No differences in return of pain-related fear after extinction and counterconditioning.

Extinction-based protocols such as exposure-in-vivo successfully reduce pain-related fear in chronic pain conditions, but return of fear and clinical relapse often occur. Counterconditioning is assumed to attenuate return of fear, likely through changing the negative affective valence of the conditioned stimulus (CS). We hypothesized that counterconditioning would outperform extinction in mitigating return of pain-related fear and decrease CS negative affective valence.