Attentional bias to pain-related information: A meta-analysis of dot-probe studies

in Health Psychology Review (2018)

Studies investigating attentional biases towards pain information vary widely in both design and results. The aim of this meta-analysis was to determine the degree to which attentional biases towards pain ... [more ▼]

Studies investigating attentional biases towards pain information vary widely in both design and results. The aim of this meta-analysis was to determine the degree to which attentional biases towards pain occur when measured with the dot-probe task. A total of 2168 references were screened, resulting in a final sample of 4466 participants from 52 articles. Participants were grouped according to pain experience: chronic pain, acute pain, anticipating experimental/procedural pain, social concern for pain, or healthy people. In general, results revealed a significant, but small bias towards pain words (d= 0.136), and pain pictures (d= 0.110) in chronic pain patients, but not in those with acute pain, those anticipating pain, or healthy people. Follow-up analyses revealed an attentional bias towards sensory pain words in the chronic pain group (d= 0.198), and the acute pain group (d= 0.303), but not other groups. In contrast, attentional biases towards affective pain stimuli were not significant for any pain groups. This meta-analysis found support for attentional biases towards sensory pain stimuli in patients with chronic pain in comparison to healthy individuals across a range of common parameters. Future researchers need to consider task design when seeking to optimally measure pain-relevant attentional biases [less ▲]

Resilience factors in children with Juvenile Idiopathic Arthritis and their parents: the role of child and parent psychological flexibility.

in Pain Medicine (2018)

Objective: Chronic pain is central to Juvenile Idiopathic Arthritis (JIA) and is predictive of impaired functioning. Whereas most work has focused on identifying psychosocial risk factors for maladaptive ... [more ▼]

Objective: Chronic pain is central to Juvenile Idiopathic Arthritis (JIA) and is predictive of impaired functioning. Whereas most work has focused on identifying psychosocial risk factors for maladaptive outcomes, we explored the idea that child and parental psychological flexibility (PF) represent resilience factors for adaptive functioning of the child. We also explored differences between general versus pain-specific PF in contributing to child outcomes. Methods: Children with JIA (8-18 years) and (one of) their parents were recruited at the department of pediatric rheumatology at the Ghent University Hospital in Belgium. They completed questionnaires assessing child and parent general and pain-specific PF and child psychosocial and emotional functioning, and disability. Results: The final sample consisted of fifty-nine children and forty-eight parents. Multiple regression analyses revealed that child PF contributed to better psychosocial functioning and less negative affect. Child pain acceptance contributed to better psychosocial functioning, lower levels of disability and lower negative affect, and also buffered against the negative influence of pain intensity on disability. Bootstrap mediation analyses demonstrated that parental (general) PF indirectly contributed to child psychosocial functioning and affect via the child’s (general) PF. Parent pain-specific PF was indirectly linked to child psychosocial functioning, disability, and negative affect via child pain acceptance. Conclusion: Our findings indicate that child and parental PF are resilience factors and show that pain acceptance buffers against the negative impact of pain intensity. Implications for psychosocial interventions that target (pain-specific) PF in children as well as in parents are discussed. [less ▲]

Pain and Attention: Towards a Motivational Account

Book published by Oxford University Press (2018)

Attention plays a pivotal role in the experience of pain and its impact upon daily activities. Accordingly, research on the interplay between attention and pain has a long scientific history. Within this ... [more ▼]

Attention plays a pivotal role in the experience of pain and its impact upon daily activities. Accordingly, research on the interplay between attention and pain has a long scientific history. Within this chapter, we discuss the theoretical frameworks that aim to explain the relationship between attention and pain. We argue for a motivational perspective on pain that highlights the critical role of cognitive, affective and contextual factors in explaining the interplay between attention and pain. To substantiate this argument, we provide an overview of available research addressing the bottom-up capture of attention by pain and the top-down modulation (both inhibition and facilitation) of attention for pain. We conclude this chapter with guidelines and suggestions for future research and discuss clinical implications of adopting a motivational perspective on pain. [less ▲]

Attentional processing of itch

in Psychological Research (2017)

Itch is a prevalent somatosensory symptom thatcan be highly disabling , because it is likely to drawattention and, as a resu lt, may interfere with the perfor-mance of daily activities. Yet, research ... [more ▼]

Itch is a prevalent somatosensory symptom thatcan be highly disabling , because it is likely to drawattention and, as a resu lt, may interfere with the perfor-mance of daily activities. Yet, research experimentallyinvestigating attention to itch is lacking. In this study weaimed to investigate attentional processing of itch usingmultiple behavioral attention tasks. Forty-one healthyparticipants performed (1) a modified Stroop task with itch-related words, (2) a dot-probe task with itch-related pic-tures, and (3) a rece ntly developed somatosensory attentiontask in which the effect of experimentally induced itch onthe localization of visual targets was examined. Addition-ally, a number of self-report questionnaires related tosomatosensory attentional processing were administered.Results indicated that participants’ attention was biasedtoward itch-related words and pictures assessed by meansof the dot- probe and modified Stroop task, respectively. Forthe somatosensory attention task, results showed that itchdid not significantly influence the allocation of attention.However, when taking into account the time course ofattention during the itch stimulus, data suggested thatparticipants tended to disengage attention away during theitch stimulus. This is the first study that indicates anattentional bias for itch, using methods that have previouslybeen validated for other sensations such as pain. In addi-tion, the newly developed somatosensory attention taskmay reflect the time course of attention toward a tonic itchstimulus. [less ▲]

Generalized hypervigilance in fibromyalgia: normal interoceptive accuracy, but reduced self-regulatory capacity

in Journal of Psychosomatic Research (2017), 93(2), 48-54

Objective: The factors underlying the aetiology of fibromyalgia (FM) are largely unknown. According to the generalized hypervigilance hypothesis (GHH), FM patients show excessive attention towards pain ... [more ▼]

Objective: The factors underlying the aetiology of fibromyalgia (FM) are largely unknown. According to the generalized hypervigilance hypothesis (GHH), FM patients show excessive attention towards pain stimuli and other sensory events, thereby increasing pain perception and dysfunctional behaviour. We tested this notion by assessing interoceptive accuracy (IA) in FM patients and matched healthy controls. We also tested the hypothesis that FM is characterized by reduced self-regulatory capacity as indexed by heart rate variability (HRV). Methods: 47 FM patients (Mage = 45.5, 39 females) and 45 healthy controls (Mage = 44.9, 37 females) completed several self-report scales (Body Vigilance Scale, Depression Anxiety Stress Scales, Pain Catastrophizing Scale). To derive HRV, heart rate was monitored under resting conditions; for the assessment of IA participants performed a heartbeat tracking task in which they were asked to silently count their heartbeats. Results: FM patients reported higher body vigilance than healthy controls, but there were no group differences in IA. FM patients had lower HRV compared with healthy controls. HRV did not predictor IA. Conclusion: In conclusion, our findings do not support the hypothesis of generalized hypervigilance in FM patients. Patients reported a heightened focus on bodily sensations, which was not reflected in IA. It may be that hypervigilance is not a general and stable characteristic but is rather context dependent and modality-specific. [less ▲]

Perceived injustice explains pain intensity over and above attentional bias.

in Journal of Pain (2016), 17(4, 1), 32

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.

in Journal of Pain (2016), 17(11), 1207-1216

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 ... [more ▼]

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 (ie, 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 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. To our knowledge, 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. [less ▲]

A componential emotion approach for the assessment of emotional awareness in youth.

in Psychological assessment (2016), 28(11), 1416-1426

The Levels of Emotional Awareness Scale for Children (LEAS-C) is a performance-based instrument that assesses emotional awareness in the structure of written responses to a set of real-life scenarios ... [more ▼]

The Levels of Emotional Awareness Scale for Children (LEAS-C) is a performance-based instrument that assesses emotional awareness in the structure of written responses to a set of real-life scenarios. While it is theoretically expected that emotional awareness develops with age, virtually no age differences have been established with the LEAS-C. The present study investigated whether an adaptation of the instructions and scoring procedure on the basis of the componential emotion approach could improve the validity of the LEAS-C and reveal the theoretically expected age differences. An adapted LEAS-C was administered to a sample of 574 children and adolescents and scored with the original and a new componential scoring procedure. An acceptable reliability for the original and a good reliability and a high interrater reliability for the componential scoring procedure were observed. Multigroup confirmatory factor analyses showed measurement invariance of factor loadings and intercepts across children (8 to 12 years) and adolescents (13 to 16 years) for all tested models, for both scoring procedures. A one-factor model fitted well for the total scores and self and other scores for both scoring procedures. The pattern of relationships with alexithymia, emotional intelligence, intelligence, personality, and social and emotional impairment as well as gender differences were comparable with prior research. Furthermore, the expected relationship with age was found, with stronger correlations for the componential than the original scoring procedure. In conclusion, analyses of the reliability, internal structure, and nomological network supported the adaptations of the LEAS-C on the basis of the componential emotion approach. (PsycINFO Database Record [less ▲]

The relationship between adolescents' pain catastrophizing and attention bias to pain faces is moderated by attention control.

in Pain (2015), 156(7), 1334-41

This study considered the attentional functioning of adolescents with varying levels of pain catastrophizing. Specifically, we investigated the relationship between pain catastrophizing and attention bias ... [more ▼]

This study considered the attentional functioning of adolescents with varying levels of pain catastrophizing. Specifically, we investigated the relationship between pain catastrophizing and attention bias to pain facial expressions. Furthermore, drawing on dual process models in the context of pain, we investigated the moderating role of attention control on this relationship. Adolescents (N = 73; age, 16-18 years) performed a dot-probe task in which facial expressions of pain and neutral expressions were presented for 100 milliseconds and 1250 milliseconds. Participants also completed self-report pain catastrophizing and attention control measures. We found that although there was no main effect of pain catastrophizing on attention bias towards pain faces, attention control did significantly moderate this relationship. Further analysis revealed that lower levels of attention control were significantly associated with increasing attentional vigilance towards pain faces only within high catastrophizing adolescents. In addition, we found that poorer attention control was related to increased attention bias for pain faces (regardless of pain catastrophizing level) when these faces were presented for relatively longer durations (ie, 1250 milliseconds) but not for short durations (ie, 100 milliseconds). This study supports a dual process model of attentional processes in pain, thus replicating previous findings within the psychopathology literature but extending them to the study of pain. Theoretical and clinical implications of our findings are discussed. [less ▲]

A Systematic Review and Meta-analysis of Interventions for Sexual Health Promotion Involving Serious Digital Games.

in Games for health journal (2015), 4(2), 78-90

OBJECTIVE: Serious games may be effective in promoting sexual health behavior. Their confidential nature may encourage users to discuss sensitive sexuality topics. Furthermore, they can tailor messages to ... [more ▼]

OBJECTIVE: Serious games may be effective in promoting sexual health behavior. Their confidential nature may encourage users to discuss sensitive sexuality topics. Furthermore, they can tailor messages to the individual's needs and may be intrinsically motivating. This meta-analysis investigates the effectiveness of interventions for sexual health promotion that use serious games. MATERIALS AND METHODS: A database search was conducted in PubMed, Web of Science, CINAHL, and PsycINFO for publications before the end of July 2013. Serious digital games studies measuring effects on behavior or its determinants, using a control condition, allowing the calculation of an effect size (Hedges' g, random-effects model) were included. RESULTS: Seven game studies for sexual health promotion were included. These showed positive effects on determinants (g=0.242; 95 percent confidence interval, 0.129, 0.356), albeit of small effect size. The effects on behavior, measured in only two studies, were not significant (g=0.456; 95 percent confidence interval, -0.649, 1.561). Most games did not use many game features that are considered to be immersive or enhancing flow. Instead, there was a strong reliance on pure gamification features, such as rewards and feedback. CONCLUSIONS: The effectiveness of the next generation of games may be enhanced by building on the behavioral change and educational gaming literatures (e.g., using role-play and simulation game formats, individual tailoring, offering adaptation in the difficulty of the challenge, and amount and timing of the feedback). There is a need for studies with rigorous evaluations of game effectiveness, longer-term follow-up, and using measures of behavior rather than merely their determinants. [less ▲]