Attentional control moderates the relationship between pain catastrophizing and selective attention to pain faces on the antisaccade task

Abstract

cognitive models of chronic pain emphasize the critical role of pain catastrophizing in attentional bias to pain-related stimuli. the aim of this study was (a) to investigate the relationship between pain catastrophizing and the ability to inhibit selective attention to pain-related faces (attentional bias); and (b) to determine whether attentional control moderated this relationship. one hundred and ten pain-free participants completed the anti-saccade task with dynamic facial expressions, specifically painful, angry, happy, and neutral facial expressions and questionnaires including a measure of pain catastrophizing. As predicted, participants with high pain catastrophizing had significantly higher error rates for antisaccade trials with pain faces relative to other facial expressions, indicating a difficulty disinhibiting attention towards painful faces. In moderation analyses, data showed that attentional control moderated the relationship between attentional bias to pain faces and pain catastrophizing. post-hoc analyses demonstrated that it was shifting attention (not focusing) that accounted for this effect. Only for those with high self-reported ability to shift attention was there a significant relationship between catastrophizing and attentional bias to pain. These findings confirm that attentional control is necessary for an association between attentional bias and catastrophizing to be observed, which may explain the lack of relationships between attentional bias and individual characteristics, such as catastrophizing, in prior research. Cognitive models of chronic pain propose pain catastrophizing as a risk factor that give rise to pain-related concerns and fuels attentional bias to pain-related information 1-6. However, meta-analyses have failed to find relationships between theoretically important constructs, such as pain catastrophizing and attentional biases 7,8. The absence of a relationship is problematic for these theories that suggest attentional biases are associated with pain catastrophizing 2-6. There are explanations for this lack of relationship. Todd et al. 1 argued that attentional biases have a curvilinear relationship with threat and therefore relationships are obscured when assessed by simple correlations. Van Ryckegham et al. 9 have argued that the context of attentional biases is important to whether biases towards or away from pain are helpful. Another possibility was raised by Dear et al. 10 , who found that the reliability of the dot-probe is poor, and reliability remains questionable for some indices using eye-tracking 11. Another frequently raised issue is the lack of ecological validity of the stimuli (typically words). Numerous authors have argued that pain-related images 12 , facial expressions 13 or somatosensory stimuli 5 are more suitable to assess attentional biases in pain. Although research has used facial expression (e.g. 19 , all studies have used static faces, whereas Ceccarini

No preconscious attentional bias towards itch in healthy individuals

“…Furthermore, after perceiving the itchrelated stimulus, switching between different demands (i.e., cognitive flexibility) is necessary to adapt our behaviour: from the external stimulus towards the actual itch-unrelated behaviour. Studies on these characteristics are scarce, with some findings indicating that attentional control (related to cognitive flexibility) is negatively associated with AB towards pain [21][22][23].…”

Predicting the quality of life based on pain dimensions and psychiatric symptoms in patients with Painful diabetic neuropathy: a cross-sectional prevalence study in Iranian patients

“…Higher scores mean greater pain catastrophizing. The PCS has shown good psychometric properties for clinical /non-clinical Iranian samples (Cronbach’s alpha = 0.88) [ 25 , 26 ].…”

Selective attention to pain and empathy: Studying frequent blood donors

“…Eye‐tracking also permits the presentation of more complex and ecologically valid stimuli instead of only two images/words that is used in the dot‐probe paradigm (Soleymani et al., 2022 ). Other future directions include examining the potential moderating role of attentional control in the association between empathy and selective attention to pain (Mazidi, Dehghani et al., 2019 ; Ranjbar et al., 2020 ), employing eye‐tracking methodology to examine attentional allocation to pain information in a continuous manner and test its association with empathy. Fourth, different components of selective attention, that is, facilitated attentional engagement and difficulty disengagement, can differentially contribute to empathy.…”

“…The higher the total score, the more the patient exhibits pain catastrophizing. The PCS has been shown to be a reliable and valid measure for both samples with and without psychopathology (Khatibi et al., 2014 ; Ranjbar et al., 2020 ). Internal consistency for the total score (Cronbach's alpha) in the present study's sample was .88.…”