Effectiveness of cognitive reappraisal and distraction for acute pain: an experimental study

Abstract

Objective: Cognitive reappraisal and distraction modulate pain; however, little is known about their effectiveness at different levels of pain intensity. Thus, the aim of this study has been to analyze the differential efficacy of both strategies to reduce perceived pain intensity and pain unpleasantness in low and moderate pain levels. Methods: 3 (Emotion regulation strategy: cognitive reappraisal, distraction, and control) by 2 (Intensity of the painful stimuli: low and moderate intensity) by 2 (time: pre-test and post-test) mixed factorial design. Ninety healthy adults were randomly assigned to one of six experimental conditions, pain was induced using an advanced thermal stimulator. All participants completed the experimental pre-test and post-test phases, in each phase twelve pain stimuli were administered. At the end of each pain stimulus, participants rated the level of perceived pain intensity and pain unpleasantness experienced during the painful stimulation using the CoVAS. Data were collected from May 2022 to November 2022. Results: Analyses of covariance (ANCOVA), showed that at post-test (n = 90), cognitive reappraisal and distraction were equally effective in reducing perceived pain intensity in low pain levels, whilst distraction was more effective than cognitive reappraisal in decreasing perceived pain intensity in moderate pain levels. Neither distraction nor cognitive reappraisal were effective in decreasing pain unpleasantness. Conclusions: These findings highlighted the beneficial use of both strategies in the short-term for pain relief, being more effective distraction in moderate pain levels. Applying both strategies to everyday situations that may cause short-term acute pain could be of great clinical relevance.