About my research

(functional data of a language task overlaid on my own brain)

Most of my research focuses on (chronic) pain and mechanisms that are relevant for understanding impairments by pain. In short, my work aims towards a better understanding of why some individuals experience chronic pain (and related disabilities) while others do not, which factors contribute to that and how treatments work to improve the lives of those living with pain.

More broadly, I aim to better understand why individuals behave the way they do. Think of why certain situations are avoided, even if they may be highly rewarding. And how our traits, expectations or stress impact such approach-avoidance behavior.

Currently, I work at the Department of Medical and Clinical Psychology at Tilburg University (the Netherlands). I furthermore have a visiting professor position at Ghent University at the Department of Rehabilitation Sciences (Belgium). Before this, I worked at Department of Rehabilitation Medicine at Maastricht University (NL) and at the Biobehavioral Pediatric Pain (BPP) lab at Stanford University (US).

Below I will give some short descriptions of a few projects I am working on.

The role of parents’ affective responses to their child’s pain

We have all experienced pain. And, we have all experienced the distress of observing someone else in pain. For a parent to see their child suffering is particularly difficult. In this project, called SCOPE, we are interested in how a parent’s brain and body responds when they see their child in pain. We place particular emphasis on empathy, or empathic distress. Our hypothesis is that observing your child in pain -especially when they are in chronic pain- can result in a strong empathic distress response. And that such a response may hinder the parent’s ability to respond in ways to promote the child’s adaptive functioning.

In SCOPE, we use several different assessments, including brain imaging of the parent, heart rate and self-reports. This project has recently started with the support of Stanford’s Maternal and Child Health Research Institute (MCHRI), and was supported by a Marie Skłodowska-Curie Action awarded to me by the European Commission.

Chronic pain in youth – the role of threat learning

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage (IASP). Learning which cues may result in pain (or will be a threat to our body) and which cues will not (and are safe) is key to our survival. One important way to learn this is through associative learning – we learn to associate a certain cue (touching a hot oven) with a certain response (pain) and may adapt our behavior accordingly (avoid a hot oven).

In this project, which is an NIH R01 project awarded to Dr. Laura Simons, my mentor at the BPP lab, we want to examine this type of learning (sometimes called threat learning) in adolescents with pain in comparison to healthy controls. We use different assessments, including brain imaging, skin conductance (or sweat responses), cortisol (stress hormones) and of course self-reports. The first papers have been published, and there are more to come!

Exposure in vivo treatment for individuals with chronic low back pain and complex regional pain syndrome (BrainEXPain project)

Exposure in vivo treatment is based on the principles of threat extinction learning, and is focused on reducing fears and worries associated with certain movements or activities (as they have been associated with pain in the past). This treatment has been very successful in improving functioning of individuals with chronic pain. In this project, BrainEXPain, we are interested in underlying neural mechanisms. Does this treatment result in changes in the brain (for instance, changes in the way the brain responds to certain cues, or changes in structural properties of the brain) and can we predict for whom it will be successful?

Data collection for this project occurred at Maastricht University Medical Center (MUMC+) from 2015-2018, in collaboration with Dr. Amanda Kaas, Dr. Jeroen de Jong and others. Some papers have been published, while others are still in preparation.

Modern neuroscience approach to treating individuals with whiplash-associated disorders

In this project, running at Ghent University, we are interested in unraveling mechanisms underlying treatment in individuals with whiplash-associated disorders. The modern neuroscience approach is tested against a treatment-as-usual in a group of patients, and in our sub-study we have added brain imaging assessments. The project is ongoing and is a collaboration with Prof. Dr. Mira Meeus, Prof. Dr. Barbara Cagnie, Dr. Iris Coppieters, and others. Two PhD students, Carlos Murillo Ezcurra and Jente Bontinck, are working hard on analysing the data and writing up results. The first papers have been published already.

Avoid at all costs?

In this project, started at Maastricht University, we are interested in approach-avoidance behavior, and how that interacts with threats and rewards. Data collection will now continue at Tilburg University, and will also include the role of cognitive functioning and extend to people with chronic pain.

The Herbert Simon Research Institute (HSRI) at Tilburg University provided the first seed funding, awarded to Dr. Mercedes Almela Zamorano and me.