The Experience of Cognitive Intrusion of Pain

Attridge, Nina; Crombez, Geert; Ryckeghem, Dimitri Van; Keogh, Edmund; Eccleston, Christopher

doi:10.1097/j.pain.0000000000000257

Cited by 52 publications

(37 citation statements)

References 62 publications

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“…The relation between pain intensity and the experience of goal conflict warrant further scrutiny. Second, we found that the number of pain-related goal conflicts was associated with a higher number of cognitive intrusions ( Attridge et al, 2015 ) as well as more anxiety ( Antony et al, 1998 ; De Beurs et al, 2001 ; Lovibond & Lovibond, 1995a ). Given the importance of pain-related fear and catastrophizing in the fear-avoidance model, we also expected that the greater pain-related fear, and the more catastrophizing, the more conflicts patients would experience.…”

Section: Discussionmentioning

confidence: 77%

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Goal conflict in chronic pain: day reconstruction method

Claes

Lauwerier

Meulders

et al. 2018

PeerJ

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BackgroundWhen suffering from chronic pain, attempts to control or avoid pain often compete with other daily activities. Engaging in one activity excludes engaging in another, equally valued activity, which is referred to as “goal conflict.” As yet, the presence and effects of goal conflicts in patients with chronic pain remain poorly understood.MethodsThis study systematically mapped the presence and experience of goal conflicts in patients with fibromyalgia compared to healthy controls. A total of 40 patients and 37 controls completed a semi-structured interview in which they first reconstructed the previous day, identified conflicts experienced during that day, and classified each of the conflicting goals in one of nine goal categories. Additionally, they assessed how they experienced the previous day and the reported conflicts.ResultsResults showed that patients did not experience more goal conflicts than healthy controls, but that they did differ in the type of conflicts experienced. Compared to controls, patients reported more conflicts related to pain, and fewer conflicts involving work-related, social or pleasure-related goals. Moreover, patients experienced conflicts as more aversive and more difficult to resolve than control participants.DiscussionThis study provides more insight in the dynamics of goal conflict in daily life, and indicates that patients experience conflict as more aversive than controls, and that conflict between pain control (and avoidance) and other valued activities is part of the life of patients.

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Section: Discussionmentioning

confidence: 77%

“…The ECIP was used to measure the extent to which the experience of pain interferes with thinking when experiencing pain ( Attridge et al, 2015 ). The scale has 10 items, all scored on a seven-point scale (0 = not at all applicable; 6 = highly applicable).…”

Section: Methodsmentioning

confidence: 99%

Goal conflict in chronic pain: day reconstruction method

Claes

Lauwerier

Meulders

et al. 2018

PeerJ

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“…In particular, studies highlight the importance of hypervigilance and selective attention for pain [15,23,65], interruption by pain [2,17], and difficulty disengaging from pain [17,29]. Yet, in recent theoretical models, biased attending is proposed as an outcome of biased interpretation, specifically, in the interpretation and appraisal of pain and pain-related information as threatening.…”

Section: Discussionmentioning

confidence: 99%

Biased interpretations of ambiguous bodily threat information in adolescents with chronic pain

Heathcote

Jacobs

Eccleston

et al. 2017

PAIN

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Adult patients with chronic pain are consistently shown to interpret ambiguous health and bodily information in a pain-related and threatening way. This interpretation bias may play a role in the development and maintenance of pain and disability. However, no studies have yet investigated the role of interpretation bias in adolescent patients with pain, despite that pain often first becomes chronic in youth. We administered the Adolescent Interpretations of Bodily Threat (AIBT) task to adolescents with chronic pain (N = 66) and adolescents without chronic pain (N = 74). Adolescents were 10 to 18 years old and completed the study procedures either at the clinic (patient group) or at school (control group). We found that adolescents with chronic pain were less likely to endorse benign interpretations of ambiguous pain and bodily threat information than adolescents without chronic pain, particularly when reporting on the strength of belief in those interpretations being true. These differences between patients and controls were not evident for ambiguous social situations, and they could not be explained by differences in anxious or depressive symptoms. Furthermore, this interpretation pattern was associated with increased levels of disability among adolescent patients, even after controlling for severity of chronic pain and pain catastrophizing. The current findings extend our understanding of the role and nature of cognition in adolescent pain, and provide justification for using the AIBT task in longitudinal and training studies to further investigate causal associations between interpretation bias and chronic pain.

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“…That way, we may find (dis)similarities with other constructs, and identify the critical components in an explanatory model of pain, distress, and disability. Some of these components may relate to repetitive negative thinking (Davey & Levy, 1998;Flink, Boersma & Linton, 2013), appraisal (Sullivan et al, 2001), expectancies about future pain and disability (Peerdeman et al, 2016), cognitive intrusion (Attridge et al, 2015), or personal inadequacies (Davey & Levy, 1998). Second, if researchers truly want to investigate the causal role of psychological variables in predicting pain, pain-related distress and disability, we need to carefully check and appropriately control for confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Let’s talk about pain catastrophizing measures: an item content analysis

Crombez

Paepe

Veirman

et al. 2020

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Background Concerns have been raised about whether self-report measures of pain catastrophizing reflect the construct as defined in the cognitive-behavioral literature. We investigated the content of these self-report measures; that is, whether items assess the construct ‘pain catastrophizing’ and not other theoretical constructs (i.e., related constructs or pain outcomes) using the discriminant content validity method. Method Items (n = 58) of six pain catastrophizing measures were complemented with items (n = 34) from questionnaires measuring pain-related worrying, vigilance, pain severity, distress, and disability. Via an online survey, 94 participants rated to what extent each item was relevant for assessing pain catastrophizing, defined as “to view or present pain or pain-related problems as considerably worse than they actually are” and other relevant constructs (pain-related worrying, vigilance, pain severity, distress, and disability). Results Data were analyzed using Bayesian hierarchical models. The results revealed that the items from pain-related worrying, vigilance, pain severity, distress, and disability questionnaires were distinctively related to their respective constructs. This was not observed for the items from the pain catastrophizing questionnaires. The content of the pain catastrophizing measures was equally well, or even better, captured by pain-related worrying or pain-related distress. Conclusion Based upon current findings, a recommendation may be to develop a novel pain catastrophizing questionnaire. However, we argue that pain catastrophizing cannot be assessed by self-report questionnaires. Pain catastrophizing requires contextual information, and expert judgment, which cannot be provided by self-report questionnaires. We argue for a person-centered approach, and propose to rename ‘pain catastrophizing’ measures in line with what is better measured: ‘pain-related worrying’.

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The Experience of Cognitive Intrusion of Pain

Abstract: The Experience of Cognitive Intrusion of Pain scale was unidimensional, showed construct validity, differentiated fibromyalgia patients and controls, and predicted pain disability.

Cited by 52 publications

References 62 publications

Goal conflict in chronic pain: day reconstruction method

Goal conflict in chronic pain: day reconstruction method

Biased interpretations of ambiguous bodily threat information in adolescents with chronic pain

Let’s talk about pain catastrophizing measures: an item content analysis

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