Towards an integrative view of cognitive biases in pain

Ryckeghem, Dimitri Van; Vervoort, Tine

doi:10.1002/ejp.913

Cited by 13 publications

(16 citation statements)

References 5 publications

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“…In line with the recent call to investigate the relationship between different cognitive biases in the field of pain 69,77,92 , we argue for an integrative model in which cognitive biases are interrelated and interacting. Similar to the combined cognitive bias hypothesis, we propose that the relationships between cognitive biases are bidirectional.…”

Section: (3) Cognitive Biases Are Interrelatedsupporting

confidence: 76%

“…20,63 In similar vein, the link between various cognitive biases should be investigated in relation to similar relevant stimuli, as the presence and magnitude of biases may be determined by the particular type and relevance of pain-related stimuli. 92 Second, cognitive biases are typically investigated without taking context into account and in isolation from active goals, which are common in individuals' daily lives (see 70,71 for an exception). Researchers should aim to test theory-driven hypotheses in dynamic functional contexts by implementing real life actions and/or goals during pain.…”

Section: The Future Research Agenda For Cognitive Bias Researchmentioning

confidence: 99%

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Cognitive biases in pain: an integrated functional–contextual framework

Ryckeghem

Noel

Sharpe

et al. 2019

Pain

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Cognitive biases in the context of pain.Contemporary models explaining the exacerbation and maintenance of pain, disability and distress, assign a pivotal role to cognitive biases. These models assume that cognitive biases are maladaptive, trait-like processes, and propose that individuals who selectively attend to pain-related information (attention bias), interpret ambiguous pain and/or health relevant information as threatening (interpretation bias), and/or recall pain-related information selectively or as more negative/threatening than initially experienced (memory bias), report higher levels of pain and disability and are at increased risk for developing chronic pain. 10,11,15,16,51,56,77,87,93,94 This intuitively appealing idea has resulted in an exponential increase in research addressing the presence, antecedents, and consequences of cognitive biases in people experiencing acute and chronic pain. 10,13,17,41,51,52,67,68,78 However, results are inconsistent and puzzling, with mixed support for theoretical-driven assumptions. 12,41,67,87,88,93 The aim of this review is to (a) synthesize and discuss current knowledge on the role of cognitive biases in pain, (b) provide conceptual and methodological explanations for equivocal findings, and (c) develop an integrated functional-contextual framework for understanding the role of cognitive biases in pain. Based on this framework, we propose a new research agenda and discuss implications for clinical practice. The presence and impact of cognitive biases in pain: The state of the science.Research on cognitive biases in (chronic) pain has been guided by the research agenda on cognitive biases in psychopathology, where similar theoretical processes are proposed (e.g., 2,24,47 ). As such, paradigms were adapted from psychopathology research (e.g., dot-probe 1,21,37,73 , homograph or homophone task 60,67 , word memory task 36,66,72 ) to investigate cognitive biases for pain-related information. These paradigms typically use symbolic descriptors of health/illness or pain experiences or situations (e.g., words and/or pictures, descriptions of ambiguous situations). Recently, a number of comprehensive reviews synthesized available evidence following this research tradition. 13,52,67,68,78 For attention bias, these reviews revealed small effects, indicating that people experiencing acute or chronic pain show a bias towards pain-related information, particularly sensory pain words. 13,78 No bias was found in people without or merely anticipating pain. 68,78 Most remarkably, no consistent relationship

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Section: (3) Cognitive Biases Are Interrelatedsupporting

confidence: 76%

Section: The Future Research Agenda For Cognitive Bias Researchmentioning

confidence: 99%

Cognitive biases in pain: an integrated functional–contextual framework

Ryckeghem

Noel

Sharpe

et al. 2019

Pain

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“…Theorists have hypothesized that cognitive biases interact with and exacerbate each other in various conditions including depression (Beck & Haigh, 2014; Holmes, Lang, & Deeprose, 2009; Wittenborn et al, 2016), anxiety disorders (Hirsch et al, 2006; Ouimet, Gawronski, & Dozois, 2009; Peschard & Philippot, 2016), chronic pain (van Ryckeghem & Vervoort, 2016), aggressive behaviors (Schippell, Vasey, Cravens-Brown, & Bretveld, 2003), and body dissatisfaction (Jiang & Vartanian, 2012). Indeed, it is plausible that the four mechanisms of interactions among attention and memory processes operate in various mental disorders because they reflect normal interactions among basic cognitive processes, which become biased as a disorder develops.…”

Section: Future Directionsmentioning

confidence: 99%

Mapping Dynamic Interactions Among Cognitive Biases in Depression

et al. 2020

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Depression is theorized to be caused in part by biased cognitive processing of emotional information. Yet, prior research has adopted a reductionist approach that does not characterize how biases in cognitive processes such as attention and memory work together to confer risk for this complex multifactorial disorder. Grounded in affective and cognitive science, we highlight four mechanisms to understand how attention biases, working memory difficulties, and long-term memory biases interact and contribute to depression. We review evidence for each mechanism and highlight time- and context-dependent dynamics. We outline methodological considerations and recommendations for research in this area. We conclude with directions to advance the understanding of depression risk, cognitive training interventions, and transdiagnostic properties of cognitive biases and their interactions.

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“…It has also been suggested that memory biases may form the basis for attention and interpretation biases, although the alternative is possible with recall biases arising as a result of biases in attention and/or interpretation. 58 Longitudinal research will be able to address these specific questions and also ascertain the effects inducing one form of bias has on other forms of bias. 3,4,7 Such research is also vital for interventions aimed at modifying cognitive biases, 58,59 and of which there is evidence for the benefits of attentional bias modification in the literature broadly 60 and in chronic pain specifically.…”

Section: Discussionmentioning

confidence: 99%

“…58 Longitudinal research will be able to address these specific questions and also ascertain the effects inducing one form of bias has on other forms of bias. 3,4,7 Such research is also vital for interventions aimed at modifying cognitive biases, 58,59 and of which there is evidence for the benefits of attentional bias modification in the literature broadly 60 and in chronic pain specifically. [61][62][63][64] As anticipated and in line with previous studies, 43 only a proportion of words in the sensory-pain category were interpreted as pain-related (26% of words for individuals with chronic headache and 17% of words for healthy controls).…”

Section: Discussionmentioning

confidence: 99%

Attentional, interpretation and memory biases for sensory-pain words in individuals with chronic headache

Schoth

Beaney

Broadbent

et al. 2018

British Journal of Pain

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Introduction: Cognitive biases in attention, interpretation and less consistently memory have been observed in individuals with chronic pain and play a critical role in the onset and maintenance of chronic pain. Despite operating in combination cognitive biases are typically explored in isolation. Aim: The primary aim of this study was to explore attentional, interpretation and memory biases and their interrelationship in individuals with chronic headache. Methods: Twenty-eight participants with chronic headache and 34 healthy controls completed paradigms assessing attentional, interpretation and memory biases with ambiguous sensory-pain and neutral words. Results: Individuals with chronic pain showed significantly greater pain-related attentional and interpretation biases relative to controls, with no differences in memory bias. No significant correlation was found between any of the three forms of cognitive bias assessed. Discussion and conclusion: The clinical implications of cognitive biases in individuals with chronic pain remain to be fully explored, although one avenue for future research would be specific investigation of the implications of biased interpretations considering the consistency of results found across the literature for this form of bias.

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Towards an integrative view of cognitive biases in pain

Cited by 13 publications

References 5 publications

Cognitive biases in pain: an integrated functional–contextual framework

Cognitive biases in pain: an integrated functional–contextual framework

Mapping Dynamic Interactions Among Cognitive Biases in Depression

Attentional, interpretation and memory biases for sensory-pain words in individuals with chronic headache

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