Expectancy variables predicting tolerance and avoidance of pain in chronic pain patients

Previous research on anxiety and some recent reports on chronic pain suggest that the response to aversive stimuli may be influenced by expectations rather than actual experience. This study examined the contributions of four expectancy-related variables to the tolerance and avoidance of pain: pain expectancy, response expectancy, self-efficacy expectancy, and danger expectancy. Chronic pain sufferers volunteered to undergo cold presser pain on two trials (the first for practice, and the second to determine tolerance) and then faced the prospect of a third trial (to determine avoidance). It was found that expected tolerance (or response expectancy) significantly predicted actual tolerance, whereas expected danger significantly predicted avoidance. These findings are in partial agreement with previous research. Among the clinical implications are that chronic pain sufferers generally associate pain with damage and they predict their pain tolerance well; they do not necessarily escape from a compulsory activity that produces pain, but given the chance they would rather avoid it in the first place. (C) 1997 Elsevier Science Ltd.