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Faculty of Graduate Studies

Sophia Mastrangelo

  • BKin (University of Toronto, 2023)
Notice of the Final Oral Examination for the Degree of Master of Science

Topic

Expectancy-Driven Modulation of Pain Intensity and Perceived Damage in a LEGO Paradigm

School of Exercise Science, Physical and Health Education

Date & location

  • Tuesday, October 28, 2025
  • 3:00 P.M.
  • McKinnon Building, Room 150

Examining Committee

Supervisory Committee

  • Dr. David Kennedy, School of Exercise Science, Physical and Health Education, University of Victoria (Supervisor)
  • Dr. Kurt Smith, School of Exercise Science, Physical and Health Education, UVic (Member)
  • Dr. Joshua Pate, Graduate School of Health, University of Technology Sydney (Outside Member)

External Examiner

  • Dr. Taru Manyanga, Division of Medical Sciences, University of Northern British Columbia

Chair of Oral Examination

  • Dr. Michelle Bonner, Department of Political Science, UVic

Abstract

Pain is a complex experience influenced by sensory, cognitive, and contextual factors. Misinterpretation of pain as direct evidence of equivocal tissue damage can reinforce fear of movement and hinder patient recovery, making it important to understand how expectations shape pain and harm appraisals. This thesis examined whether expectancy framing alters pain responses to an ecologically valid mechanical threat and whether participants dissociate pain intensity from perceived damage. Sixty healthy adults completed five walking trials across a fixed LEGO board: baseline, unexpected LEGO, expected LEGO, and two randomized cream conditions framed as protective (placebo) or sensitizing (nocebo). After each trial, participants reported immediate and delayed pain and damage ratings (0–10 NRS), while ground-reaction forces and step timing were recorded. Results indicated that pain intensity increased sharply at first LEGO exposure (ΔM = +2.95, ~30% of the NRS scale) and was further amplified by the nocebo frame (ΔM = +1.22). The placebo frame showed no significant effects. Changes in damage ratings were more subtle, diverging from pain intensity. Overall, findings demonstrate that contextual threat amplifies pain intensity more strongly than perceived damage, reinforcing a dissociation between the two and underscoring the importance of expectation in pain appraisal.

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