The effects of failing to control pain: an experimental investigation
Abstract
Chronic pain patients are often confronted with repeated failure to achieve pain relief. The aim of this study was to experimentally investigate the effects of repeated failing attempts to control pain on pain impact (pain intensity, emotional and physiological responses). Perceived control over an electrocutaneous pain stimulus was manipulated between subjects by success or failure feedback on a task by which control over pain could be acquired. In addition, success or failure at the task was manipulated without suggesting a possibility to control pain. It was hypothesized that successful control would lead to lowest pain impact, whereas failure to control pain would lead to even higher pain impact than absent control. Furthermore, it was hypothesized that failure feedback would increase pain impact when compared to success feedback. Results indicated that repeated failure to control pain increased anger and heart rate responses compared to the other conditions, but not pain intensity. It is concluded that persistent efforts to control pain in the face of failure may lead to the maintenance or exacerbation of physiological and emotional responses.
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Attempts to reduce or eliminate intrinsic chronic symptoms have been reported to be futile or even detrimental.
“attempts to reduce or eliminate the intrinsic chronic symptoms of the disease have been reported to be futile or even detrimental (Janssen et al., 2004; McCracken et al., 2007; Jensen et al., 2012; Bushnell et al., 2013; Hughes et al., 2017).”
From Acceptance and commitment therapy reduces psychological distress in patients with cancer: a systematic review and meta-analysis of randomized controlled trials (2024) · cites this paper as Janssen et al., 2004
Cites
(1970) · Cited by 24,983 · see citing works
Generalized expectancies for internal versus external control of reinforcement.
Rotter, J. B. (1966) · Psychological Monographs: General and Applied · doi:10.1037/h0092976 · Cited by 21,937 · see citing works
Learned helplessness in humans: Critique and reformulation.
Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.87.1.49 · Cited by 7,121 · see citing works
STAI manual for the State-trait anxiety inventory
Cd, S. (1970) · Medical Entomology and Zoology · Cited by 2,433 · see citing works
Perception and the Conditioned Reflex
Hay, J. C., & Sokolov, Y. N. (1966) · The American Journal of Psychology · doi:10.2307/1420734 · Cited by 2,122 · see citing works
Pain demands attention: A cognitive–affective model of the interruptive function of pain.
Eccleston, C., & Crombez, G. (1999) · Psychological Bulletin · doi:10.1037/0033-2909.125.3.356 · Cited by 1,718 · see citing works
Will it hurt less if I can control it? A complex answer to a simple question.
Thompson, S. C. G. (1981) · Psychological Bulletin · doi:10.1037/0033-2909.90.1.89 · Cited by 1,083 · see citing works
Distraction and coping with pain.
McCaul, K. D., & Malott, J. M. (1984) · Psychological Bulletin · doi:10.1037/0033-2909.95.3.516 · Cited by 713 · see citing works
Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain
McCracken, L. M. (1998) · Pain · doi:10.1016/s0304-3959(97)00146-2 · Cited by 685 · see citing works
Stress, personal control and health.
Steptoe, A., & Appels, A. (1989) · Cited by 599 · see citing works
Controllability and human stress: Method, evidence and theory
Miller, S. M. (1979) · Behaviour Research and Therapy · doi:10.1016/0005-7967(79)90001-9 · Cited by 426 · see citing works
The Impact of Acceptance Versus Control Rationales on Pain Tolerance
Hayes, S. C., Bissett, R. T., Korn, Z., Zettle, R. D., Rosenfarb, I. S., Cooper, L. D., & Grundt, A. M. (1999) · The Psychological Record · doi:10.1007/bf03395305 · Cited by 388 · see citing works
Distinguishing among Orienting, Defense, and Startle Reflexes
Graham, F. K. (2021) · Routledge eBooks · doi:10.4324/9781003171409-10 · Cited by 354 · see citing works
Pain and aggression: Some findings and implications
Berkowitz, L. (1993) · Motivation and Emotion · doi:10.1007/bf00992223 · Cited by 309 · see citing works
Depression and distortion in the attribution of causality.
Rizley, R. C. (1978) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.87.1.32 · Cited by 296 · see citing works
The scope and significance of anger in the experience of chronic pain
Fernández, E., & Turk, D. C. (1995) · Pain · doi:10.1016/0304-3959(95)00192-u · Cited by 281 · see citing works
The effects of induced mood on laboratory pain.
Zelman, D. C., Howland, E. W., Nichols, S. N., & Cleeland, C. S. (1991) · Pain · doi:10.1016/0304-3959(91)90040-5 · Cited by 247 · see citing works
Self-control and predictability: Their effects on reactions to aversive stimulation.
Staub, E., Tursky, B., & Schwartz, G. E. (1971) · Journal of Personality and Social Psychology · doi:10.1037/h0030851 · Cited by 244 · see citing works
Worrying about chronic pain: vigilance to threat and misdirected problem solving.
Aldrich, S., Eccleston, C., & Crombez, G. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00062-5 · Cited by 220 · see citing works
Risdon, A., Eccleston, C., Crombez, G., & McCracken, L. M. (2002) · Social Science & Medicine · doi:10.1016/s0277-9536(02)00043-6 · Cited by 210 · see citing works
Customizing Treatment for Chronic Pain Patients
Turk, D. C. (1990) · Clinical Journal of Pain · doi:10.1097/00002508-199012000-00002 · Cited by 204 · see citing works
Turpin, G. (1986) · Psychophysiology · doi:10.1111/j.1469-8986.1986.tb00583.x · Cited by 183 · see citing works
Okifuji, A., Turk, D. C., & Curran, S. L. (1999) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(99)00006-9 · Cited by 162 · see citing works
Anxiety and pain: attentional and endorphinergic influences
Janssen, S. A., & Arntz, A. R. (1996) · Pain · doi:10.1016/0304-3959(96)03031-x · Cited by 119 · see citing works
van den Hout, J. H. C., Vlaeyen, J. W. S., Houben, R. M. A., Soeters, A. P. M., & Peters, M. L. (2001) · Pain · doi:10.1016/s0304-3959(01)00261-5 · Cited by 88 · see citing works
Experimentally induced anger, cardiovascular reactivity, and pain sensitivity
Janssen, S. A., Spinhoven, P., & BROSSCHOT, J. F. (2001) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00222-7 · Cited by 80 · see citing works
Subject versus experimenter control in the reaction to pain
Weisenberg, M., Wolf, Y., Mittwoch, T., Mikulincer, M., & Aviram, O. (1985) · Pain · doi:10.1016/0304-3959(85)90059-4 · Cited by 67 · see citing works
Feldner, M. T., & Hekmat, H. M. (2001) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(01)00034-9 · Cited by 66 · see citing works
Perceived control and the experience of pain.
Arntz, A. R., & Schmidt, A. J. M. (1989) · Cited by 52 · see citing works
Failure hurts: the effects of stress due to difficult tasks and failure feedback on pain report
Levine, F. M., Krass, S., & Padawer, W. J. (1993) · Pain · doi:10.1016/0304-3959(93)90034-m · Cited by 34 · see citing works
Does failure hurt? The effects of failure feedback on pain report, pain tolerance and pain avoidance
van den Hout, J. H. C., Vlaeyen, J. W. S., Peters, M. L., Engelhard, I. M., & van den Hout, M. (2000) · European Journal of Pain · doi:10.1053/eujp.2000.0195 · Cited by 28 · see citing works
Flagged first, then by citations
5 of the 36 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
The biopsychosocial approach to chronic pain: Scientific advances and future directions.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.4.581 · Cited by 3,392 · see citing works
Consequences of Inadequate Postoperative Pain Relief and Chronic Persistent Postoperative Pain
Joshi, G. P., & Ogunnaike, B. O. (2005) · Anesthesiology Clinics of North America · doi:10.1016/j.atc.2004.11.013 · Cited by 620 · see citing works
“Prolonged and unrelieved pain can lead to the expression of anger and resentment, especially when it is believed that treatment is being withheld [19].”
BackgroundWiech, K., Kalisch, R., Weiskopf, N., Pleger, B., Stephan, K. E., & Dolan, R. J. (2006) · The Journal of Neuroscience · doi:10.1523/jneurosci.2568-06.2006 · Cited by 323 · see citing works
“In line with our self report data, previous behavioral studies have shown that perceived control decreases the subjective pain intensity and increases pain tolerance (Staub et al., 1971; Maier and Watkins, 1998; Feldner and Hekmat, 2001) (but see Janssen et al., 2004; Salomons et al., 2004).”
ResultVowles, K. E., McNeil, D. W., Gross, R. T., McDaniel, M. L., Mouse, A., Bates, M., Gallimore, P., & McCall, C. (2007) · Behavior Therapy · doi:10.1016/j.beth.2007.02.001 · Cited by 116 · see citing works
The Fear of Pain Questionnaire (FPQ): Further psychometric examination in a non-clinical sample
Roelofs, J., Peters, M. L., Deutz, J., Spijker, C., & Vlaeyen, J. W. S. (2005) · Pain · doi:10.1016/j.pain.2005.05.003 · Cited by 114 · see citing works
“Further, future research of the role of (perceived) control on the pain experience by manipulating control over pain and to examine the influence on the pain experience is warranted (Janssen et al., 2004).”
BackgroundThe effect of pain‐related fear on sexual arousal in women with superficial dyspareunia
Brauer, M., Kuile, M. M. L., Janssen, S. A., & Laan, E. T. M. (2007) · European Journal of Pain · doi:10.1016/j.ejpain.2006.12.006 · Cited by 111 · see citing works
“These pain stimuli produce a painful, stinging sensation, which is unlike shocks caused by electrical fencing, electric mains, etc., and have been used in several experimental studies (e.g., Janssen and Arntz, 1997; Janssen et al., 1998; Janssen et al., 2004).”
BackgroundMethodAn evaluation of the measurement of pain catastrophizing by the coping strategies questionnaire
Hirsh, A. T., George, S. Z., Riley, J. L., & Robinson, M. E. (2006) · European Journal of Pain · doi:10.1016/j.ejpain.2005.12.010 · Cited by 103 · see citing works
Crombez, G., Eccleston, C., De Vlieger, P., Van Damme, S., & De Clercq, A. (2008) · Pain · doi:10.1016/j.pain.2007.10.028 · Cited by 68 · see citing works
Noise within the social context: Annoyance reduction through fair procedures
Maris, E., Stallen, P. J. M., Vermunt, R. C., & Steensma, H. (2007) · The Journal of the Acoustical Society of America · doi:10.1121/1.2535507 · Cited by 65 · see citing works
Perceived control alters the effect of acute stress on persistence.
Bhanji, J. P., Kim, E. S., & Delgado, M. R. (2016) · Journal of Experimental Psychology General · doi:10.1037/xge0000137 · Cited by 58 · see citing works
Du, S., Dong, J., Jin, S., Zhang, H., & Zhang, Y. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.09.022 · Cited by 48 · see citing works
Jiang, X., Sun, J., Song, R., Wang, Y., Li, J., & Shi, R. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1253266 · Cited by 43 · see citing works
Both, S., Brauer, M., Weijenborg, P. T. M., & Laan, E. T. M. (2017) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2017.03.244 · Cited by 37 · see citing works
“The pain stimulus produces a painful, stinging sensation and has been used in several experimental studies.(17,29,30) The intensity of the US was set at a level that the participant described as painful and demanding some effort to tolerate.”
Impact of controllability on pain and suffering
Löffler, M., Kamping, S., Brunner, M., Bustan, S., Kleinböhl, D., Anton, F., & Flor, H. (2018) · PAIN Reports · doi:10.1097/pr9.0000000000000694 · Cited by 35 · see citing works
“This is in line with a study showing that changes in SCR were not associated with the failure to control pain.(28) This study, however, also showed that changes in HRwere associated with the failure to control pain.”
Vancleef, L. M. G., & Peters, M. L. (2011) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2011.05.006 · Cited by 35 · see citing works
“Janssen, Spinhoven, and Arntz (2004) demonstrated that successful control over pain has a positive influence on individuals’ mood.”
Efficacy of non-opioid analgesics to control postoperative pain: a network meta-analysis
Carter, J. A., Black, L. K., Sharma, D., Bhagnani, T., & Jahr, J. S. (2020) · BMC Anesthesiology · doi:10.1186/s12871-020-01147-y · Cited by 26 · see citing works
Acute Painful Stress and Inflammatory Mediator Production
Griffis, C. A., Breen, E. C., Compton, P. A., Goldberg, A. R., Witarama, T., Kotlerman, J. B., & Irwin, M. R. (2013) · NeuroImmunoModulation · doi:10.1159/000346199 · Cited by 25 · see citing works
Controllability and hippocampal activation during pain expectation in fibromyalgia syndrome
González‐Roldán, A. M., Bomba, I. C., Diesch, E., Montoya, P., Flor, H., & Kamping, S. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.09.007 · Cited by 24 · see citing works
Psychiatric and physical comorbidities and pain in patients with multiple sclerosis
Scherder, R. J., Kant, N., Wolf, E. T., Pijnenburg, B. A. C. M., & Scherder, E. (2018) · Journal of Pain Research · doi:10.2147/jpr.s146717 · Cited by 22 · see citing works
“41 In the Janssen et al study, not being able to manage pain caused several stress-related physiological reactions, like an increase in heart rate response.”
Styles of Pain Coping Predict Cardiovascular Function Following a Cold Pressor Test
Edwards, R. R., & Fillingim, R. B. (2005) · Pain Research and Management · doi:10.1155/2005/216481 · Cited by 19 · see citing works
“Paralleling the results, other laboratory studies have shown that increasing the uncontrollability of pain (a feature of catastrophizing) produces increases in cardiac reactivity (32).”
ResultChanges in pain-related fear and pain when avoidance behaviour is no longer effective.
van Vliet, C. V., Meulders, A., Vancleef, L., Meyers, E., & Vlaeyen, J. (2020) · Journal of Pain · doi:10.1016/j.jpain.2019.09.002 · Cited by 14 · see citing works
Ruehlman, L. S., Karoly, P., & Pugliese, J. (2010) · Pain Medicine · doi:10.1111/j.1526-4637.2010.00933.x · Cited by 17 · see citing works
Robinson, J. P., Dansie, E. J., Wilson, H., Rapp, S. E., & Turk, D. C. (2015) · Pain Medicine · doi:10.1111/pme.12770 · Cited by 16 · see citing works
Neuropsychological effects of hostility and pain on emotion perception
Mitchell, G. A., & Harrison, D. W. (2009) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390902889614 · Cited by 15 · see citing works
Pagé, M. G., Dassieu, L., Develay, É., Roy, M., Vachon‐Presseau, É., LUPIEN, S. J., & Rainville, P. (2020) · Pain Medicine · doi:10.1093/pm/pnaa370 · Cited by 13 · see citing works
“Sense of control: Experimental studies suggest that an enhanced sense of control over pain does not reduce pain intensity but rather lessens the affective dimension of pain (25-28).”
BackgroundThe physiatric approach to low back pain
Stanos, S. P., Muellner, P. M., & Harden, R. N. (2004) · Seminars in Pain Medicine · doi:10.1016/j.spmd.2004.08.006 · Cited by 7 · see citing works
Ghaffari, A., Jørgensen, M. K., Rømer, H., Sørensen, M. P. B., Kold, S., Rahbek, O., & Bisgaard, J. (2021) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2021-0029 · Cited by 2 · see citing works
Cercles vicieux et greffe douloureuse
Benezech, J.-P., & Giniès, P. (2005) · Douleur et Analgésie · doi:10.1007/bf03014558 · Cited by 2 · see citing works
Treister, R., Emergui, G., Agostinho, M. R., Khashan, M., & Hochberg, U. (2026) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2026.112694 · Cited by 1 · see citing works
Stanos, S. P., Tyburski, M. D., & Harden, R. N. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-0884-4.10042-4 · Cited by 1 · see citing works
Benezech, J.-P. (2004) · Douleurs Évaluation - Diagnostic - Traitement · doi:10.1016/s1624-5687(04)94517-9 · Cited by 1 · see citing works
Frew, A. K. (2008) · Murdoch University Research Portal
Hager, K. K. (2006) · UKnowledge (University of Kentucky)
Busch, H. (2007)
Berquin, A., & Grisart, J. (2016) · Les défis de la douleur chronique · doi:10.3917/mard.berq.2016.01.0515
When pain remains: Appraisals and adaptation
Busch, H. (2007) · PsycEXTRA Dataset · doi:10.1037/e529842013-001
- Authors
- Janssen, S. A., Spinhoven, P., & Arntz, A.
- Affiliations
- Leiden University (NL)
- Maastricht University (NL)
- Corresponding author
- Spinhoven, Philip
- Venue
- Pain
- Published
- 2004-02
- Volume
- 107
- Issue
- 3
- Pages
- 227-233
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2082081067
- Cited by
- 38
- References
- 36
- Citations by year
- 2026: 1 · 2024: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 3 · 2015: 2 · 2013: 1
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic pain, pain management, pain impact, pain intensity, anger, heart rate, feedback, pain maintenance
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Affect, Attention, Biofeedback, Psychology, Chronic Disease, Electric Stimulation, Female, Galvanic Skin Response, Heart Rate, Humans, Male, Pain, Pain Measurement, Regression Analysis, Stress, Psychological, Pain Threshold
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