Inter-individual predictors of pain inhibition during performance of a competing cognitive task

Abstract

The main function of pain is to automatically draw attention towards sources of potential injury. However, pain sometimes needs to be inhibited in order to address or pursue more relevant tasks. Elucidating the factors that influence how people manage this relationship between pain and task performance is essential to understanding the disruptive nature of pain and its variability between individuals. Here, 41 healthy adults completed a challenging working memory task (2-back task) while receiving painful thermal stimulations. Examining the trial-by-trial relationship between pain perception and task performance revealed that pain’s disruptive effects on performance were mediated by self-reported pain intensity, and that the analgesic effects of a competing task were influenced by task performance. We found that higher pain catastrophizing, higher trait anxiety, and lower trait mindfulness were associated with larger trade-offs between pain perception and task performance, suggesting that these psychological factors can predict increased fluctuations between disruption by pain and analgesia from a competing task. Altogether these findings provide an important and novel perspective on our understanding of individual differences in the interplay between pain and ongoing task performance.

Effects of Brief Mindfulness Interventions on the Interference Induced by Experimental Heat Pain on Cognition in Healthy Individuals

“…Trait mindfulness was also found to negatively moderate the relation between pain intensity and pain interference in a cross-sectional study of cancer survivors suffering from chronic neuropathic pain (13). Consistent with these clinical findings, we recently observed a reduction in the impact of experimental heat pain on working-memory performance in healthy individuals with high trait mindfulness (14). Interestingly, brief mindfulness intervention of 4 daily sessions of 20 min of attention monitoring meditation may be sufficient to induce change in acute pain perception (15)(16)(17), although such results are not systematically reproduced (15,18).…”

“…Trait mindfulness was also found to negatively moderate the relation between pain intensity and pain interference in a cross-sectional study of cancer survivors suffering from chronic neuropathic pain ( 13 ). Consistent with these clinical findings, we recently observed a reduction in the impact of experimental heat pain on working-memory performance in healthy individuals with high trait mindfulness ( 14 ).…”

“…Here the term specifically refers to the decrease in working-memory performance caused by experimental heat pain. The pain interference task is detailed below and is also further described in our previous study ( 14 ).…”

“…The temperature used for the painful and non-painful stimulation in the interference task was calibrated for each participant to control for inter-individual differences in pain sensitivity ( 4 , 14 , 28 ). This procedure also generated two measures of pain sensitivity: pain threshold and temperature required to produce a moderately painful experience.…”

“…Here, we hypothesized that a short meditation intervention involving mindfulness attention monitoring would reduce the disruptive effect of acute pain on cognitive performance. The experimental model and the primary outcome were defined based on our previous study ( 14 ). To further circumscribe the effect of meditation training, the target intervention group was compared to an education group exposed to 5 daily sessions involving only conceptual information about mindfulness, and to a no-intervention control group.…”