Towards a new model of attentional biases in the development, maintenance, and management of pain

Todd, Jemma; Sharpe, Louise; Johnson, Anya; Perry, Kathryn Nicholson; Colagiuri, Ben; Dear, Blake F.

doi:10.1097/j.pain.0000000000000214

Cited by 124 publications

(220 citation statements)

References 41 publications

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“…Indeed, research on AB to pain has mainly focused on its role in healthy participants and experimental pain tasks (e.g., the coldpressor paradigm [42,49]). In this way, the current findings corroborate demonstrated associations between AB to pain and reported pain and disability among individuals with chronic pain [4, 33,48].…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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

View full text Add to dashboard Cite

show abstract

“…They did not however find any relationship between attentional biases and pain outcomes. Conversely, we recently reviewed prospective studies and found that avoidance of salient stimuli or a bias towards positive stimuli predicted chronicity (Todd et al, 2015).…”

Section: Introductionmentioning

confidence: 98%

“…Research exploring the role of attentional biases in the experience of pain is growing rapidly, with a number of recent systematic reviews (Pincus & Morley, 2001;Todd et al, 2015) and metaanalyses (Crombez, Van Ryckeghem, Eccleston, & Van Damme, 2013;Schoth, Nunes, & Liossi, 2012) having been published. Importantly, although most researchers agree that attentional biases play a role in pain, the specific nature of these attentional biases is still yet to be determined and research to date remains somewhat inconsistent regarding the best parameters under which to detect these biases.…”

Section: Introductionmentioning

confidence: 99%

Attentional bias modification and pain: The role of sensory and affective stimuli

Todd

Sharpe

Colagiuri

2016

Behaviour Research and Therapy

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There is growing evidence to support attentional bias modification (ABM) techniques such as the modified dot-probe task within the pain literature. Such techniques can help to inform theoretical models of pain by identifying the causal role of attentional bias constructs. The aim of this research was to explore the effects of dot-probe ABM that trains individuals towards (+) or away from (-) sensory (S) and affective (A) pain words, on attentional biases, interpretation biases, and pain outcomes. Healthy undergraduate students (N = 106) completed questionnaires, an attentional bias dot-probe task, and an interpretation bias task before and after ABM, one of four ABM versions that differed in training direction (S+A+, S-A+, S+A-, S-A-), and pain outcomes using the cold pressor task. Those trained towards affective pain words were found to have a greater pain threshold but also greater distress at tolerance. However, mechanisms of change could not be established, as ABM did not affect attentional or interpretation bias, even though changes in attentional bias were associated with pain outcomes. These findings provide partial support for the threat interpretation model and highlight the utility of affective pain ABM, although further investigation of causal mechanisms is warranted.

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“…Definitely, there is room for improvement, but space limitations do not allow us to elaborate this further. Following the rationale on the causal role of attentional bias in anxiety and fear (Hakamata et al, 2010), pain researchers have formulated a similar role for attentional bias in the development and maintenance of chronic pain (Todd et al, 2015). They also argued to directly modify the attentional bias towards painrelated information by teaching patients to direct their attention away from pain-related information (Sharpe et al, 2012).…”

Section: Pain and Attentional Biasmentioning

confidence: 99%

The experimental analysis of the interruptive, interfering, and identity-distorting effects of chronic pain

Vlaeyen

Morley

Crombez

2016

Behaviour Research and Therapy

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Pain is an unpleasant sensory and emotional experience urging the individual to take action to restore the integrity of the body. The transition from a common episode of acute pain to a state of intermittent or chronic pain has been a constant preoccupation of researchers and clinicians alike. In this review, we approach chronic pain from a modern learning perspective that incorporates cognitive, affective, behavioral and motivational aspects. We view pain as a biologically hard-wired signal of bodily harm that competes with other demands in the person's environment. The basic tenet is that pain urges people to interrupt ongoing activity, elicits protective responses that paradoxically increase interference with daily activities, and compromises the sense of self. Here we briefly summarize existing evidence showing how pain captures attention, and how attention for pain can be controlled.We also consider pain as a strong motivator for learning, and review the recent evidence on the acquisition and generalization of pain-related fear and avoidance behavior, which are likely to interfere with daily life activities. We highlight the paradoxical effects of pain avoidance behavior, and review treatment effects of exposure in vivo. A generally neglected area of research is the detrimental consequences of repeated interference by pain with daily activities on one's sense of "self". We end this review with a plea for the implementation of single-case experimental designs as a means to help customize and develop novel cognitive-behavioral treatments for individuals for chronic pain aimed at reducing the suffering of this large group of individuals.3

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Towards a new model of attentional biases in the development, maintenance, and management of pain

Cited by 124 publications

References 41 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

Attentional bias modification and pain: The role of sensory and affective stimuli

The experimental analysis of the interruptive, interfering, and identity-distorting effects of chronic pain

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