DETAILS OF PROJECT

Fibromyalgia (FM) is a chronic pain syndrome characterised 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’ lives and clinical practice, offering to move basic and applied science forward.

The project is funded by the European Commission (EC), Horizon Europe Framework Programme (MSCA) no 101059716.

Project outcomes:

• Nencki Foundation Popular Science Lecture - Public lecture recording. A talk about our research on decision-making in FM and some key information about pain in general. "Mózg, ciało, zachowanie, czyli o tym jak przewlekły ból wpływa na podejmowanie decyzji" [in Polish]. Target group: General public

• Recording from the Pain and Activity Webinar that took place in 2024. Learn all about physical activity in persistent pain and why it is so difficult too keep moving while it hurts. Target group: Patients, advocacy groups, clinicians

• Blog Post for Noigroup HQ: "Decision-making amidst pain". Can experience of pain affect how we make decisions? How does our perception of delayed and effortful rewards influence our engagement in physical activity? This short blog post answers these questions and summarises our current work on the topic. Target group: Clinicians, pain science enthusiasts, general public

• The first preprint (manuscript before peer-review) is out: Herman, AM., Berryman, C. and Stanton, TR. 2025. Heightened Protective Decision-making Related to Physical, but Not Cognitive, Effort in Individuals with Fibromyalgia; PsyArXiv. March 13. doi:10.31234/osf.io/6tup2_v1! In this manuscript we show that individuals with fibromyalgia exhibit heightened protective decision-making for physical, but not cognitive, effort and increased reward sensitivity in delay discounting, which may inform tailored interventions.