Attentional bias towards pain-related information in chronic pain; a meta-analysis of visual-probe investigations

Schoth, Daniel E.; Nunes, Vanessa Delgado; Liossi, Christina

doi:10.1016/j.cpr.2011.09.004

Cited by 196 publications

(234 citation statements)

References 71 publications

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“…Words are only semantic representations of pain and may be less capable in activating bodily threat than actual signals of pain [14,66]. In line with this argument is the finding that results of studies using pain words as stimulus material are inconsistent and effect-sizes are small [16,48,49], whereas results from studies that used cues which are predictive of pain as stimulus material are more consistent and show medium to large effect-sizes [62,63,64,67].…”

Section: Discussionsupporting

confidence: 71%

Attentional bias towards pain-related information diminishes the efficacy of distraction

Ryckeghem

Crombez²,

Hulle³

et al. 2012

Pain

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IntroductionThe ability of attention to modulate pain processing [32,51,57,66] makes it a key factor in how people cope with pain. Distraction, defined as directing attention away from pain, is probably one of the most intuitively and commonly used coping strategies [33]. Although distraction seems to be omnipresent in pain treatment programs for acute and chronic pain [20,41], results on its efficacy are variable. Some studies found that distraction reduces pain [36,39,44,57,58,65], whereas other studies reported no effect [25,35] or even counter-productive effects [8,21]. An understanding of the conditions under which distraction works is therefore required. Both pain-related factors (e.g., intensity, novelty, threat) and factors related to the task towards which attention is directed (e.g., task difficulty, motivational significance) are likely to play a role [19,32,66].A tendency to selectively attend to pain has been argued to hamper the efficacy of distraction [15,32,72], and is largely discussed in the context of hypervigilance and attentional bias towards pain-related information [15,31]. Indeed, it is reasonable to assume that an attentional bias towards pain-related information may bring along difficulties to direct attention away from pain and, hence, result in a failure of distraction to diminish the experience of pain. However, there is no direct test of this idea. Most often, studies on attentional bias in pain aimed to validate the phenomenon (e.g. [23,34,45,52]), or attempted to identify its antecedent conditions (e.g. catastrophic thinking about pain, state/trait anxiety) [4,46,47,62]. In this study we focussed upon one of the putative consequences of We hypothesized that participants would show an attentional bias towards both cues signalling the experimental pain stimulus and words describing this pain stimulus. Furthermore, we expected that self-reported pain would be less when attention was directed away from pain than when it was directed towards pain. The crucial hypothesis of this study, however, was that a larger attentional bias would be associated with smaller effects of distraction. Finally, we wanted to explore whether an attentional bias towards pain-related information would mediate the relationship between catastrophic thinking about pain and the efficacy of distraction.4 Method ParticipantsThe sample consisted of 56 undergraduate students from Ghent University, who received course credits for participation (45 females; Mage = 18.1years, SD = 1.1; 55 Caucasian) with normal or corrected-to-normal vision. Exclusion criteria included a self-reported current pain problem (e.g. fibromyalgia, back pain) or a self-reported current psychiatric problem (e.g., psychosis, anxiety disorder).Furthermore, all participants were required to have Dutch as a first language, because the experiment, including all instructions and stimulus materials, was undertaken in Dutch. Based on these criteria, two persons were excluded due to a headache on time of testing. One additional participant was excluded...

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Section: Discussionsupporting

confidence: 71%

Attentional bias towards pain-related information diminishes the efficacy of distraction

Ryckeghem

Crombez²,

Hulle³

et al. 2012

Pain

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“…Adopting theories and paradigms from the anxiety literature, researchers have investigated whether chronic pain patients also selectively attend to pain-related information. Although results are not always consistent, chronic pain patients are often found to have an attentional bias towards pain-related information in comparison with healthy volunteers [38,43,46]. …”

Section: Introductionmentioning

confidence: 99%

The predictive value of attentional bias towards pain-related information in chronic pain patients: A diary study

Ryckeghem

Crombez²,

Goubert³

et al. 2013

Pain

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“…Recent meta-analyses of such studies showed that attentional bias was overall smaller in magnitude than would have been expected, and that its manifestation was dependent upon specific procedural aspects, such as type of stimuli and presentation time of stimuli (Crombez, Van Ryckeghem, Eccleston, & Van Damme, 2013;Schoth, Nunes, & Liossi, 2012). One potential explanation for these underwhelming results is that visual representations of pain may not sufficiently capture bodily threat, and that the adaptive value of bias to (the location of) such stimuli is very limited Van Damme et al, 2010).…”

mentioning

confidence: 82%

Attentional bias to pain-relevant body locations: New methods, new challenges

Damme

Bulcke

Durnez

et al. 2016

Consciousness and Cognition

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In a recent issue of Consciousness and Cognition, Filbrich, Torta, Vanderclausen, Azanon, and Legrain (2016) commented on a paper in which we used a tactile Temporal Order Judgment (TOJ) task to show that expecting pain on a specific body location biased attention to that location (Vanden Bulcke, Crombez, Durnez, & Van Damme, 2015). Their main criticism is that the effects are likely to reflect response bias rather than genuine attentional bias. We agree that the TOJ task used may be susceptible to response bias, and welcome the authors' methodological suggestions to control for such bias. However, we feel that certain aspects of our work are misrepresented in their paper. Most importantly, we contest their argument that our instructions made the threat location task-relevant, thereby increasing risk of response bias. Further, we reply to other methodological and theoretical issues raised by these authors.

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Attentional bias towards pain-related information in chronic pain; a meta-analysis of visual-probe investigations

Cited by 196 publications

References 71 publications

Attentional bias towards pain-related information diminishes the efficacy of distraction

Attentional bias towards pain-related information diminishes the efficacy of distraction

The predictive value of attentional bias towards pain-related information in chronic pain patients: A diary study

Attentional bias to pain-relevant body locations: New methods, new challenges

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