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

Jemma Todd, Louise Sharpe, Ameika Johnson, Kathryn Nicholson Perry, Ben Colagiuri, Blake F Dear, Jemma Todd, Louise Sharpe, Ameika Johnson, Kathryn Nicholson Perry, Ben Colagiuri, Blake F Dear

Abstract

Individuals with chronic pain demonstrate attentional biases (ABs) towards pain-related stimuli. However, the clinical importance of these biases is yet to be determined and a sound theoretical model for explaining the role of ABs in the development and maintenance of pain is lacking. Within this article, we (1) systematically review prospective and experimental research exploring ABs and pain outcomes in light of current theoretical models and (2) propose a theoretical framework for understanding AB in pain. Across prospective research, an attentional pattern of vigilance-avoidance was observed. Interventions targeting ABs were less consistent; however, there were promising findings among studies that found attentional training effects, particularly for laboratory research. The proposed Threat Interpretation Model suggests a relationship between threat, interpretation, and stimuli in determining attentional processes, which while tentative generates important testable predictions regarding the role of attention in pain and builds on previous theoretical and empirical work in this area.

References

    1. Aldrich S, Eccleston C, Crombez G. Worrying about chronic pain: vigilance to threat and misdirected problem solving. Behav Res Ther 2000;38:457–70.
    1. Baum C, Schneider R, Keogh E, Lautenbacher S. Different stages in attentional processing of facial expressions of pain: a dot-probe task modification. J Pain 2013;14:223–32.
    1. Boston A, Sharpe L. The role of threat-expectancy in acute pain: effects on attentional bias, coping strategy effectiveness and response to pain. PAIN 2005;119:168–75.
    1. Carleton RN, Richter AA, Asmundson GJG. Attention modification in persons with fibromyalgia: a double blind, randomized clinical trial. Cogn Behav Ther 2011;40:279–90.
    1. Clarke PJ, Notebaert L, MacLeod C. Absence of evidence or evidence of absence: reflecting on therapeutic implementations of attentional bias modification. BMC Psychiatry 2014;14:8.
    1. Cohen J. A power primer. Psychol Bull 1992;112:155.
    1. Crombez G, Eccleston C, Van Damme S, Vlaeyen JW, Karoly P. Fear-avoidance model of chronic pain: the next generation. Clin J Pain 2012;28:475–83.
    1. Crombez G, Van Ryckeghem D, Eccleston C, Van Damme S. Attentional bias to pain-related information: a meta-analysis. PAIN 2013;154:497–510.
    1. Dear BF, Sharpe L, Nicholas MK, Refshauge K. Pain-related attentional biases: the importance of the personal relevance and ecological validity of stimuli. J Pain 2011;12:625–32.
    1. Dear BF, Sharpe L, Nicholas MK, Refshauge K. The psychometric properties of the dot-probe paradigm when used in pain-related attentional bias research. J Pain 2011;12:1247–54.
    1. Eccleston C, Crombez G. Pain demands attention: a cognitive-affective model of the interruptive function of pain. Psychol Bull 1999;125:356–66.
    1. Eccleston C, Crombez G. Worry and chronic pain: a misdirected problem solving model. PAIN 2007;132:233–6.
    1. Garg AX, Hackam D, Tonelli M. Systematic review and meta-analysis: when one study is just not enough. Clin J Am Soc Nephrol 2008;3:253–60.
    1. Haggman SP, Sharpe LA, Nicholas MK, Refshauge KM. Attentional biases toward sensory pain words in acute and chronic pain patients. J Pain 2010;11:1136–45.
    1. Khatibi A, Schrooten M, Vancleef LM, Vlaeyen JW. An experimental examination of catastrophizing-related interpretation bias for ambiguous facial expressions of pain using an incidental learning task. Front Psychol 2014;5:1002.
    1. Lautenbacher S, Huber C, Baum C, Rossaint R, Hochrein S, Heesen M. Attentional avoidance of negative experiences as predictor of postoperative pain ratings and consumption of analgesics: comparison with other psychological predictors. Pain Med 2011;12:645–53.
    1. Lautenbacher S, Huber C, Kunz M, Parthum A, Weber PG, Griessinger N, Sittl R. Hypervigilance as predictor of postoperative acute pain: its predictive potency compared with experimental pain sensitivity, cortisol reactivity, and affective state. Clin J Pain 2009;25:92–100.
    1. Lautenbacher S, Huber C, Schöfer D, Kunz M, Parthum A, Weber PG, Roman C, Griessinger N, Sittl R. Attentional and emotional mechanisms related to pain as predictors of chronic postoperative pain: a comparison with other psychological and physiological predictors. PAIN 2010;151:722–31.
    1. Liossi C. Attentional biases in chronic pain: do they exist and does it really matter? PAIN 2012;153:9–10.
    1. Liossi C, Schoth DE, Godwin HJ, Liversedge SP. Using eye movements to investigate selective attention in chronic daily headache. PAIN 2014;155:503–10.
    1. MacLeod C, Koster EH, Fox E. Whither cognitive bias modification research? Commentary on the special section articles. J Abnorm Psychol 2009;118:89–99.
    1. McGowan N, Sharpe L, Refshauge K, Nicholas MK. The effect of attentional re-training and threat expectancy in response to acute pain. PAIN 2009;142:101–7.
    1. Mogg K, Bradley B, Miles F, Dixon R. Time course of attentional bias for threat scenes: testing the vigilance-avoidance hypothesis. Cogn Emot 2004;18:689–700.
    1. Munafò MR, Stevenson J. Selective processing of threat-related cues in day surgery patients and prediction of post-operative pain. Br J Health Psychol 2003;8:439–49.
    1. Pincus T, Morley S. Cognitive-processing bias in chronic pain: a review and integration. Psychol Bull 2001;127:599–617.
    1. Priebe JA, Messingschlager M, Lautenbacher S. Gaze behaviour when monitoring pain faces: an eye-tracking study. Eur J Pain 2015;19:817–25.
    1. Roelofs J, Peters ML, Zeegers MP, Vlaeyen JW. The modified Stroop paradigm as a measure of selective attention towards pain-related stimuli among chronic pain patients: a meta-analysis. Eur J Pain 2002;6:273–81.
    1. Schoth DE, Nunes VD, Liossi C. Attentional bias towards pain-related information in chronic pain: a meta-analysis of visual-probe investigations. Clin Psychol Rev 2012;32:13–25.
    1. Sharpe L, Haggman S, Nicholas MK, Dear B, Refshauge K. Avoidance of affective pain stimuli predicts chronicity in acute low back pain patients. PAIN 2014;155:45–52.
    1. Sharpe L, Ianiello M, Dear BF, Nicholson Perry K, Refshauge K, Nicholas MK. Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials. PAIN 2012;153:722–31.
    1. Sharpe L, Nicholson Perry K, Rogers P, Dear BF, Nicholas MK, Refshauge K. A comparison of the effect of attention training and relaxation on responses to pain. PAIN 2010;150:469–76.
    1. Sharpe L, Nicholson Perry K, Rogers P, Refshauge K, Nicholas MK. A comparison of the effect of mindfulness and relaxation on responses to acute experimental pain. Eur J Pain 2013;17:742–52.
    1. Van Damme S, Crombez G, Eccleston C, Koster EH. Hypervigilance to learned pain signals: a componential analysis. J Pain 2006;7:346–57.
    1. Van Ryckeghem D, Crombez G. Attentional bias and chronic pain: where to go from here? PAIN 2014;155:6–7.
    1. Van Ryckeghem DM, Crombez G, Goubert L, De Houwer J, Onraedt T, Van Damme S. The predictive value of attentional bias towards pain-related information in chronic pain patients: a diary study. PAIN 2013;154:468–75.
    1. Vervoort T, Trost Z, Prkachin KM, Mueller SC. Attentional processing of other's facial display of pain: an eye tracking study. PAIN 2013;154:836–44.
    1. Vervoort T, Trost Z, Van Ryckeghem DML. Children's selective attention to pain and avoidance behaviour: the role of child and parental catastrophizing about pain. PAIN 2013;154:1979–88.
    1. Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. PAIN 2000;85:317–32.
    1. Wells A. Panic disorder in association with relaxation induced anxiety: an attentional training approach to treatment. Behav Ther 1990;21:273–80.
    1. Yang Z, Jackson T, Chen H. Effects of chronic pain and pain-related fear on orienting and maintenance of attention: an eye movement study. J Pain 2013;14:1148–57.
    1. Yang Z, Jackson T, Gao X, Chen H. Identifying selective visual attention biases related to fear of pain by tracking eye movements within a dot-probe paradigm. PAIN 2012;153:1742–8.

Source: PubMed

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