Worrying about chronic pain: vigilance to threat and misdirected problem solving

Aldrich, Sarah; Eccleston, Christopher; Crombez, Geert

doi:10.1016/s0005-7967(99)00062-5

Cited by 171 publications

(125 citation statements)

References 77 publications

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“…Physical disability may also focus attention on perceptions of helplessness and worry. Whereas the sensory aspects of pain may elicit fear, attention to and anticipation of pain, and an urge to avoid increased pain (Aldrich et al, 2000;Eccleston and Crombez, 1999;McCracken and Gross, 1993), they may not result in loss of pleasure or depression.…”

Section: Discussionmentioning

confidence: 99%

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Marital functioning, chronic pain, and psychological distress

Caño

Gillis

Heinz

et al. 2004

Pain

117

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This study examined whether marital functioning variables related uniquely to psychological distress and diagnoses of depressive disorder independent of pain severity and physical disability. Participants were 110 chronic musculoskeletal pain patients. Hierarchical regression results showed that marital variables (i.e. marital satisfaction, negative spouse responses to pain) contributed significantly to depressive and anxiety symptoms over and above the effects of pain severity and physical disability. In contrast, marital variables were not significantly related to diagnoses of depressive disorder (i.e. major depression, dysthymia, or both) after controlling for pain variables. In multivariate analyses, physical disability and marital satisfaction were uniquely related to depressive symptoms whereas physical disability, pain severity, and negative spouse responses to pain were uniquely related to anxiety symptoms. Only physical disability was uniquely related to major depression. The results suggest that models of psychological distress in chronic pain patients might be enhanced by attributing greater importance to interpersonal functioning and increasing attention to anxiety.

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Section: Discussionmentioning

confidence: 99%

“…We expect that pain and marital variables will also be related to anxiety. Attention to the physical sensations of pain may result in worry (Aldrich et al, 2000) and attention to physiological symptoms of anxiety (e.g. racing heart, sweating).…”

Section: Introductionmentioning

confidence: 99%

Marital functioning, chronic pain, and psychological distress

Caño

Gillis

Heinz

et al. 2004

Pain

117

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“…This interpretation is further corroborated by the physiological data indicating a superior peak performance with higher metabolic stress in the condition with distraction. Another explanation, which is not entirely incompatible with the idea of cue competition, is that distraction inhibits and stops ruminative and worrisome thinking about bodily sensations 39 and, hence, postpones the decision to stop the treadmill test. The latter was confirmed by self-reports: participants reported more thoughts about carrying on in the condition without distraction than in the condition with distraction.…”

Section: Discussionmentioning

confidence: 99%

Effects of distraction on treadmill running time in severely obese children and adolescents

et al. 2002

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OBJECTIVE: (1) To examine the effects of attentional distraction on running time in an incremental treadmill test in obese youngsters; (2) to investigate whether distraction works at the same extent at the beginning and at the end of residential treatment; and (3) to explore the underlying mechanisms of the possible distraction effects. METHODS: Thirty severely obese youngsters (10 boys, 20 girls, age range 9 -17) who were following a 10 month residential treatment, performed a treadmill test until exhaustion in four different sessions using a within subjects design. The two sessions at the beginning of the treatment and the two sessions at the end the treatment were counterbalanced, one with attentional distraction (music) and one without distraction. RESULTS: Obese youngsters ran significantly longer during distraction. This distraction effect seemed to be larger at the beginning compared to at the end of obesity treatment. The absence of differences between the condition with music and the condition without music on perceived bodily symptoms is in line with the idea that it took longer to perceive sufficient bodily sensations to decide to stop the treadmill test in the distraction condition. This interpretation is further corroborated by the physiological data indicating a superior peak performance in the condition with distraction. CONCLUSIONS: Attentional distraction has a positive effect on perseverance in obese youngsters. Further research has to show the usefulness of attentional distraction as a technique to increase exercise adoption and adherence in obesity treatment.

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“…Regions such as SII and posterior insular cortices appear to be the first stations that house processes by which attention profoundly shapes both behavioral responses to pain and subjective pain experience (Lorenz and Garcia-Larrea, 2003). In clinical contexts, attention toward pain can aggravate chronic pain and the associated subjective experience (Aldrich et al, 2000;Eccleston et al, 2001). Furthermore, it can interfere with concurrent cognitive activities (Eccleston and Crombez, 1999).…”

Section: Introductionmentioning

confidence: 99%

Attention to Painful Stimulation Enhances γ-Band Activity and Synchronization in Human Sensorimotor Cortex

Hauck

Lorenz²,

Engel³

2007

J. Neurosci.

143

137

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A number of cortical regions are involved in processing pain-related information. The SI and SII somatosensory cortices process mainly sensory discriminative attributes but also play an important role in recognition and memory of painful events. Regions such as SII and the posterior insula appear to be the first stations that house processes by which attention profoundly shapes both behavioral responses and subjective pain experience. We investigated the influence of directed attention on pain-induced oscillations and synchronization processes using magnetoencephalogram in combination with an oddball paradigm in 20 healthy subjects. The subject's task was to count rare painful electrical stimuli applied to one finger, while ignoring frequent stimuli at a different finger. A high detection ratio was observed for all blocks and subjects. Early evoked oscillations in the ␦-band increased with higher stimulus intensity and directed attention, most prominently at contralateral sensorimotor sites. Furthermore, suppression and rebound of ␤ activity were observed after painful stimulation. Moreover, induced oscillatory activity in the high ␥-band increased with directed attention, an effect being significantly stronger for high compared with low stimulus intensity. Coupling analysis performed for this high ␥ response revealed stronger functional interactions between ipsilateral and contralateral sites during attention. We conclude that pain-induced high-frequency activity in sensorimotor areas may reflect an attentional augmentation of processing, leading to enhanced saliency of pain-related signals and thus to more efficient processing of this information by downstream cortical centers.

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Worrying about chronic pain: vigilance to threat and misdirected problem solving

Cited by 171 publications

References 77 publications

Marital functioning, chronic pain, and psychological distress

Marital functioning, chronic pain, and psychological distress

Effects of distraction on treadmill running time in severely obese children and adolescents

Attention to Painful Stimulation Enhances γ-Band Activity and Synchronization in Human Sensorimotor Cortex

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