Cognitive Biases in Children and Adolescents With Chronic Pain: A Review of Findings and a Call for Developmental Research

Abstract

This article provides a rationale for the theoretical and practical importance of studying the role of cognitive biases in children and adolescents with chronic pain, which has to date, been relatively understudied. Existing findings are reviewed critically, and recommendations for future research are offered.

Cognitive biases in pain: an integrated functional–contextual framework

“…10,11,15,16,51,56,77,87,93,94 This intuitively appealing idea has resulted in an exponential increase in research addressing the presence, antecedents, and consequences of cognitive biases in people experiencing acute and chronic pain. 10,13,17,41,51,52,67,68,78 However, results are inconsistent and puzzling, with mixed support for theoretical-driven assumptions. 12,41,67,87,88,93 The aim of this review is to (a) synthesize and discuss current knowledge on the role of cognitive biases in pain, (b) provide conceptual and methodological explanations for equivocal findings, and (c) develop an integrated functional-contextual framework for understanding the role of cognitive biases in pain.…”

“…10,13,17,41,51,52,67,68,78 However, results are inconsistent and puzzling, with mixed support for theoretical-driven assumptions. 12,41,67,87,88,93 The aim of this review is to (a) synthesize and discuss current knowledge on the role of cognitive biases in pain, (b) provide conceptual and methodological explanations for equivocal findings, and (c) develop an integrated functional-contextual framework for understanding the role of cognitive biases in pain. Based on this framework, we propose a new research agenda and discuss implications for clinical practice.…”

“…13 Equally inconsistent relationships have been found in prospective research 42,43,44,74 and in youth with pain. 6,41 For interpretation bias, a recent meta-analysis indicated that individuals with chronic pain tend to interpret ambiguous information as more pain-related than healthy individuals. 67 This meta-analysis also revealed a lack of research addressing the link between interpretation bias and its theoretically-proposed antecedents and consequences.…”

“…67 This meta-analysis also revealed a lack of research addressing the link between interpretation bias and its theoretically-proposed antecedents and consequences. 41 The few studies investigating the link between pain severity or pain-related anxiety and biased interpretations for bodily threat in individuals living with chronic pain failed to find consistent associations. 57,60,but see39 Similarly, in healthy individuals, no systematic link was observed between pain-related anxiety and interpretation bias.…”

Cognitive bias and stuttering in adolescence

“…On the other hand, participants with high social anxiety showed a negative interpretation bias for the verbal scenarios only, with no bias for the nonverbal scenarios. This negative interpretation bias for verbal scenarios mirrors the findings of negative interpretation bias in other studies of socially anxious youth (Haller et al, 2016;Miers et al, 2008;Orchard, Apetroaia, Clarke, & Creswell, 2017) and adults (Amir et al, 2005;Dryman & Heimberg, 2015;Giannini & Loscalzo, 2016;Huppert et al, 2003;Kanai, Sasagawa, Chen, Shimada, & Sakano, 2010), as well as other health issues in youth and adult populations such as depression (Eley et al, 2008;Holmes, Lang, & Shah, 2009;Normansell & Wisco, 2017) and chronic pain (see review by Lau et al, 2018). Speaking is regarded as a performance-based social situation whereby the manner and content of one's verbal delivery can be judged by listeners, whereas non-speaking social situations may not necessarily subsume such listener evaluation.…”