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The Effect of Subliminal Evaluative Conditioning of Cognitive Self-schema and Illness Schema on Pain Tolerance

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Abstract

Background

Cognitive models explaining medically unexplained complaints propose that activating illness-related memory causes increased complaints such as pain. However, our previous studies showed conflicting support for this theory.

Purpose

Illness-related memory is more likely to influence reporting of complaints when its activation is enmeshed with that of self-related memory. We, therefore, investigated whether inducing this association would cause a stronger decrease in pain tolerance. In addition, we examined whether SFA acted as a moderator of this effect.

Methods

We used subliminal evaluative conditioning (SEC) to induce an association between activated self-related and illness-related memory. Seventy-six participants were randomly assigned to four combinations of two priming factors: (1) the self-referent word “I” versus the nonself-referent “X” to manipulate activated self-related memory and (2) health complaint (HC) words versus neutral words to manipulate activated illness-related memory. Pain tolerance was assessed using a cold pressor task (CPT).

Results

Participants primed with the self-referent “I” and HC words did not demonstrate the expected lower pain tolerance. However, SFA acted as a moderator of the main effect of the self-prime: priming with “I” resulted in increased pain tolerance in participants with low SFA.

Conclusions

The current study did not support the hypothesis that associations between activated self-related memory and illness-related memory cause increased reporting of complaints. Instead, activating self-related memory increased pain tolerance in participants with low SFA. This seems to indicate that the self-prime might cause an increase in SFA and suggests possible new ways to promote adaptive coping with pain.

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Acknowledgments

This work was supported by a grant from the Netherlands Organization for Scientific Research (NWO) to J.F.B. The funders did not have any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Clinical, Health and Neuropsychology Unit, Institute of Psychology, Leiden University, P.O. Box 9555, 2300 RB, Leiden, The Netherlands

    Esther E. Meerman, Jos F. Brosschot, Stefanie A. M. van der Togt & Bart Verkuil

Authors
  1. Esther E. Meerman
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  2. Jos F. Brosschot
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  3. Stefanie A. M. van der Togt
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  4. Bart Verkuil
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Corresponding author

Correspondence to Esther E. Meerman.

Appendix

Appendix

Table 3 Prime words used for the complaint versus neutral prime factor
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Meerman, E.E., Brosschot, J.F., van der Togt, S.A.M. et al. The Effect of Subliminal Evaluative Conditioning of Cognitive Self-schema and Illness Schema on Pain Tolerance. Int.J. Behav. Med. 20, 627–635 (2013). https://doi.org/10.1007/s12529-012-9270-1

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