Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials

Sharpe, Louise; Ianiello, Melissa; Dear, Blake F.; Perry, Kathryn Nicholson; Refshauge, Kathryn M.; Nicholas, Michael K.

doi:10.1016/j.pain.2011.12.014

Cited by 118 publications

(132 citation statements)

References 43 publications

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“…Collectively, such findings suggest that AB toward pain may contribute to greater pain/difficulty appraisals of everyday physical activity, and may ultimately contribute to greater disability. Accordingly, these findings further attest to the critical role of modifying attention to pain within clinical interventions or its underlying cognitions that fuel AB for pain [34,47].…”

Section: Discussionmentioning

confidence: 69%

The Effect of Perceived Injustice on Appraisals of Physical Activity: An Examination of the Mediating Role of Attention Bias to Pain in a Chronic Low Back Pain Sample

Trost

Ryckeghem

Scott

et al. 2016

The Journal of Pain

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The current study examined the relationship between perceived injustice and attentional bias (AB) toward pain among individuals with chronic low back pain asked to perform and appraise the pain and difficulty of a standardized set of common physical activities. A pictorial dot-probe task assessed AB toward pain stimuli (i.e., pain faces cueing pain), after which participants performed the physical tasks. Participants also rated face stimuli in terms of pain, sadness, and anger expression. As hypothesized, perceived injustice was positively associated with AB toward pain stimuli; additionally, perceived injustice and AB were both positively associated with appraisals of pain and difficulty. Counter to expectations, AB did not mediate the relationship between perceived injustice and task appraisals, suggesting that AB is insufficient to explain this relationship. Exploratory analyses indicated that participants with higher levels of perceived injustice rated stimulus faces as sadder and angrier; no such differences emerged for pain ratings. This is the first study to examine the association between perceived injustice and AB toward pain, as well as perceived injustice and in-vivo appraisals of common physical activity. Results extend existing literature and suggest that attentional and potential interpretive bias should be considered in future research.Perspective: This article identifies significant associations between perceived injustice, biased attention to pain, and appraisals of common physical activities among individuals with chronic low back pain. These findings suggest targets for intervention as well as directions for future research regarding individuals with high perceptions of injustice related to pain.

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Section: Discussionmentioning

confidence: 69%

The Effect of Perceived Injustice on Appraisals of Physical Activity: An Examination of the Mediating Role of Attention Bias to Pain in a Chronic Low Back Pain Sample

Trost

Ryckeghem

Scott

et al. 2016

The Journal of Pain

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show abstract

“…Several treatment options have been proposed. Recent findings suggest that attentional bias may be modified in such way that attention is directed away from fear-related information (e.g., [47]) and pain-related information (e.g., [33], but see [48]). Other treatment options that have been proposed are interventions that target the fear system and the threat value of pain as this has been argued to fuel attentional bias towards pain-related information [53,59].…”

Section: Discussionmentioning

confidence: 99%

The predictive value of attentional bias towards pain-related information in chronic pain patients: A diary study

Ryckeghem

Crombez²,

Goubert³

et al. 2013

Pain

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“…Some consider such biases as etiopathological factors in the development, maintenance or exacerbation of pain problems [53,54]. In line with this view are the findings of an experimental study with healthy volunteers performing a cold-pressor task which showed that attentional retraining may affect peoples' pain threshold as well as their pain experience [37], indicating a causal influence of attentional bias towards pain-related information on pain outcomes.…”

mentioning

confidence: 85%

Attentional bias towards pain-related information diminishes the efficacy of distraction

Ryckeghem

Crombez²,

Hulle³

et al. 2012

Pain

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IntroductionThe ability of attention to modulate pain processing [32,51,57,66] makes it a key factor in how people cope with pain. Distraction, defined as directing attention away from pain, is probably one of the most intuitively and commonly used coping strategies [33]. Although distraction seems to be omnipresent in pain treatment programs for acute and chronic pain [20,41], results on its efficacy are variable. Some studies found that distraction reduces pain [36,39,44,57,58,65], whereas other studies reported no effect [25,35] or even counter-productive effects [8,21]. An understanding of the conditions under which distraction works is therefore required. Both pain-related factors (e.g., intensity, novelty, threat) and factors related to the task towards which attention is directed (e.g., task difficulty, motivational significance) are likely to play a role [19,32,66].A tendency to selectively attend to pain has been argued to hamper the efficacy of distraction [15,32,72], and is largely discussed in the context of hypervigilance and attentional bias towards pain-related information [15,31]. Indeed, it is reasonable to assume that an attentional bias towards pain-related information may bring along difficulties to direct attention away from pain and, hence, result in a failure of distraction to diminish the experience of pain. However, there is no direct test of this idea. Most often, studies on attentional bias in pain aimed to validate the phenomenon (e.g. [23,34,45,52]), or attempted to identify its antecedent conditions (e.g. catastrophic thinking about pain, state/trait anxiety) [4,46,47,62]. In this study we focussed upon one of the putative consequences of We hypothesized that participants would show an attentional bias towards both cues signalling the experimental pain stimulus and words describing this pain stimulus. Furthermore, we expected that self-reported pain would be less when attention was directed away from pain than when it was directed towards pain. The crucial hypothesis of this study, however, was that a larger attentional bias would be associated with smaller effects of distraction. Finally, we wanted to explore whether an attentional bias towards pain-related information would mediate the relationship between catastrophic thinking about pain and the efficacy of distraction.4 Method ParticipantsThe sample consisted of 56 undergraduate students from Ghent University, who received course credits for participation (45 females; Mage = 18.1years, SD = 1.1; 55 Caucasian) with normal or corrected-to-normal vision. Exclusion criteria included a self-reported current pain problem (e.g. fibromyalgia, back pain) or a self-reported current psychiatric problem (e.g., psychosis, anxiety disorder).Furthermore, all participants were required to have Dutch as a first language, because the experiment, including all instructions and stimulus materials, was undertaken in Dutch. Based on these criteria, two persons were excluded due to a headache on time of testing. One additional participant was excluded...

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Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials

Cited by 118 publications

References 43 publications

The Effect of Perceived Injustice on Appraisals of Physical Activity: An Examination of the Mediating Role of Attention Bias to Pain in a Chronic Low Back Pain Sample

The Effect of Perceived Injustice on Appraisals of Physical Activity: An Examination of the Mediating Role of Attention Bias to Pain in a Chronic Low Back Pain Sample

The predictive value of attentional bias towards pain-related information in chronic pain patients: A diary study

Attentional bias towards pain-related information diminishes the efficacy of distraction

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