuracies revealed that differential fear learning affected perceptual decision-making about the intensities of visceral sensations such that sensations were more likely to be categorized as more intense. These results suggest that associative learning might indeed contribute to visceral hypersensitivity in functional gastrointestinal disorders.Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

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