Book of Abstracts

Many factors influence our decision-making in a complex, adapting world. One group that is most susceptible to these influences is individuals with chronic pain, due to pain disrupting decision-making at neurological and psychological levels. In particular, this affects how these individuals weigh potential rewards against risks such as those presented in approach-avoidance paradigms. However, a neuropsychological factor found to moderate these effects is known as cognitive flexibility. Cognitive flexibility is often disrupted in individuals with chronic pain due to putting strain on the prefrontal cortex and neural networks such as the default-mode and affective salience network. The study had three primary hypotheses: individuals with chronic pain would display lower cognitive flexibility; these differences in cognitive flexibility and perceptual changes would result in more avoidant behavior, even in low-risk situations; and lastly, that these decision-making effects are mediated by cognitive flexibility, as it plays a fundamental role in effective decision-making. The study tested these through an approach-avoidance paradigm to test behavior at various potential threat and reward levels. The final sample consisted of 46 individuals, 35 ‘healthy’ controls and 11 with chronic pain. Results indicated that no significant results were found across all three hypotheses; however, an effect was found within approaching behavior as threat and reward changed. This suggests that the pilot study requires further research to address the inequality in sample size and age distribution, as well as to investigate the factors contributing to higher approaching behavior in chronic pain groups, particularly in the context of high-threat and low-reward.