The effects of distraction on responses to cold pressor pain

Hodes, Robert; Rowland, Eric W.; Lightfoot, Nancy; Cleeland, Charles S.

doi:10.1016/0304-3959(90)91115-y

Cited by 103 publications

(78 citation statements)

References 7 publications

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“…Studies investigating this idea have manipulated the difficulty of the distraction task. However, results do not support the central role of task difficulty [23,40,47], thereby challenging the validity of the capacity models.…”

Section: Introductionmentioning

confidence: 68%

The role of motivation in distracting attention away from pain: An experimental study

Verhoeven

Crombez

Eccleston

et al. 2010

Pain

123

128

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Research on the effectiveness of distraction as a method of pain control is inconclusive. One mechanism pertains to the motivational relevance of distraction tasks. In this study the motivation to engage in a distraction task during pain was experimentally manipulated. Undergraduate students (N=73) participated in a cold pressor test (CPT) and were randomly assigned to three groups: a distraction-only group performed a tone-detection task during ther CPT, a motivated-distraction group performed the same task and received a monetary reward for good task performance, and a control group did not perform the tone-detection task. Results indicated that engagement in the distraction task was better in the motivated-distraction group in comparison with the distraction-only group. Participants in both distraction groups experienced less pain compared to the control group. There were no overall differences in pain intensity between the two distraction groups. The effect of distraction was influenced by the level of catastrophic thinking about pain. For low catastrophizers, both distraction groups reported less pain as compared to the nondistracted control group. This was not the case for high catastrophizers. For high catastrophizers it mattered whether the distraction task was motivationally relevant:High catastrophizers reported less intense pain in the motivated distraction group, as compared to the non-distracted control group. We conclude that increasing the motivational relevance of the distraction task may increase the effects of distraction, especially for those who catastrophize about pain.

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Section: Introductionmentioning

confidence: 68%

The role of motivation in distracting attention away from pain: An experimental study

Verhoeven

Crombez

Eccleston

et al. 2010

Pain

123

128

View full text Add to dashboard Cite

show abstract

“…We chose the cold pressor (ie immersion of a limb in ice water) because it exhibits these attributes (al'Absi and Petersen, 2003;Bullinger et al, 1984;Ehrenreich et al, 1997;Farhadi et al, 2005;Gregg et al, 1999;Lovallo, 1975) yet is difficult to ignore. In fact, the response is independent of the subjects' attentiveness (Hodes et al, 1990) and is predicted by the duration of exposure to the stimulus (Lovallo, 1975). Equally important is that data suggest that the systemic actions of the cold pressor (ie cold, elevated blood pressure) have no effect or may actually blunt HPA secretion (Edelson and Robertson, 1986;Kendler et al, 1978;Wittert et al, 1992).…”

Section: Introductionmentioning

confidence: 99%

Neuroendocrine Responses to a Cold Pressor Stimulus in Polydipsic Hyponatremic and in Matched Schizophrenic Patients

Goldman

Gnerlich

Hussain

2006

Neuropsychopharmacol

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Schizophrenia, many believe, reflects an enhanced vulnerability to psychological stress. Controlled exposure to stressors, however, has produced inconclusive results, particularly with regards to neurohormones. Some of the variability may be attributable to the nature and psychological significance of the stimulus and failure to control physiologic confounds. In addition, it is possible that the heterogeneity of schizophrenia is an important factor. In a carefully designed study and in a controlled setting, we measured the neuroendocrine response of eight polydipsic hyponatremic (PHS), seven polydipsic normonatremic (PNS), and nine nonpolydipsic normonatremic (NNS) (ie normal water balance) schizophrenic in-patients as well as 12 healthy controls (HC) to two different stressors: one of which appears to influence neuroendocrine secretion through its psychological (cold pressor) and the other (upright posture) through its systemic actions. Subjects in the three psychiatric groups were stabilized and acclimated to the research setting, and all received saline to normalize plasma osmolality. Following the cold pressor, plasma adrenocorticotropin and cortisol levels showed a more prolonged rise in PHS patients relative to PNS patients. NNS patients, in contrast, exhibited blunted responses relative to both of the polydipsic groups and the HC. Peak vasopressin responses were also greater in PHS and blunted in NNS patients. Responses to the postural stimulus were similar across patient groups. These findings provide a mechanism for life threatening water intoxication in schizophrenia; help to reconcile conflicting findings of stress responsiveness in schizophrenia; and potentially identify a discrete patient subset with enhanced vulnerability to psychological stress.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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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The effects of distraction on responses to cold pressor pain

Cited by 103 publications

References 7 publications

The role of motivation in distracting attention away from pain: An experimental study

The role of motivation in distracting attention away from pain: An experimental study

Neuroendocrine Responses to a Cold Pressor Stimulus in Polydipsic Hyponatremic and in Matched Schizophrenic Patients

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

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