Processing of Emotional Faces in Patients with Chronic Pain Disorder: An Eye-Tracking Study

Giel, Katrin Elisabeth; Paganini, Sarah; Schank, Irena; Enck, Paul; Zipfel, Stephan; Junne, Florian

doi:10.3389/fpsyt.2018.00063

Cited by 14 publications

(19 citation statements)

References 38 publications

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“…Independent of group (patients vs. controls), we found that (1) emotional faces attracted more attention than neutral faces, and (2) happy faces were attentionally preferred over angry and pain faces in the later stages of processing. These findings are in line with the results of our previous study [ 16 ] and with several other eye tracking studies either reporting attentional preference for emotional stimuli in general (emotionality bias) [ 8 , 9 , 12 , 14 ] or attentional preference for happy faces (positivity bias) [ 10 , 29 ] in both pain patients and controls.…”

Section: Discussionsupporting

confidence: 93%

Attentional processing of pain faces and other emotional faces in chronic pain–an eye-tracking study

et al. 2021

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Altered attentional processing of pain-associated stimuli–which might take the form of either avoidance or enhanced vigilance–is thought to be implicated in the development and maintenance of chronic pain. In contrast to reaction time tasks like the dot probe, eye tracking allows for tracking the time course of visual attention and thus differentiating early and late attentional processes. Our study aimed at investigating visual attention to emotional faces in patients with chronic musculoskeletal pain (N = 20) and matched pain-free controls (N = 20). Emotional faces (pain, angry, happy) were presented in pairs with a neutral face for 2000 ms each. Three parameters were determined: First fixation probabilities, fixation durations (overall and divided in four 500 ms intervals) and a fixation bias score as the relative fixation duration of emotional faces compared to neutral faces. There were no group differences in any of the parameters. First fixation probabilities were lower for pain faces than for angry faces. Overall, we found longer fixation duration on emotional compared to neutral faces (‘emotionality bias’), which is in accord with previous research. However, significant longer fixation duration compared to the neutral face was detected only for happy and angry but not for pain faces. In addition, fixation durations as well as bias scores yielded evidence for vigilant-avoidant processing of pain faces in both groups. These results suggest that attentional bias towards pain-associated stimuli might not generally differentiate between healthy individuals and chronic pain patients. Exaggerated attentional bias in patients might occur only under specific circumstances, e.g., towards stimulus material specifically relating to the specific pain of the patients under study or under high emotional distress.

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Section: Discussionsupporting

confidence: 93%

Attentional processing of pain faces and other emotional faces in chronic pain–an eye-tracking study

et al. 2021

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“…While they found differences in biases towards emotional stimuli (including happy faces) between the participants with and without chronic pain in the control group where depression differed, no such differences were observed between the participants with and without chronic pain where both groups were matched on depression. Unfortunately, Giel et al 57 did not include pain faces in their study and therefore whether similar levels of depression could account for the current findings remains speculative.…”

Section: Discussionmentioning

confidence: 76%

“…On the contrary, it may be that anxiety, stress, and depression are important to attentional processes and that biases towards pain are ONLY observed in samples that differ on key measures of distress. For example, Giel et al 57 assessed the ABs of participants with chronic pain and two control groups, one of whom were matched for depressive symptoms. While they found differences in biases towards emotional stimuli (including happy faces) between the participants with and without chronic pain in the control group where depression differed, no such differences were observed between the participants with and without chronic pain where both groups were matched on depression.…”

Section: Discussionmentioning

confidence: 99%

Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study

Mazidi

Dehghani

Sharpe

et al. 2019

British Journal of Pain

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Introduction: This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional bias in chronic pain patients. Methods: A total of 28 patients with chronic pain and 29 pain-free individuals observed pictures of pain, happy and neutral facial expressions while their gaze behaviour was recorded. Pain intensity and duration, anxiety, depression, stress, attentional control and pain catastrophizing were assessed by questionnaires. Results: In all subjects, the pattern of attention for pain faces was characterized by initial vigilance, followed by avoidance. No significant difference was found between the two groups in terms of orientation towards the stimuli, the duration of first fixation, the average duration of fixation or number of fixations on the pain stimuli. Attentional control moderated the relationship between catastrophizing and overall dwell time for happy faces in pain patients, indicating that those with high attentional control and high catastrophizing focused more on happy faces, whereas the reverse was true for those with low attentional control. Conclusion: This study supported the vigilance–avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients.

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“…In free-viewing tasks, participants were typically asked to freely explore one (Schoth, Wu, et al, 2019) or more (Priebe et al, 2015) visual stimuli simultaneously presented in random locations as if they were watching television. In some studies, participants were informed about locations in which emotional stimuli (i.e., happy or sad face) would appear prior to free-viewing (Giel et al, 2018). In others, free-viewing of certain visual stimuli was followed by possible pain stimulation versus its absence (Jackson et al, 2018a(Jackson et al, , 2018b.…”

Section: Pain and Eye-tracking Measures Of Attentional Biasesmentioning

confidence: 99%

Pain-related attentional processes: A systematic review of eye-tracking research

Chan

Suen

Jackson

et al. 2020

Clinical Psychology Review

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Biases in the way that people direct their attention towards or away from pain-related information are hypothesised to contribute to the onset and severity of pain-related disorders. This systematic review summarised 24 eye-tracking studies (N = 1424) examining effects of chronic pain, stimulus valence, individual differences in pain-related constructs such as fear of pain and pain catastrophising, and experimentally-induced pain or pain-related threat on attentional processing of visual stimuli. The majority of studies suggest that people with and without chronic pain do not differ in their eye movements on pain-related stimuli, although there is preliminary evidence that gaze biases vary across subtypes of chronic pain and may be evident only for certain stimuli. In contrast, participants with and without chronic pain exhibit a general tendency to allocate more first fixations and total fixations upon pain-related compared to neutral stimuli. Fear of pain was found to have limited effects on eye movements, whereas the tendency to catastrophise about pain, the anticipation of pain, and actual experimental pain stimulation have had stronger associations with eye movements, although results have been mixed. Methodological limitations and future research directions are discussed.

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Processing of Emotional Faces in Patients with Chronic Pain Disorder: An Eye-Tracking Study

Cited by 14 publications

References 38 publications

Attentional processing of pain faces and other emotional faces in chronic pain–an eye-tracking study

Attentional processing of pain faces and other emotional faces in chronic pain–an eye-tracking study

Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study

Pain-related attentional processes: A systematic review of eye-tracking research

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