Visual attention to pain cues for impending touch versus impending pain: An eye tracking study

Abstract

Background In this eye tracking study, we evaluated pain‐related biases in orienting and maintenance of gaze within impending touch versus impending pain tasks and examined features of pain resilience as individual difference influences on potential biases. Methods Gaze preferences of healthy adults (25 women and 39 men) were assessed during standardized pain‐neutral (P‐N) image pair presentations (2,000 ms) of an impending touch task versus an impending pain task whereby image pair offsets were followed by potential non‐painful touch and potential pain stimulation, respectively. Results Within each task, participants were significantly more likely to fixate first upon pain images in P‐N pairs and maintain gaze on these images for longer overall durations during trials. Between task comparisons indicated pain‐related biases in orienting and maintenance were significantly stronger when image pairs signalled potential pain rather than impending touch. Finally, within the impending pain task, higher scores on the behaviour perseverance dimension of pain resilience were related to shorter first fixation durations and overall gaze durations towards pain images. Conclusions Supporting specific threat interpretation model premises, comparatively more threatening external pain cues for impending pain were characterized by gaze biases reflecting pronounced early attentional capture and subsequent prolonged vigilance. However, elevations in self‐reported behavioural perseverance in spite of pain corresponded to an increased capacity to disengage from pain images that signalled potential pain. Significance Gaze biases were assessed within a comparatively benign “impending touch” paradigm versus a higher threat, impending pain task. Early capture and maintenance of gaze towards pain images were more pronounced on the latter task, although pain resilient participants were able to disengage more easily from pain images signalling possible pain.

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

“…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;.…”

“…Moreover, first fixation durations on pain-related stimuli are not influenced by fear of pain (Sharpe et al, 2017;Yang et al, 2012Yang et al, , 2013, pain-related threatening instructions on a separate task (Sharpe et al, 2017;Sun et al, 2016;, or experimental thermal pain prior to a dot-probe task (Sun et al, 2016). However, in two studies of pain-free participants that featured pain-related images signalling possible electric pain versus neutral images signalling its absence, first fixation durations for pain-related images were significantly longer (d = 0.47-0.58) (Jackson et al, 2018a;Ling et al, 2019).…”

“…Eight studies conducted between-stimulus comparisons of first fixation proportion within chronic pain samples, with five indicating that participants made significantly more first fixations on pain-related stimuli than neutral stimuli (d = 0.47-2.00) (Jackson et al, 2018b(Jackson et al, , 2019Liossi et al, 2014;Mahmoodi-Aghdam et al, 2017;Schoth, Godwin, et al, 2015). Five studies indicated that first fixations on pain stimuli were more common among healthy participants (d = 0.11-2.00) (Heathcote et al, 2017;Jackson et al, 2018a;Ling et al, 2019;Mahmoodi-Aghdam et al, 2017;Pilch et al, 2020). In contrast, one study based on healthy adults found a lower first fixation proportion on pained faces than neutral faces (Priebe et al, 2015), but this exception cannot be explained by differences in study characteristics.…”

Gray matter volume differences between lower, average, and higher pain resilience subgroups

“…Hence, more challenging cognitive tasks such as the high difficulty NIT condition reflected resilience (and resilience subgroup differences) more clearly than did the less demanding, lower difficulty (i.e., lower adversity) condition that reflected resilience only weakly. Results from recent eye‐tracking research align with these contentions in that resilience was found to correlate with the capacity to disengage more easily from pain images in a more demanding task that featured painful stimulation but was not correlated with disengagement capacities in a less demanding task that involved nonpainful touch stimuli (Ling, Yang, & Jackson, 2019).…”

The N2pc component as a neural index of early attention allocation among adults with chronic musculoskeletal pain

“…Meta-analyses based on RT have provided selective support for this premise based on stronger ABs towards sensory pain words in chronic pain groups relative to controls (Crombez et al, 2013;Todd et al, 2018), albeit mean effect sizes have been small, and do not extend reliably to other stimulus categories. Extensions based on eye-tracking have found that the threat of impending pain is associated with prolonged attention towards cues that signal the threat of potential pain compared to cues that signal its absence (Jackson, Su, & Wang, 2018a, 2018bLing, Yang, & Jackson, 2019).…”