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Updated: Sep 27, 2025

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How expectancy violations facilitate learning to cope with pain - An experimental approach
Tobias Kube1, Karoline Körfer2, Jenny Riecke2
1Pain and Psychotherapy Research Lab, University of Koblenz-, Landau, Germany.
Journal of Psychosomatic Research
|April 7, 2022
Summary
People adjust pain expectations differently when pain decreases are expected versus unexpected. Confirming pain expectations led to lower perceived pain and greater expectation adjustment, while unexpected decreases showed longer-term benefits for pain coping.
Area of Science:
- Psychology
- Neuroscience
- Pain Research
Background:
- Pain expectations significantly influence the chronic pain experience.
- Understanding how individuals revise pain expectations after disconfirming experiences is clinically relevant.
Purpose of the Study:
- To investigate how individuals adjust their pain expectations when experiencing decreasing pain, comparing expected versus unexpected scenarios.
- To examine the impact of expectation confirmation versus disconfirmation on pain perception and expectation adjustment.
Main Methods:
- A randomized between-subjects design was employed with participants experiencing painful thermal stimulations.
- Participants were assigned to either an expectation-confirmation group (decreasing pain was expected) or an expectation-disconfirmation group (decreasing pain was unexpected).
Main Results:
- Lower perceived pain intensity was reported in the expectation-confirmation group compared to the expectation-disconfirmation group.
- Greater adjustment of pain expectations occurred in the expectation-confirmation condition.
- Significant expectation violations, regardless of group, were linked to enhanced pain tolerance and coping abilities at one-week follow-up.
Conclusions:
- Perceived pain intensity is assimilated towards pre-existing pain expectations, indicating a confirmation bias in pain perception.
- While immediate adjustment may be hesitant after large discrepancies, unexpected pain experiences can yield beneficial long-term effects on pain coping.
- The study highlights the dynamic interplay between pain expectations and experiences in modulating pain perception and adaptation.
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