Eye‐movement behaviours when viewing real‐world pain‐related images

Abstract

Background Pain‐related cues are evolutionarily primed to capture attention, although evidence of attentional biases towards pain‐related information is mixed in healthy individuals. The present study explores whether healthy individuals show significantly different eye‐movement behaviours when viewing real‐world pain‐related scenes compared to neutral scenes. The effect of manipulating via written information the threat value of the pain‐related scenes on eye‐movement behaviours was also assessed. Methods Participants were randomized to threatening (n = 28) and non‐threatening (n = 27) information conditions. All completed a free‐viewing task with real‐world pain‐related and neutral images while their eye movements were recorded. Results Participants made significantly fewer fixations of significantly longer duration when viewing pain‐related images compared to neutral images. No significant differences were found between threatening and non‐threatening information groups in their pattern of eye movements. Conclusions This study shows that healthy individuals demonstrate attentional biases to pain‐related real‐world complex images compared to neutral images. Future research is needed to establish the implications of these biases, particularly in the context of acute pain, on the onset and/or subsequent maintenance of chronic pain conditions. Significance Healthy individuals show different eye‐movement behaviours when viewing pain‐related scenes than neutral scenes, supporting evolutionary accounts of pain. Implications for the onset and/or maintenance of chronic pain need to be explored.

Pain-related attentional processes: A systematic review of eye-tracking research

“…One study found healthy people with higher fear of pain fixated more quickly on sensory pain words than less pain-fearful cohorts during a dot-probe task (d = 0.21) (Yang et al, 2012). However, six studies comprising chronic pain or healthy samples did not find an association between fear of pain and this particular index (Jackson et al, 2018b(Jackson et al, , 2018aSchoth, Wu, et al, 2019;Sharpe et al, 2017;Yang et al, 2013). In relation to moderating effects of pain catastrophising, one study found that low catastrophising healthy participants had shorter first fixation latencies for pained faces than neutral faces during free-viewing, with initial fixation latencies becoming increasing faster with increasing levels of pain expression in images (Vervoort et al, 2013).…”

“…Dot-probe tasks used in eye-tracking studies have been similar to those used in the reaction time literature. In free-viewing tasks, participants were typically asked to freely explore one (Schoth, Wu, et al, 2019) or more (Priebe et al, 2015) visual stimuli simultaneously presented in random locations as if they were watching television. In some studies, participants were informed about locations in which emotional stimuli (i.e., happy or sad face) would appear prior to free-viewing (Giel et al, 2018).…”

“…One study provided evidence for an initial orienting bias (i.e., more first fixations) towards sensory pain words in healthy adults with high fear of pain compared to those with low fear of pain (Yang et al, 2012) but three other studies found no fear of pain effects on orienting (Jackson et al, 2018b;Sharpe et al, 2017;Yang et al, 2013). In six studies that investigated effects of threat on first fixation proportion, three found that first EYE MOVEMENTS AND PAIN 15 fixation proportion on pain-related stimuli was reduced by the threat of pain (d = 0.26-0.84) (Jackson et al, 2018a(Jackson et al, , 2018bSharpe et al, 2017), while one found a complementary effect (d = 0.32) (Ling et al, 2019), and two others found no effect (Schoth, Wu, et al, 2019;.…”

“…Patterns displayed by healthy participants were also inconsistent; three studies found these groups initially fixate more slowly on pain-related images than neutral images (d = 0.57-0.70) (Mahmoodi-Aghdam et al, 2017;Schoth, Wu, et al, 2019), two studies observed faster first fixations on pain-related images (d = 0.26-1.12) (Jackson et al, 2018a;Schoth, Godwin, et al, 2015), and five studies reported no such biases (Mazidi et al, 2019;Sharpe et al, 2017;Sun et al, 2016;Yang et al, 2013). In addition, first fixation latency differences between stimulus valences may not be unique to pain-related stimuli, as groups with and without chronic pain have both been found to fixate more rapidly on happy faces than neutral faces (d = 0.53) .…”

<p>Attentional Bias Toward Cupping Therapy Marks: An Eye-Tracking Study</p>

“…11,12 Eye-tracking methodology continuously measures visual-spatial attention and overcomes the shortcomings of a brief snapshot of attentional bias inferred from the visual probe task. 13 Recent eyetracking studies have shown that individuals with chronic pain exhibit greater vigilance to pain-related stimuli and earlier disengagement from pain words. [14][15][16][17] The initial vigilance for pain-related stimuli reflects an adaptive reaction to detect subsequent pain.…”