Visualizing one's Best Possible Self increases positive future expectancies, but does not boost selective learning in fibromyalgia

Compromised learning is considered to contribute importantly to the development and maintenance of chronic pain disability. More specifically, predictive learning is impaired in people with chronic pain. Therefore, learning mechanisms have been identified as treatment targets. A widely neglected, but relevant question is whether resilience factors can enhance selective learning. This online study combined a selective learning task with a positive psychology intervention in participants with fibromyalgia (FM). The Best Possible Self group (BPS) described and visualized a future in which everything had gone well, which is shown to increase optimism and positive affect, while the active control group described and visualized their Typical Day (TD). Subsequently, selective learning was tested within a contingency learning scenario task using a blocking procedure and pain expectancies as main outcome. We successfully manipulated positive future expectancies (a proxy for state optimism), but not positive affect within a single-session intervention. In contrast with our expectations, the positive psychology intervention did not increase selective learning in the BPS group compared to the TD group, but a small blocking effect was observed in the merged sample. However, because no healthy control group was included, no conclusions can be drawn as to whether the selective learning effect is reduced compared to a non-clinical population. To conclude, there was partial evidence for selective learning in people with fibromyalgia, but manipulated resilience factors did not modulate the selective learning effect.