Fear-conditioned cues of impending pain facilitate attentional engagement (original) (raw)
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Selective attentional bias for pain-related stimuli amongst pain fearful individuals
Pain, 2001
Recent research indicates that people who are fearful of pain tend to report more negative pain experiences. It also seems that attentional mechanisms may be particularly important in the perception of painful stimuli, especially amongst pain fearful individuals. Drawing on a paradigm used to examine biased cognitive processes in the emotional disorders, the current study investigated whether the fear of pain would be related to a greater selective attentional bias in favour of pain-related stimuli. In order to determine the nature of this bias, stimuli material were varied in terms of whether they were related to pain sensations, were related to socially threatening situations or were relatively positive. Those with a high fear of pain exhibited a selective attentional bias towards pain-related information, compared to those classi®ed as low in the fear of pain. No group differences were found for either social threat or positive stimuli. These results indicate that one reason why those with a high fear of pain are particularly susceptible to negative pain experiences could be due to biased attentional processes. Suggestions for cognitive interventions designed to reduce such biases are discussed, as are directions for future research. q
Non-pain goal pursuit inhibits attentional bias to pain. Pain, 153, 1180-1186.
Pain, 2012
Although dealing with pain is a vital goal to pursue, most individuals are also engaged in the pursuit of other goals. The aim of the present experiment was to investigate whether attentional bias to pain signals is inhibited when one is pursuing a concurrent salient but nonpain task goal. Attentional bias to pain signals was measured in pain-free volunteers (n = 63) using a spatial cueing task with pain cues and neutral cues. The pursuit of a concurrent goal was manipulated by including additional trials in which a digit appeared at the middle of the screen. Half of the participants (goal group) were instructed to name these additional stimuli aloud. In order to increase the affective-motivational value of this non-pain-related goal, monetary reward and punishment were made contingent upon the performance of this task. Participants of the control group did not perform the additional task. As predicted, the results show attentional bias to pain signals in the control group, but not in the goal group. This indicates that attentional bias to signals of impending pain is inhibited when one is engaged in the pursuit of another salient but nonpain goal. The results of this study underscore a motivational view on attention to pain, in which the pursuit of multiple goals, including nonpain goals, is taken into account.
Anxious anticipation and pain: the influence of instructed vs conditioned threat on pain
Social cognitive and affective neuroscience, 2016
Negative emotions such as anxiety enhance pain perception. However, certain threat characteristics are discussed to have different or even divergent effects on pain (hypoalgesia vs hyperalgesia). In order to investigate the neurobiological basis of different threats, we compared the impact of conditioned threat (CT) vs instructed threat (IT) on pain using fMRI. In two groups, participants underwent either Pavlovian threat conditioning or an instructed threat procedure. Afterwards, in an identical test phase participants watched the same visual cues from the previous phase indicating potential threat or safety, and received painful thermal stimulation. In the test phase, pain ratings were increased in both groups under threat. Group comparisons show elevated responses in amygdala and hippocampus for pain under threat in the CT group, and higher activation of the mid-cingulate gyrus (MCC) in the IT group. Psychophysiological interaction analyses in CT demonstrated elevated connectivit...
Effects of context and individual predispositions on hypervigilance to pain-cues: an ERP study
Journal of Pain Research, 2015
Hypervigilance to pain is the automatic prioritization of pain-related compared with other stimuli. The processing of threat information is influenced by negative contexts. Therefore, we intended to explore such context effects on hypervigilance to pain-cues, taking individual differences in self-reported vigilance to pain into consideration. Methods: In all, 110 healthy subjects viewed task-irrelevant emotional facial expressions (anger, happy, neutral, and pain) overlaid in half of the trials with a fine grid. The instructed task was to indicate the presence/absence of this grid. A threatening context was established by applying electrical stimuli slightly below pain-threshold. Using scores of Pain Vigilance and Awareness Questionnaire, the sample was divided into high vs low pain vigilant subjects. Reaction times and event-related brain potentials were recorded. Results: No distinct attentional processing of pain faces (based on the event-related brain potentials) was observed as a function of high levels of self-reported vigilance to pain and contextual threat induction. High pain vigilant subjects showed generally enhanced processing of emotional and neutral faces as indicated by parameters of early (early posterior negativity) and late (late positive complex) processing stages. This enhancement was abolished when electro-stimuli were presented. Conclusion: Contextual threat does not enhance the attentional capture of pain-cues when they are presented concurrently with competing task demands. The study could, however, replicate a generally enhanced attentional processing of emotional cues in high pain vigilant subjects. This underpins that hypervigilance to pain is related to changes in emotional processing.
The Journal of Pain, 2007
The purpose of this investigation was to clarify mixed findings reported in selective attention investigations. To accomplish this, recently published dot-probe data from 36 patients with chronic musculoskeletal pain and 29 healthy control participants were reanalyzed with consideration of fear of pain (FOP) as a categorical variable. FOP groups were identified by using a variety of strategies and represented differing conceptualizations of the FOP construct. Selective attention for sensory pain, affect pain, and health catastrophe words was assessed by using raw dot-probe detection latencies and the bias, congruency, and incongruency indices. Analysis of the raw detection latencies revealed no significant interactions that permit inferences regarding attentional shifts to or away from specific word types.
Pain, 2011
Clinical evidence suggests that a persistent search for solutions for chronic pain may bring along costs at the cognitive, affective, and behavioral level. Specifically, attempts to control pain may fuel hypervigilance and prioritize attention towards pain-related information. This hypothesis was investigated in an experiment with 41 healthy volunteers. Prioritization of attention towards a signal for pain was measured using an adaptation of a visual search paradigm in which participants had to search for a target presented in a varying number of colored circles. One of these colors (Conditioned Stimulus) became a signal for pain (Unconditioned Stimulus: electrocutaneous stimulus at tolerance level) using a classical conditioning procedure. Intermixed with the visual search task, participants also performed another task. In the pain-control group, participants were informed that correct and fast responses on trials of this second task would result in an avoidance of the Unconditioned Stimulus. In the comparison group, performance on the second task was not instrumental in controlling pain. Results showed that in the paincontrol group, attention was more prioritized towards the Conditioned Stimulus than in the comparison group. The theoretical and clinical implications of these results are discussed.
Attention to chronic pain is dependent upon pain-related fear
Journal of Psychosomatic Research, 1999
Pain interrupts, distracts, and is difficult to disengage from. In this study, the role of painrelated fear in moderating attentional interference produced by chronic pain was investigated. Forty chronic pain patients completed a list of questionnaires assessing pain severity, pain-related fear (Tampa Scale for Kinesiophobia), and negative affect (Negative Emotionality scale). Attentional interference was measured by a numerical interference test. Multiple regression analysis revealed that the attentional interference was best predicted by the interaction between pain severity and pain-related fear. These results are discussed in terms of how pain-related fear creates a hypervigilance to pain.
Selective attention to pain: a psychophysical investigation
Experimental Brain Research, 2002
Laboratory research suggests that the processing of painful stimuli can be modulated by selective attention to a particular sensory modality. However, alternative accounts for previous findings remain possible in terms of task-switching and spatial attention effects. In the present study, we examined whether attention can be selectively directed to the pain modality in order to facilitate the processing of the sensory-discriminative aspects of painful laser heat stimuli when these alternatives were ruled out. Participants made speeded spatial discrimination responses to an unpredictable sequence of painful laser heat and visual stimuli presented on the left forearm. On each trial, a symbolic cue predicted the likely modality for the upcoming target on the majority of trials. Participants responded more rapidly when the target was presented in the expected as opposed to the unexpected modality, demonstrating that selective attention can modulate the processing of painful stimuli. These findings are discussed in relation to contemporary theories of crossmodal attention and multisensory information-processing.
Hypervigilance to Learned Pain Signals: A Componential Analysis
Journal of Pain, 2006
We report 2 experiments investigating hypervigilance to pain signals in healthy individuals. In order to allow a detailed analysis, we decomposed attention in 3 different processes: 1) initial shifting, 2) engagement, and 3) disengagement. We used a spatial cueing paradigm in which the location of targets is validly or invalidly predicted by spatial cues. In the first experiment, cues were differentially conditioned to create pain signals, allowing the investigation of engagement and disengagement of attention. Because this procedure does not allow an adequate isolation of the shift component, we introduced a new adaptation of the spatial cueing paradigm in the second experiment, in which targets instead of cues were differentially conditioned. We replicated previous findings, showing enhanced engagement to and retarded disengagement from pain signals compared to control signals. In addition, we demonstrated that participants were still hypervigilant to pain signals after extinction. We were not able to demonstrate speeded shifting to pain signals. Instead we found a generally faster detection of pain signals compared to control signals. We conclude that hypervilance to pain signals does not emerge as rapid initial shifting to the pain signal but rather as enhanced processing once it is detected. Theoretical and clinical implications of these findings are discussed.We investigated the fundamental processes associated with hypervigilance to pain. Our findings suggest that treatment approaches using attention techniques should not focus on preventing patients to shift their attention to the pain but rather on diminishing the threat value and learning to disengage from their pain.
PloS one, 2017
It is well known that the efficacy of treatment effects, including those of placebos, is heavily dependent on positive expectations regarding treatment outcomes. For example, positive expectations about pain treatments are essential for pain reduction. Such positive expectations not only depend on the properties of the treatment itself, but also on the context in which the treatment is presented. However, it is not clear how the preceding threat of pain will bias positive expectancy effects. One hypothesis is that threatening contexts trigger fearful and catastrophic thinking, reducing the pain-relieving effects of positive expectancy. In this study, we investigated the disruptive influence of threatening contexts on positive expectancy effects while 41 healthy volunteers experienced laser-induced heat pain. A threatening context was induced using pain-threatening cues that preceded the induction of positive expectancies via subsequent pain-safety cues. We also utilised electroencep...