The Interruptive Effect of Pain on Attention

Abstract

Pain is known to disrupt attentional performance in both healthy adults and patients with chronic pain. Exactly which aspects of attentional function are affected are, however, still to be determined. The primary aim of this investigation was to systematically examine the effects of experimentally induced pain on a range of attentional performance tasks. Following a review of tests of attentional disruption, seven best candidate tasks were selected and examined across seven experiments. The tasks were: continuous performance, flanker, endogenous precueing, n-back, inhibition, attentional switching, and divided attention. Healthy adult participants performed each of these tasks under three different conditions: a painful heat sensation, a warm heat sensation, and a nonheat control. Pain differentially affected attentional performance across these tasks; pain-related attentional impairment was found on the n-back, attentional switching, and divided attention tasks, but not on the other tasks. This finding suggests that the aspects of attention most affected by pain are those essential for the completion of complex tasks that require the processing of multiple cues and control over attentional deployment. These results are discussed in the context of an emerging view of pain as a demand for executive control and the development of measures that could be used to examine attentional disruption in the context of pain.

The effects of menstrual-related pain on attentional interference

“…When experiencing menstrual pain, women were generally slower or less accurate on the flanker and switching task. This is in contrast to results reported in pain induction studies, where pain seems to have specific attentional interference effects [21]. It is more difficult to directly ascertain specificity of effects for the dual (both tasks are given equal priority) and n-back tasks (no Menstrual pain and attention 20 control condition).…”

“…However, for the dual task there was indirect evidence for a general pain-related effect. Here, pain produced a general decline in accuracy across both tasks, whereas in our laboratory study [21] a specific decrease in accuracy was found on the lines task, and a relative improvement on the numbers task. Overall, this would seem to suggest a general pain-related dampening effect on performance.…”

“…These differences may partly reflect task demands, including instructions given to participants [3]. Indeed, we have argued that the flanker task may be less complex, and less demanding on executive functions, than the switching task [21]. However, this pattern may also reflect different processing strategies being employed by participants when in pain, which may depend on the type or complexity of task being performed.…”

“…Similarly, others have found that pain interference is more likely to occur when the task in question is demanding, with easier tasks escaping interference effects [21].…”

Headache Impairs Attentional Performance: A Conceptual Replication and Extension

“…Curiously, while many of these studies find disrupted attention performance under pain, the specific nature of effects tends to vary, even when using identical tasks. For example, on an identical n-back task, thermal pain reduced overall accuracy 28 , while menstrual pain increased the number of false alarms 20 , and headache reduced the number of hits 30 . On a cued switching task, thermal pain increased response times (RTs) for switch but not repeat trials 28 , and menstrual and headache pain decreased accuracy overall 20 .…”