PAInful Decisions - How chronic pain affects daily decision-making

ended

Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain, multiple tender points, fatigue, and impaired mental functioning. Best practice interventions for chronic pain typically include effortful exercise and long-term treatment – i.e., short-term costs (effort) with delayed benefit (improved pain and function). Problematically, adherence to these treatments is often low, suggesting that people with chronic pain may have altered decision-making related to delayed and effortful rewards. Understanding if long-term pain influences decision-making, what aspects of long-term pain contribute most to decision-making (e.g., emotional versus physical), and the neural underpinnings, are essential given clear relevance of altered decision-making to the adherence to evidence-based management strategies. The PAInful Decisions (PAID) project will address these critical aspects by evaluating delay and effort attitudes in those experiencing FM and in a group of matched pain-free controls. Additionally, I will investigate the unique role of emotions and bodily sensation perception as potential contributing factors to altered decision-making involving delayed and effortful gratification. PAID is a highly innovative and interdisciplinary project, integrating approaches from experimental psychology, behavioural economics, clinical practice, psychophysiology, and neuroimaging. This way, I will be able to comprehensively investigate the role of body-brain interactions in the context of chronic pain. Such a systematic, selective, and interdisciplinary approach to study decision-making in chronic pain is a considerable research challenge, yet the results have an essential meaning for patients’ life and clinical practice, offering to move basic and applied science forward.