Pain and Attention: Attentional Disruption or Distraction?

Abstract

The effect of pain processing on attention capacity during visual search was examined in 2 experiments. In the first experiment, we investigated whether pain draws on the same limited resources as attentional task performance. It was hypothesized that pain would negatively affect task performance under different load manipulations. Low and high load conditions of a visual search task were presented in a mixed design combined with a painfully cold or neutral cold pressor test. Performance was not affected by pain. In experiment 2, low and high load conditions were separated in different blocks to study whether pain perception was affected when task load could be anticipated. Again, pain did not significantly affect task performance. In contrast, subjective pain intensity scores were significantly lower after performing the high load compared with the low load condition. Simultaneous recordings of event-related potentials indicated an increased negativity during the pain compared with the control condition. Also, in the early (350 to 450 msec) interval of event-related potentials, an increase in negativity was found for the high load compared with the low load condition. Topographic distributions suggested that pain and task load are mediated by qualitatively different resources.Perspective: Our findings indicate that highly demanding attentional task performance and pain processing interfere as a result of difficulties in allocating attention. The clinical relevance of this finding is that performing a highly demanding task might distract attention from pain. © 2006 by the American Pain Society Key words: Pain, cold pressor test, attention capacity, event-related potentials, distraction, visual search.I t has long been recognized that there are limitations to the capacity to allocate attention. 21,38 The resourcebased model of attention and pain processing suggests that pain and attentional tasks draw on the same limited attentional resources. 12 Results from studies investigating the role of attention in the processing of pain are, however, inconclusive. On the one hand, it has been shown that allocating attention to a cognitive task can modulate pain perception, ie, pain is perceived as less intense when distraction occurs, 12,45 although this has been challenged. 17,27 Performing an attention demanding cognitive task is hypothesized to displace attention available for the processing of pain. Moreover, a number of studies have shown that difficult tasks might be more successful in altering pain perception than easier tasks. 3,26,30,36 Hence, attention to a cognitive task might alter pain perception only when task load is sufficiently high.On the other hand, it has been hypothesized that pain perception can modulate attention demanding task performance. 9 Pain is a high-priority signal for danger and threat and therefore draws on limited capacity, which might lead to capacity limits being exceeded and there-

Changes in self-perceived role identity modulate pain perception

“…If the hero condition had a higher cognitive load capturing more attention, a pain stimulus would be then less of a distraction, resulting in higher tolerance values. Highly demanding tasks might distract attention from pain causing lower subjective intensity values (Veldhuijzen et al, 2006). Interestingly, we observed a significant increase and not a decrease of pain intensity ratings for heroes/heroines.…”

The Interruptive Effect of Pain in a Multitask Environment: An Experimental Investigation

“…This finding is in line with research showing that task performance during the presence of pain was poorer. 2,7,10,11,12,13,16,24,32,43, but also see 31,36,45 This effect was, however, small and just failed to reach significance. This is in contrast with previous findings which mostly report that pain has a relatively large interference effect on concurrent tasks.…”

“…Most often, attention is prioritized towards pain, which interrupts the smooth-running of goal-directed behavior. 17,27 Performance on a cognitive task is known to be hindered by the simultaneous presence of pain 2,7,10,11,12,13,16,24,32,43, but also see 31,36,45 or pain-related information (e.g. pain words).…”

Pain and Attention: A Discussion of Two Studies

“…Vancleef et al 2 showed that administration of a pain stimulus caused task performance deterioration. In contrast, Veldhuijzen et al 3 demonstrated that administration of pain did not cause deficits in attentional task performance.…”

“…Although the subjects were instructed to ignore the pain stimuli and to concentrate on performing the task, task performance deteriorated when the pain stimulus was simultaneously applied with the task. In contrast, in the study of Veldhuijzen et al, 3 participants were not informed that the stimulus applied would be painful, and therefore, the participants did not experience anticipatory fear toward the pain stimulus. The results of this study demonstrated that when participants were not expecting a painful stimulus, and therefore the pain stimulus had no threat value, no disruptive effects of pain on attention were found.…”