The purpose of this study was to examine the effects of monetary motivation on the relationship between pain-related fear and avoidance behavior.

Eighty healthy volunteers were randomly assigned to one of four groups in accordance with task conditions of pain-related fear (high or low) and monetary motivation (high or low).

The autonomic nervous system was more active in the high pain-related fear group than in the low pain-related fear group as the participants watched a video and performed a task. Also, pain-related fear and monetary motivation had a significant interaction effect on avoidance behavior. High monetary motivation was associated with a shorter delay time during task performance in the high pain-related fear group. No significant difference was observed in the delay time in the low pain-related fear group.

This study provides empirical evidence supporting the modified fear-avoidance model and experimentally proves the activation of the goal shielding mechanism.