The Influence of Negative Affective States on Pain and Physical Symptom Perception in Individuals with Chronic Shoulder Pain

• Grant number: 25/01991-8
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• Start date: August 15, 2025
• End date: August 14, 2026
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Anamaria Siriani de Oliveira
• Grantee: Marcela Camargo Tozzo
• Supervisor: Ann Meulders
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Institution abroad: Maastricht University, Maastricht (UM), Netherlands
• Associated to the scholarship: 23/00513-0 - Heart Rate Variability in People with Chronic Shoulder Pain Exposed to Passive Visualization of Shoulder Motion Images, BP.DR

Abstract

Chronic shoulder pain is prevalent and influenced by various factors, including emotional ones. Emotions can be understood as synchronized changes in several physiological systems in response to the identification of different stimuli. Negative affective states play a crucial role in the perception of physical symptoms and pain. The aims of the study are: (i) to compare the reports of bodily symptoms and pain intensity of individuals with chronic shoulder pain when presented with neutral and negative pictures; and (ii) to compare the reports of bodily symptoms after viewing negative pictures between individuals with chronic shoulder pain and a pain-free control group. Data collection will involve 60 participants divided into two groups: 30 individuals with chronic shoulder pain and 30 pain-free controls matched by age and sex. The inclusion criteria for participants with chronic shoulder pain will be: (i) having been diagnosed with any disease that affects the shoulder, (ii) having shoulder pain for at least three months with a mean pain intensity of at least 3/10 in the week prior to the assessment, and (iii) being over 18 years old. The inclusion criteria for the control group will be: (i) being over 18 years old and (ii) having no pain or history of trauma in the shoulder complex or upper limb. The exclusion criteria for both groups will be: (i) a history of neurological diseases, (ii) neoplasms, and (iii) uncorrected vision problems. The study will employ the Affective Picture Paradigm (APP), an innovative experimental task that uses pictures with negative and neutral emotional valences to induce emotional changes and assess their effects on bodily symptoms. Linear mixed models will be used to test the main and interaction effects of between-group (chronic shoulder pain vs. pain-free control) and within-group (baseline, after viewing neutral picture blocks, and after viewing negative picture blocks) factors as fixed effects, with participants as random effects. We expect that individuals with chronic shoulder pain will report more physical symptoms and pain when assessed with negative pictures compared to neutral pictures and individuals with chronic shoulder pain will report more bodily symptoms compared to the pain-free control group after viewing negative pictures