Effects of attentional bias modification on chronic low back pain in older outpatients

Hasegawa, Takashi; Nishi, Keita; Nakashima, Akira; Moriuchi, Takefumi; Iso, Nozomi; Koseki, Hironobu; Tabira, Takayuki; Higashi, Toshio

doi:10.1097/md.0000000000027738

Cited by 4 publications

(3 citation statements)

References 49 publications

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“…Therefore, we cannot conclude that the ABM-training worked as we assume. This is in line with the most recent findings on ABM-training for itch ( 16 ) and also pain ( 39 , 40 ), as well as the limited findings on preconscious ABM-training for threat ( 27 ). In addition to the fact that the current ABM-training had not the expected effect on the AB assessment measures, it also did not show effects on itch sensitivity, although this appeared to be more promising according to earlier findings in pain ( 17–19 ).…”

Section: Discussionsupporting

confidence: 91%

Subliminal attentional bias modification training for itch

Becker,

Van Ryckeghem,

Van Damme

et al. 2023

Front. Med.

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IntroductionItch is unpleasant and induces the urge to scratch. This is adaptive to remove the itch-inducing stimulus from the skin. Accordingly, itch draws attention to protect our bodily integrity. Recent studies investigated whether attention is preferentially drawn towards its location, i.e., attentional bias (AB), and also whether this bias could be changed in healthy individuals. So far, results are mixed concerning the existance of an attentional bias towards itch stimuli in healthy individuals as well as the impact of modifications. However, available studies have typically focused on conscious processing and might miss preconscious aspects of attention and potential biases at these stages.MethodsThis study included 117 healthy individuals who underwent a subliminal Attentional Bias Modification (ABM)- training for itch based on a dot-probe paradigm with itch- related pictures. Participants were randomly assigned to a training towards itch group, a training away from itch group and a control group. This was done by manipulating the itch-target congruency of the dot-probe task during a training block. Pre- and post-training assessments were regular dot-probe tasks. Exploratorily, also attentional inhibition, cognitive flexibility and itch-related cognitions were assessed. Lastly, participants received an itchy stimulus on the inner forearm before and after the ABM-training to assess potential effects on itch sensitivity.ResultsResults showed no AB towards itch across groups at baseline, i.e., pre-training, but an AB away from itch, hence, avoidance of itch, post-training. Further analyses showed that this effect was driven by an attentional bias away from itch in the control group, while there were no significant effects in the experimental groups. There was no effect on itch sensitivity.ConclusionThese findings are in line with recent studies on conscious ABM-training for itch and pain that also did not find significant training effects. Therefore, it is suggested that the field of AB might need to reconsider the current assessment of AB. Moreover, AB is probably a dynamic process that is highly dependent on current itch-related goals and relevance of itch in a specific situation. This suggests that processes probably differ in patients with chronic itch and that also ABM-training might work differently in these populations.Clinical trial registrationhttps://trialsearch.who.int/Trial2.aspx?TrialID=NTR7561, identifier NTR7561.

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Section: Discussionsupporting

confidence: 91%

Subliminal attentional bias modification training for itch

Becker,

Van Ryckeghem,

Van Damme

et al. 2023

Front. Med.

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“…Ten studies required participants to be 65 years old or above [ 25 , 26 , 32 , 34 , 39 , 46 – 49 , 51 ]; 16 studies included participants at least 50 years old; two studies included all adults from 18 [ 50 ] or 21 years old [ 29 ]; and no age criterion was specified in three studies [ 37 , 52 , 54 ]. Two studies placed a maximum age criterion: 80 [ 33 ] or 85 [ 36 ] years.…”

Section: Resultsmentioning

confidence: 99%

“…The conditions targeted were back or neck pain [ 25 , 32 , 33 , 37 – 39 , 46 – 48 , 54 ], osteoarthritis- or arthritis-related pain [ 26 , 27 , 29 , 40 , 41 , 50 , 52 ], musculoskeletal pain [ 42 , 51 , 55 ], unspecified chronic pain or from more than one site in bones, muscles, or joints [ 28 , 30 , 31 , 34 – 36 , 45 , 49 , 53 ], and undiagnosed knee pain [ 43 , 44 ]. Eleven studies excluded people with pain due to conditions which were not the target of the intervention, e.g., pain from cancer, acute injury or trauma, or infection [ 27 , 33 – 35 , 37 , 40 , 44 , 46 , 50 , 54 , 55 ].…”

Section: Resultsmentioning

confidence: 99%

Mapping review of pain management programmes and psychological therapies for community-dwelling older people living with pain

Lam,

Green,

Hallas

et al. 2023

Eur Geriatr Med

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Purpose Persistent pain is common in older people and people living with frailty. Pain or the impact of pain on everyday life is potentially modifiable. We sought to map research evidence and information from randomised controlled trials (RCTs) of pain management programmes and psychological therapies targeting community-dwelling older people, and explore appropriate strategies and interventions for managing or reducing the negative impact of pain for older people, particularly those with frailty. Method A mapping review of pain management programmes and psychological therapies for community-dwelling older people living with chronic pain. We searched for systematic reviews of randomised controlled trials and for individual randomised controlled trials and extracted data from eligible studies. Results Searches resulted in 3419 systematic review records and 746 RCT records from which there were 33 eligible interventions identified in 31 eligible RCTs (48 reports). Broad aims of the interventions were to: improve physical, psychological, or social functioning; adjust the effects or sensation of pain psychologically; enhance self-care with self-management skills or knowledge. Common mechanisms of change proposed were self-efficacy enhanced by self-management tasks and skills, using positive psychological skills or refocusing attention to improve responses to pain, and practising physical exercises to improve physiological well-being and reduce restrictions from pain. Content of interventions included: skills training and activity management, education, and physical exercise. Interventions were delivered in person or remotely to individuals or in groups, typically in 1–2 sessions weekly over 5–12 weeks. Conclusion All the evaluated interventions appeared to show potential to provide some benefits to older people. None of the included studies assessed frailty. However, some of the included interventions appear appropriate for community-dwelling older people living with both frailty and pain.

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