Brief mindfulness training can mitigate the influence of prior expectations on pain perception

in European Journal of Pain (2021), 25(9), 2007-2019

Motor action changes pain perception : a sensory attenuation paradigm in the context of pain

in PAIN (2021)

Cognitive biases in pain: An integrated functional-contextual framework

in Pain (2019)

The efficacy of attentional distraction and sensory monitoring in chronic pain patients: A meta-analysis

in Clinical Psychology Review (2018), 59

Attentional strategies, such as distraction and sensory monitoring, are often offered to reduce pain and pain-related distress. However, evidence for their efficacy in chronic pain patients is equivocal ... [more ▼]

Attentional strategies, such as distraction and sensory monitoring, are often offered to reduce pain and pain-related distress. However, evidence for their efficacy in chronic pain patients is equivocal. We report a meta-analysis on the efficacy of distraction and sensory monitoring in chronic pain patients, and explore possible methodological and theoretical moderators. The scientific literature was searched for relevant articles, which were coded for methodological quality and several theoretical and methodological moderator variables. Only 10 articles fulfilled the search criteria. Eight studies allowed us to compare distraction with a control condition, two studies to compare sensory monitoring with a control condition, and four studies to compare the effect of distraction with the effect of sensory monitoring. Overall, results indicate that distraction did not differ from control in altering pain experience (k=8; Hedges’ g=0.10, ns) and distress (k=2; Hedges’ g=0.549). Sensory monitoring did also not alter pain experience (k=2; Hedges’ g=-.21, ns) and distress (k=1; Hedges’ g=-0.191, ns). We found no evidence to support the superiority of distraction or sensory monitoring in altering pain compared to control conditions. We offer guidance for future theory-driven research to investigate distraction and sensory monitoring in this largely unexplored field, albeit one replete with methodological difficulties. [less ▲]

Do tonic itch and pain stimuli draw attention towards their location?

in BioMed Research International (2017)

Background: Although itch and pain are distinct experiences, both are unpleasant, and may demand attention and interfere with daily activities. Research investigating the role of attention in tonic itch ... [more ▼]

Background: Although itch and pain are distinct experiences, both are unpleasant, and may demand attention and interfere with daily activities. Research investigating the role of attention in tonic itch and pain stimuli, particularly whether attention is drawn to the stimulus location, is scarce. Methods: In the somatosensory attention task, fifty-three healthy participants were exposed to 35-seconds electrical itch or pain stimuli on either the left or right wrist. Participants responded as quickly as possible to visual targets appearing at the stimulated location (ipsilateral trials) or at the arm without stimulation (contralateral trials). During control blocks, participants performed the visual task without stimulation. Attention allocation at the itch and pain location is inferred when responses are faster ipsilaterally than contralaterally. Results: Results did not indicate that attention was directed towards or away from the itch and pain location. Notwithstanding, participants were slower during itch and pain than during control blocks. Conclusions: In contrast with our hypotheses, no indications were found for spatial attention allocation towards the somatosensory stimuli. This may relate to dynamic shifts in attention over the time course of the tonic sensations. Our secondary finding that itch and pain interfere with task performance is in line with attention theories of bodily perception. [less ▲]

Implicit associations between pain and self-schema in patients with chronic pain.

in Pain (2013), 154(12), 2700-6

Chronic pain often interferes with daily functioning, and may become a threat to an individual's sense of self. Despite the development of a recent theoretical account focussing upon the relationship ... [more ▼]

Chronic pain often interferes with daily functioning, and may become a threat to an individual's sense of self. Despite the development of a recent theoretical account focussing upon the relationship between the presence of chronic pain and a person's self, research investigating this idea is limited. In the present study we aimed to (1) compare the strength of association between self- and pain schema in patients with chronic pain and healthy control subjects and (2) research whether the strength of association between self- and pain-schema is related to particular pain-related outcomes and individual differences of patients with chronic pain. Seventy-three patients with chronic pain (M(age) = 49.95; SD = 9.76) and 53 healthy volunteers (M(age) = 48.53; SD = 10.37) performed an Implicit Association Test (IAT) to assess the strength of association between pain- and self-schema. Patients with chronic pain also filled out self-report measures of pain severity, pain suffering, disability, depression, anxiety, acceptance, and helplessness. Results indicated that the pain- and self-schema were more strongly associated in patients with chronic pain than in healthy control subjects. Second, results indicated that, in patients with chronic pain, a stronger association between self- and pain-schema, as measured with the IAT, is related to a heightened level of pain severity, pain suffering, anxiety, and helplessness. Current findings give first support for the use of an IAT to investigate the strength of association between self- and pain-schema in patients with chronic pain and suggest that pain therapies may incorporate techniques that intervene on the level of self-pain enmeshment. [less ▲]

The predictive value of attentional bias towards pain-related information in chronic pain patients: a diary study.

in Pain (2013), 154(3), 468-75

Theoretical accounts of chronic pain hypothesize that attentional bias towards pain-related information is a maintaining or exacerbating factor, fuelling further pain, disability, and distress. However ... [more ▼]

Theoretical accounts of chronic pain hypothesize that attentional bias towards pain-related information is a maintaining or exacerbating factor, fuelling further pain, disability, and distress. However, empirical research testing this idea is currently lacking. In the present study, we investigated whether attentional bias towards pain-related information predicts daily pain-related outcomes in a sample of chronic pain patients (n=69; M(age)=49.64 years; 46 females). During an initial laboratory session, attentional bias to pain-related information was assessed using a modified spatial cueing task. In advance, patients completed a number of self-report measures assessing current pain intensity, current disability, and pain duration. Subsequently, daily pain outcomes (self-reported pain severity, disability, avoidance behaviour, and distractibility) were measured for 2 weeks by means of an electronic diary. Results indicated that, although an attentional bias towards pain-related information was associated with the current level of disability and pain severity, it had no additional value above control variables in predicting daily pain severity, avoidance, distractibility, and disability. Attentional bias towards pain-related information did, however, moderate the relationship between daily pain severity and both daily disability and distractibility, indicating that, particularly in those patients with a strong attentional bias, increases in pain were associated with increased disability and distractibility. The use of interventions that diminish attentional bias may therefore be helpful to reduce daily disability and the level of distraction from current tasks despite the presence of pain in chronic pain patients. [less ▲]

No pain no gain? Pursuing a competing goal inhibits avoidance behavior.

in Pain (2012), 153(4), 800-4

This experiment investigated pain-related avoidance behavior in context of competing goals. Participants (N=56) were presented trials of 2 different tasks of which 1 task could produce pain. They were ... [more ▼]

This experiment investigated pain-related avoidance behavior in context of competing goals. Participants (N=56) were presented trials of 2 different tasks of which 1 task could produce pain. They were free to decide whether or not to perform trials of these tasks. In half of the participants, a competing goal was activated by instructing them that they would receive a monetary reward corresponding to the number of pain task trials actually performed (competition group). In the other half of the participants, no competing goal was installed (control group). Results showed that the competition group showed less frequent avoidance behavior than the control group. Furthermore, the association between pain-related avoidance behavior and fear of pain was smaller in the competition group than in the control group. The findings indicate that the emergence of pain-related avoidance behavior depends upon the motivational context, and that the association between pain-related fear and avoidance is not stable. This study has implications for our understanding of disability, and points to the need to consider avoidance behavior within a broad context of multiple, often competing, goals. [less ▲]

Distraction from pain and executive functioning: an experimental investigation of the role of inhibition, task switching and working memory.

in European Journal of Pain (2011), 15(8), 866-73

Although many studies have investigated the effectiveness of distraction as a method of pain control, the cognitive processes by which attentional re-direction is achieved, remain unclear. In this study ... [more ▼]

Although many studies have investigated the effectiveness of distraction as a method of pain control, the cognitive processes by which attentional re-direction is achieved, remain unclear. In this study the role of executive functioning abilities (inhibition, task switching and working memory) in the effectiveness of distraction is investigated. We hypothesized that the effectiveness of distraction in terms of pain reduction would be larger in participants with better executive functioning abilities. Ninety-one undergraduate students first performed executive functioning tasks, and subsequently participated in a cold pressor task (CPT). Participants were randomly assigned to (1) a distraction group, in which an attention-demanding tone-detection task was performed during the CPT, or (2) a control group, in which no distraction task was performed. Participants in the distraction group reported significantly less pain during the CPT, but the pain experience was not influenced by executive functioning abilities. However, the performance on the distraction task improved with better inhibition abilities, indicating that inhibition abilities might be important in focussing on a task despite the pain. [less ▲]

The role of motivation in distracting attention away from pain: an experimental study.

in Pain (2010), 149(2), 229-34

Research on the effectiveness of distraction as a method of pain control is inconclusive. One mechanism pertains to the motivational relevance of distraction tasks. In this study the motivation to engage ... [more ▼]

Research on the effectiveness of distraction as a method of pain control is inconclusive. One mechanism pertains to the motivational relevance of distraction tasks. In this study the motivation to engage in a distraction task during pain was experimentally manipulated. Undergraduate students (N=73) participated in a cold pressor test (CPT) and were randomly assigned to three groups: a distraction-only group performed a tone-detection task during the CPT, a motivated-distraction group performed the same task and received a monetary reward for good task performance, and a control group did not perform the tone-detection task. Results indicated that engagement in the distraction task was better in the motivated-distraction group in comparison with the distraction-only group. Participants in both distraction groups experienced less pain compared to the control group. There were no overall differences in pain intensity between the two distraction groups. The effect of distraction was influenced by the level of catastrophic thinking about pain. For low catastrophizers, both distraction groups reported less pain as compared to the non-distracted control group. This was not the case for high catastrophizers. For high catastrophizers it mattered whether the distraction task was motivationally relevant: high catastrophizers reported less intense pain in the motivated-distraction group, as compared to the non-distracted control group. We conclude that increasing the motivational relevance of the distraction task may increase the effects of distraction, especially for those who catastrophize about pain. [less ▲]