Christopher France

Distinguished Professor

Contact Information:

Email: france(->AT<-)
Phone: 740-593-1079
251 Porter Hall
Ohio University
Athens, OH 45701

Research Areas:

Pain; Cardiovascular Psychophysiology; Blood Donor Motivation; Health Interventions


Adult, Health

Professional Positions:

2009-14 Editor-in-Chief,  Annals of Behavioral Medicine

2005-10 Editor-in-Chief, Journal of Behavioral Medicine

2010-11 President, American Psychological Association, Division 38 (Health Psychology)

Research Interests

Pain and Risk for Hypertension

Family history of hypertension, high blood pressure, and increased cardiovascular reactivity have been associated with decreased sensitivity to pain. Our research on pain perception as a potential marker of hypertension risk looks at:

  • Mechanisms of decreased pain perception in individuals with hypertension and/ or a family history of the disorder
  • Hypoalgesia predicting longitudinal blood pressure changes in individuals at high and low risk for hypertension
  • The relationship between pain and emotion in the context of hypertension risk
Pain-related Fear

Pain-related fear refers to constructs such as pain catastrophizing and kinesiophobia (fear that physical activity will exacerbate pain or prompt reinjury) and is linked with hypervigilance to pain, avoidance, and disability. Pain-related fear has been linked to the development and maintenance of chronic pain conditions. We work with healthy participants and individuals with chronic pain to examine:

  • The effect of pain-related fear on pain perception, behavior, and psychosocial adjustment.
  • The relationship between pain-related fear and patterns of movement.
Nociceptive Flexion Reflex Assessment

The nociceptive flexion reflex (NFR) allows withdrawal from noxious stimuli. NFR assessment is often used in experimental and clinical pain research as an index of descending modulation by the central nervous system (i.e., the brain). Evidence for this comes from findings that NFR threshold and amplitude are not always linearly associated with subjective pain intensity.

Given the growing demand for blood products, attracting and retaining blood donors has become a national priority. The ultimate aim of our work in this area is to enhance the donation experience in order to sustain an adequate blood supply for individuals in need of blood products. Accordingly, we focus on:
Recruitment of Blood Donors
  • Coping strategies to attenuate donation reactions (e.g., nausea, dizziness, lightheadedness)
  • Psychosocial and physiological predictors of donor return behavior (e.g., physical reactions, self-efficacy, satisfaction)
  • Post-donation interventions to enhance donor return (e.g., motivational interviewing)
Retention of Blood Donors
  • Coping strategies to attenuate donation reactions (e.g., nausea, dizziness, lightheadedness)
  • Psychosocial and physiological predictors of donor return behavior (e.g., physical reactions, self-efficacy, satisfaction)
  • Post-donation interventions to enhance donor return (e.g., motivational interviewing)

Selected Publications

  • Kowalsky, J. M., France, C. R., France, J. L., Whitehouse, E. & Himawan, L.K. (2014). The Blood Donation Fears Inventory: A measure of fear developed for use with whole blood donors. Transfusion and Apheresis Science, 51, 146-151. PMID: 25151096.

  • Geers, A.L., Fowler, S.L., Wellman, J.A., Helfer, S.G., Close, S., France, C.R. (in press). Prior experience with a pain stimulus as a predictor of placebo analgesia. Journal of Behavioral Medicine. PMID: 25056444.
  • Rose, J.P., Geers, A.L., France, J.L., & France, C.R. (2014). Norm perception and communication of vasovagal symptoms in blood donation. Transfusion, 54, 2258-2266. PMID: 24654738.
  • France, C.R., Kowalsky, J.M., France, J.L., Himawan, L.K., Kessler, D.A., & Shaz, B.H. (2014). The Blood Donor Identity Survey: A multi-dimensional measure of blood donor motivations. Transfusion, 54, 2098-2015. PMID: 24601946.
  • Gupta, R., Bruehl, S., Burns, J.W., Buvanendran, A., Chont, M., Schuster, E., & France, C.R. (2014). Relationship Between Endogenous Opioid Function and Opioid Analgesic Side Effects. Regional Anesthesia and Pain Medicine, 39(3), 219-224. PMID: 24682081.
  • France, C.R., France, J.L., Carlson, B.W., Himawan, L.K., Stephens, K.Y., Frame-Brown, T.A., Venable, G.A., & Menitove, J.E. (2014). Fear of blood draws, vasovagal reactions, and retention among high school donors. Transfusion, 54, 918-924. PMID: 23915025.
  • France, J.L., Kowalsky, J.M., France, C.R., McGlone, S.T., Himawan, L.K., Kessler, D.A., & Shaz, B.H. (2014). Development of common metrics for donation attitude, subjective norm, perceived behavioral control and intention for the blood donation context. Transfusion, 54, 839-847.  PMID: 24660764.
  • Trost, Z., France, C.R., Vervoort, T., Lange, J.M., Goubert, L. (2014). Learning about pain through observation: The role of pain related fear. Journal of Behavioral Medicine, 37, 257-265. PMID: 23264004.
  • Bruehl, S., Burns, J.W., Gupta, R., Buvanendran, A., Chont, M., Schuster, E., & France, C.R. (2014). Endogenous Opioid Inhibition of Chronic Low Back Pain Influences Degree of Back Pain Relief Following Morphine Administration. Regional Anesthesia and Pain Medicine, 39, 120-125. PMID: 24553304.
  • Kowalsky, J.M., France, C.R., Wissel, M.E., & Conatser, R. (2013).  Enhancing cerebral oxygenation during blood donation using biofeedback. Clinical Autonomic Research, 23, 339-341. PMID: 23864480.
  • Ditto, B., Gilchrist, P.T., Holly, C.D., Dubuc, S., Delage, G., France, C.R. (2013). The effects of leg crossing and applied tension on blood donor return.  Vox Sanguinis, 105, 299-304. PMID: 23724940.
  • Bruehl, S., Burns, J.W., Guta, R., Buvanendran, A., Chont, M., Kinner, E., Schuster, E., Passik, S., & France, C.R. (2013). Endogenous opioid function mediates the association between experimental evoked pain sensitivity and morphine analgesic responses.  Pain, 154, 1856-1864.  PMID: 23748117.
  • France, C.R., France, J.L., Wissel, M.E., Ditto, B., Dickert, T., & Himawan, L.K. (2013). Donor anxiety, needle pain, and syncopal reactions combine to determine retention: A path analysis of two-year donor return data.  Transfusion, 53, 1992-2000. PMID: 23305267.
  • France, C.R., France, J.L., Kowalsky, J.M., Copley, D.M., Lewis, K.N., Ellis, G.D., McGlone, S.T., & Sinclair, K.S. (2013). A Web-based approach to blood donor preparation. Transfusion, 53, 328-336. PMID: 22671311.
  • France, C.R., France, J.L., Himawan, L.K., Stephens, K.Y., Frame-Brown, T.A., Venable, G.A., & Menitove, J.E. (2013). How afraid are you of having blood drawn from your arm? A simple fear question predicts vasovagal reactions without causing them among high school donors. Transfusion, 53, 315-321. PMID: 22670781.
  • Weeks, J.W., Lee, C., Reilly, A.R., Howell, A.N., France, C.R., Kowalsky, J.M., & Bush, A. (2012). “The sound of fear”: Assessing vocal fundamental frequency as a physiological indicator of social anxiety disorder. Journal of Anxiety Disorders, 26, 811-822. PMID: 23070030.  
  • Heffner, K.L., Ng, H.M., Suhr, J.A., France, C.R., Marshall, G.D., Pigeon, W.R., Moynihan, J.A. (2012).  Sleep disturbance and older adults’ inflammatory responses to acute stress. American Journal of Geriatric Psychiatry, 20, 744-752. PMID: 22327621.
  • Trost, Z., France, C.R., Sullivan, M.J., Thomas, J.S. (2012). Pain-related Fear Predicts Reduced Spinal Motion Following Experimental Back Injury. Pain, 153, 1015-1021. PMID: 22377437.
  • France, C.R., France, J.L., Kowalsky, J.M., Ellis, G.D., Copley, D.M., Geneser, A., Frame-Brown, T., Venable, G., Graham, D., Shipley, P., Menitove, J.E. (2012). Assessment of donor fear enhances prediction of presyncopal symptoms among volunteer blood donors. Transfusion, 52, 375-380. PMID: 21848969.
  • Warfel, R.M., France, C.R., & France, J.L. (2012). Application of implicit attitude measures to the blood donation context. Transfusion, 52, 356-365. PMID: 21827501.
  • Wieling, W., France, C.R., van Dijk, N., Kamel, H., Thijs, R.D., & Tomasulo, P. (2011). Physiological strategies to prevent fainting responses during or after whole blood donation. Transfusion, 51, 2727-2738. PMID: 21645008.
  • Lovejoy, T.I., Heckman, T.G., Suhr, J.A., Anderson, T., Heckman, B.D., & France, C.R. (2011). Telephone-Administered Motivational Interviewing Reduces Risky Sexual Behavior in HIV-Positive Late Middle-Age and Older Adults: A Pilot Randomized Controlled Trial. AIDS and Behavior, 15, 1623-1634.  PMID:21809048.
  • Terry, E.L., France, C.R., Bartley, E.J., DelVentura, J.L., Kerr, K.L., Vincent, A.L., & Rhudy, J.L. (2011). Standardizing procedures to study sensitization of human spinal nociceptive processes:  Comparing parameters for temporal summation of the nociceptive flexion reflex (TS-NFR). International Journal of Psychophysiology, 81, 263-274. PMID: 21767583.
  • France, C.R., France, J.L., Wissel, M.E., Kowalsky, J.M., Bolinger, E.M., & Huckins, J.L. (2011). Enhancing blood donation intentions using multimedia donor education materials. Transfusion, 51, 1796-1801. PMID: 21303366.
  • Lovejoy, T., Revenson, T.A., & France, C.R. (2011).  Reviewing manuscripts for peer-review journals: A primer for novice and seasoned reviewers. Annals of Behavioral Medicine, 42, 1-13. PMID: 21505912.
  • Rhudy, J.L. & France, C.R. (2011). Reliability and validity of a brief method to assess nociceptive flexion reflex (NFR) threshold. The Journal of Pain, 12, 782-791. PMID: 21481651.
  • Kowalsky, J.M., France, J.L., Wissel, M.E., & France, C.R. (2011). Effect of applied muscle tension on cerebral oxygenation during blood donation in female blood donors. Transfusion, 51, 1802-1808. PMID: 21382044.
  • Trost, Z., France, C.R., & Thomas, J.S. (2011). Pain-related fear and avoidance of physical exertion following delayed onset muscle soreness. Pain, 152, 1540-1547. PMID: 21419575.
  • Rhudy, J.L., Martin, S.L., Terry, E.L., France, C.R., Bartley, E.J., DelVentura, J.L., & Kerr, K.L. (2011). Pain catastrophizing is related to temporal summation of pain, but not temporal summation of the nociceptive flexion reflex. Pain, 152, 794-801. PMID: 21316150
  • Ang, D.C., Chakr, R., France, C.R., Mazzuca, S., Stump, T., Hilligoss, J., & Lengerich, A. (2011).  Association of nociceptive responsivity with clinical pain and the moderating effect of depression.  The Journal of Pain, 12, 384-389. PMID: 21111683.
  • Fowler, S.L., Rasinski, H.M., Geers, A.L., Helfer, S.G., & France, C.R. (2011). Concept priming and pain: An experimental approach to understanding gender roles in sex-related pain differences. Journal of Behavioral Medicine, 34, 139-147. PMID: 20878354.
  • Heffner, K.L., France, C.R., Trost, Z., Ng, H.M., & Pigeon, W.R. (2011). Chronic low back pain, sleep disturbance, and interleukin-6.  Clinical Journal of Pain, 27, 35-41. PMID: 21188850.
  • Palit, S., Sheaff, R.J., France, C.R., McGlone, S.T., Potter, W.T., Harkness, A.R., McNulty, J.L., Bartley, E.J., Hoffmann, R., Monda, J.K., & Rhudy, J.L. (2011).  Serotonin transporter gene (SLC6A4) polymorphisms are associated with modulation of pain but not modulation of spinal nociception, Biological Psychology, 86, 360-369. PMID: 21291949.
  • Masser, B., & France, C.R. (2010). An evaluation of a donation coping brochure with Australian non-donors.  Transfusion and Apheresis Science, 43, 291-297. PMID: 20934386.
  • Sinclair, K.S., Campbell, T.S., Carey, P.M., Langevin, E., Bowser, B, & France, C.R. (2010). An adapted post-donation motivational interview enhances blood donor retention. Transfusion, 50, 1778-1786. PMID: 20456674. PMCID: PMC2948616.
  • Geers, A.L., Wellman, J.A., Fowler, S.L., Helfer, S.G., & France, C.R. (2010).  Dispositional optimism predicts placebo analgesia. The Journal of Pain, 11, 1165-1171. PMID: 20627818.
  • France, C.R., Ditto, B., Wissel, M., France, J.L., Dickert, T., Rader, A., Sinclair, K., McGlone, S., Trost, Z., & Matson, E. (2010). Pre-donation hydration and applied muscle tension combine to reduce presyncopal reactions to blood donation. Transfusion, 50, 1257-1264. PMID: 20113455. PMCID: PMC2935324.
  • Ditto, B., France, C.R., Holly, C. (2010). Applied tension may help retain donors who are ambivalent about needles. Vox Sanguinis, 98, e225-230.  PMID: 20432513.
  • Ang, D.C., Chakr, R., Mazzuca, S., France, C.R., Steiner, J., & Stump, T. (2010). Cognitive behavioral therapy attenuates nociceptive responding in patients with fibromyalgia: A pilot study.  Arthritis Care and Research, 62, 618-623. PMID: 20191481.
  • Shah, D., France, C.R., & Thomas, J.S. (2010). Mechanical energy expenditures and movement efficiency in full body reaching movements. Journal of Applied Biomechanics, 26, 32-44. PMID: 20147756.
  • France, C.R., France, J.L., Kowalsky, J.M., & Cornett,T.L. (2010). Education in donation coping strategies encourages individuals to give blood: Further evaluation of a donor recruitment brochure. Transfusion, 50, 85-91.  PMID: 19778341.

Recent Grants

  • Motivating type O- blood donors to return. NIH/NHLBI (R56HL119180). Role: PI.

  • Using an interactive game to reduce fear & increase spine motion in low back pain. NIH/NIAMS (NIH R21AR064430). Role: Co-PI with James Thomas.
  • THE RELIEF STUDY: Neuromuscular mechanisms underlying spinal manipulation treatments. NIH/NCCAM (NIH R01 AT006978).  Role: Co-I, with James Thomas and Brian Clark as co-PIs.
  • Overcoming the impact of situationally-induced anxiety on wouldbe donors. Australian Red Cross Blood Service. Role: Co-I, with Barbara Masser as PI.
  • Slow wave sleep and inflammatory processes in pain. NIH/NIA (NIH R21 AG041942).  Role: Co-I, with Kathi Heffner and Wilfred Pigeon as co-PIs.
  • Preventing adverse reactions in novice blood donors. National Heart Lung and Blood Institute (NIH R01 HL077438) (Role: PI)
  • Identifying bariers and enhancing confidence in young adults conteplating blood donation.  Canadian Blood Services/Canadaian Institutes of Health Research (Role: Co-I with Blaine Ditto as PI).
  • Using aplied tension in the blood donation clinic: Effects on vasovagal symptoms, anxiety, and donor return. Canadian Blood Services/Canadaian Institutes of Health Research (Role: Co-I with Blaine Ditto as PI).
  • Altered motor coordination in recurrent low back pain. NIH - National Institute of Child Health and Human Development (R01 HD045512) (Role: Co-PI with James S. Thomas).
  • Psychophysiological mechanisms of blood donation-related fainting and a treatment to reduce fainting. Canadian Institutes for Health Research (Role: Co-I with Blaine Ditto, PI)
  • Hypertension, risk for hypertension, and hypoalgesia. National Heart Lung and Blood Institute (R01 HL64794), (Role: PI)
  • Gender, coping and the arthritis pain experience. National Institute of Arthritis & Musculoskeletal and Skin Diseases (R01-AR46305) (Role: PI at Ohio University site, with Francis J. Keefe as primary PI).
  • Reducing vasovagal reactions to blood donation with applied muscle tension: A controlled outcome study. Fonds de la Recherche en Santé du Québec, (Role: Co-PI with Blaine Ditto and Pauline Lavoie).


Courses Taught


  • Psychology of Health and Illness
  • Abnormal Psychology


  • Applied Psychophysiology
  • Health Psychology
  • Interventions in Health Psychology
  • Individual Psychotherapy