Volume 8, Issue 6 (November & December 2017)                   BCN 2017, 8(6): 467-478 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Mahmoodi-Aghdam M, Dehghani M, Ahmadi M, Khorrami Banaraki A, Khatibi A. Chronic Pain and Selective Attention to Pain Arousing Daily Activity Pictures: Evidence From an Eye Tracking Study. BCN. 2017; 8 (6) :467-478
URL: http://bcn.iums.ac.ir/article-1-821-en.html
1- Institute for Cognitive Science Studies (ICSS), Tehran, Iran
2- Family Research Institute, Shahid Beheshti University, Tehran, Iran.
3- Department of Cognitive Psychology, Institute for Cognitive Science Studies (ICSS), Tehran, Iran.
4- Department of Psychology, Faculty of Economics, Administrative, and Social Sciences, Bilkent University, Ankara, Turkey.

Introduction: According to the pain research literature, attentional bias for pain is the mechanism responsible for the development and maintenance of fear of pain in patients with chronic pain. However, there is still some debate about the exact mechanism and the role of faster engagement versus difficulty in disengagement in the development of attentional bias. 
Methods: To investigate attentional bias in patients with chronic pain, we used an eye-tracker with the pictures of pain-provoking activities and compared the results with an age- and gender-matched group of pain-free participants. In addition, other measures of pain-related cognition and pain severity ratings were included to assess their contribution to the attentional bias toward pain-related information. 
Results: Calculating the frequency of the first fixations showed that both groups fixated initially on pain-provoking pictures compared to neutral one. Calculating the speed of fixations showed that control participants were faster in fixating on neutral stimuli, but patients with pain were faster in fixating on pain-provoking pictures, indicating a relative vigilance for the pain-related stimuli among them. These patients reported that the intensity of pain in the previous week was positively correlated with the speed of their fixation on the painful stimuli. 
Conclusion: Although these results did not provide unequivocal support for the vigilance-avoidance hypothesis, they are generally consistent with the results of studies using eye tracking technology. Furthermore, our findings put a question over characterization of attentional biases in patients with chronic pain by simply relating that to difficulty in disengaging from pain-related stimuli.

Type of Study: Original | Subject: Behavioral Neuroscience
Received: 2016/08/25 | Accepted: 2016/10/10 | Published: 2017/11/1

1. Akbari, F., Dehghani, M., Khatibi, A., & Vervoort, T. (2016). Incorporating Family function into chronic pain disability: The role of catastrophizing. Pain Research and Management, 2016, 1–9. doi: 10.1155/2016/6838596 [DOI:10.1155/2016/6838596]
2. Andersson, G., & Haldrup, D. (2003). Personalized pain words and Stroop interference in chronic pain patients. European Journal of Pain, 7(5), 431–438. doi: 10.1016/s1090-3801(03)00002-8 [DOI:10.1016/S1090-3801(03)00002-8]
3. Asghari, A., & Nicholas, M. K. (2001). Pain self-efficacy beliefs and pain behaviour. A prospective study. Pain, 94(1), 85–100. doi:10.1016/s0304-3959(01)00344-x [DOI:10.1016/S0304-3959(01)00344-X]
4. Asmundson, G. J., Norton, P. J., & Vlaeyen, J. W. (2004). Fear-avoidance models of chronic pain: An overview. In G. J. Asmundson, J. W. Vlaeyen, & G. Crombez (Eds.), Understanding and Treating Fear of Pain (pp. 3-24). Oxford: Oxford University Press.
5. Asmundson, G. J., Vlaeyen, J. W. S., & Crombez, G. (2004). Understanding and treating the fear of pain. Oxford: Oxford University Press.
6. Asmundson, G. J. G., Wright, K. D., & Hadjistavropoulos, H. D. (2005)(2005). Hypervigilance and attentional fixedness in chronic musculoskeletal pain: consistency of findings across modified stroop and dot-probe tasks. The Journal of Pain, 6(8), 497–506. doi: 10.1016/j.jpain.2005.02.012 [DOI:10.1016/j.jpain.2005.02.012]
7. Bayani, A. A. (2010). Reliability and preliminary evidence of validity of a Farsi version of the depression anxiety stress scales. Perceptual and Motor Skills, 111(1), 107–114. doi: 10.2466/08.13.pms.111.4.107-114 [DOI:10.2466/08.13.PMS.111.4.107-114]
8. Crombez, G., Van Ryckeghem, D. M. L., Eccleston, C., & Van Damme, S. (2013). Attentional bias to pain-related information: A meta-analysis. Pain, 154(4), 497–510. doi: 10.1016/j.pain.2012.11.013 [DOI:10.1016/j.pain.2012.11.013]
9. Dear, B. F., Sharpe, L., Nicholas, M. K., & Refshauge, K. (2011). Pain-related attentional biases: The importance of the personal relevance and ecological validity of stimuli. The Journal of Pain, 12(6), 625–632. doi: 10.1016/j.jpain.2010.11.010. [DOI:10.1016/j.jpain.2010.11.010]
10. Dyer, A. G., Found, B., & Rogers, D. (2006). Visual attention and expertise for forensic signature analysis. Journal of Forensic Sciences, 51(6), 1397–1404. doi: 10.1111/j.1556-4029.2006.00269.x [DOI:10.1111/j.1556-4029.2006.00269.x]
11. Eccleston, C., & Crombez, G. (1999). Pain demands attention: A cognitive–affective model of the interruptive function of pain. Psychological Bulletin, 125(3), 356–366. doi: 10.1037/0033-2909.125.3.356 [DOI:10.1037/0033-2909.125.3.356]
12. Haggman, S. P., Sharpe, L. A., Nicholas, M. K., & Refshauge, K. M. (2010). Attentional biases toward sensory pain words in acute and chronic pain patients. The Journal of Pain, 11(11), 1136–1145. doi: 10.1016/j.jpain.2010.02.017 [DOI:10.1016/j.jpain.2010.02.017]
13. Khatibi, A., Dehghani, M., Sharpe, L., Asmundson, G. J. G., & Pouretemad, H. (2009). Selective attention towards painful faces among chronic pain patients: Evidence from a modified version of the dot-probe. Pain, 142(1), 42–47. doi:10.1016/j.pain.2008.11.020 [DOI:10.1016/j.pain.2008.11.020]
14. Khatibi, A., Sharpe, L., Jafari, H., Gholami, S., & Dehghani, M. (2015). Interpretation biases in chronic pain patients: an incidental learning task. European Journal of Pain, 19(8), 1139–1147. doi: 10.1002/ejp.637 [DOI:10.1002/ejp.637]
15. Khatibi, A., Schrooten, M. G. S., Vancleef, L. M. G., & Vlaeyen, J. W. S. (2014). An experimental examination of catastrophizing-related interpretation bias for ambiguous facial expressions of pain using an incidental learning task. Frontiers in Psychology, 5, 1002. doi: 10.3389/fpsyg.2014.01002 [DOI:10.3389/fpsyg.2014.01002]
16. Lang, P., Bradley, M., & Cuthbert, B. (2008). International affective picture system (IAPS): Affective ratings of pictures and instruction manual: Technical report A-8. Gainesville: University of Florida.
17. Lautenbacher, S., Huber, C., Baum, C., Rossaint, R., Hochrein, S., & Heesen, M. (2011). Attentional avoidance of negative experiences as predictor of postoperative pain ratings and consumption of analgesics: يomparison with other psychological predictors. Pain Medicine, 12(4), 645-653. doi: 10.1111/j.1526-4637.2011.01076.x [DOI:10.1111/j.1526-4637.2011.01076.x]
18. Lautenbacher, S., Huber, C., Schöfer, D., Kunz, M., Parthum, A., Weber, P. G., et al. (2010). Attentional and emotional mechanisms related to pain as predictors of chronic postoperative pain: a comparison with other psychological and physiological predictors. Pain, 151(3), 722-731. doi: 10.1016/j.pain.2010.08.041 [DOI:10.1016/j.pain.2010.08.041]
19. Liossi, C., Schoth, D. E., Godwin, H. J., & Liversedge, S. P. (2014). Using eye movements to investigate selective attention in chronic daily headache. Pain, 155(3), 503–510. doi: 10.1016/j.pain.2013.11.014 [DOI:10.1016/j.pain.2013.11.014]
20. Lovibond, S., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation of Australia.
21. Mogg, K., Millar, N., & Bradley, B. P. (2000). Biases in eye movements to threatening facial expressions in generalized anxiety disorder and depressive disorder. Journal of Abnormal Psychology, 109(4), 695–704. doi: 10.1037/0021-843x.109.4.695 [DOI:10.1037/0021-843X.109.4.695]
22. Mohammadi, S., Dehghani, M., Sharpe, L., Heidari, M., Sedaghat, M., & Khatibi, A. (2012). Do main caregivers selectively attend to pain-related stimuli in the same way that patients do? Pain, 153(1), 62–67. doi: 10.1016/j.pain.2011.08.021 [DOI:10.1016/j.pain.2011.08.021]
23. Mohammadi, S., Dehghani, M., Khatibi, A., Sanderman, R., & Hagedorn, M. (2015). Caregivers' attentional bias to pain: does it affect caregiver accuracy in detecting patient pain behaviors? Pain, 156(1), 123-130. doi: 10.1016/j.pain.0000000000000015 [DOI:10.1016/j.pain.0000000000000015]
24. Roelofs, J., McCracken, L., Peters, M. L., Crombez, G., Van Breukelen, G., & Vlaeyen, J. W. (2004). Psychometric evaluation of the Pain Anxiety Symptoms Scale (PASS) in chronic pain patients. Journal of Behavioral Medicine, 27(2), 167–183. doi: 10.1023/b:jobm.0000019850.51400.a6 [DOI:10.1023/B:JOBM.0000019850.51400.a6]
25. Roelofs, J., Peters, M. L., McCracken, L., & Vlaeyen, J. W. . (2003). The Pain Vigilance and Awareness Questionnaire (PVAQ): further psychometric evaluation in fibromyalgia and other chronic pain syndromes. Pain, 101(3), 299–306. doi: 10.1016/s0304-3959(02)00338-x [DOI:10.1016/S0304-3959(02)00338-X]
26. Roelofs, J., Peters, M. L., Zeegers, M. P. A., & Vlaeyen, J. W. S. (2002). The modified Stroop paradigm as a measure of selective attention towards pain-related stimuli among chronic pain patients: A meta-analysis. European Journal of Pain, 6(4), 273–281. doi: 10.1053/eujp.2002.0337 [DOI:10.1053/eujp.2002.0337]
27. Roland, M., & Fairbank, J. (2000). The Roland–Morris disability questionnaire and the Oswestry disability questionnaire. Spine, 25(24), 3115–3124. doi: 10.1097/00007632-200012150-00006 [DOI:10.1097/00007632-200012150-00006]
28. Schoth, D. E., Nunes, V. D., & Liossi, C. (2012). Attentional bias towards pain-related information in chronic pain; a meta-analysis of visual-probe investigations. Clinical Psychology Review, 32(1), 13–25. doi: 10.1016/j.cpr.2011.09.004 [DOI:10.1016/j.cpr.2011.09.004]
29. Sharpe, L. (2014). Attentional biases in pain: More complex than originally thought? Pain, 155(3), 439–440. doi: 10.1016/j.pain.2013.12.020 [DOI:10.1016/j.pain.2013.12.020]
30. Sharpe, L., Haggman, S., Nicholas, M., Dear, B. F., & Refshauge, K. (2014). Avoidance of affective pain stimuli predicts chronicity in patients with acute low back pain. Pain, 155(1), 45–52. doi: 10.1016/j.pain.2013.09.004 [DOI:10.1016/j.pain.2013.09.004]
31. Swinkels-Meewisse, E., Swinkels, R., Verbeek, A., Vlaeyen, J., & Oostendorp, R. (2003). Psychometric properties of the Tampa Scale for kinesiophobia and the fear-avoidance beliefs questionnaire in acute low back pain. Manual Therapy, 8(1), 29–36. doi: 10.1054/math.2002.0484. [DOI:10.1054/math.2002.0484]
32. Van Damme, S., Crombez, G., & Eccleston, C. (2004). The anticipation of pain modulates spatial attention: Evidence for pain-specificity in high-pain catastrophizers. Pain, 111(3), 392–399. doi: 10.1016/j.pain.2004.07.022 [DOI:10.1016/j.pain.2004.07.022]
33. Van Ryckeghem, D. M., Crombez, G., Goubert, L., De Houwer, J., Onraedt, T., & Van Damme, S. (2013). The predictive value of attentional bias towards pain-related information in chronic pain patients: A diary study. Pain, 154(3), 468-475. doi: 10.1016/j.pain.2012.12.008 [DOI:10.1016/j.pain.2012.12.008]
34. Vervoort, T., Trost, Z., Prkachin, K. M., & Mueller, S. C. (2013). Attentional processing of other's facial display of pain: An eye tracking study. Pain, 154(6), 836–844. doi: 10.1016/j.pain.2013.02.017 [DOI:10.1016/j.pain.2013.02.017]
35. Vlaeyen, J. W. S., & Linton, S. J. (2012). Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain, 153(6), 1144–1147. doi: 10.1016/j.pain.2011.12.009 [DOI:10.1016/j.pain.2011.12.009]
36. Yang, Z., Jackson, T., & Chen, H. (2013). Effects of chronic pain and pain-related fear on orienting and maintenance of attention: An eye movement study. The Journal of Pain, 14(10), 1148–1157. doi: 10.1016/j.jpain.2013.04.017 [DOI:10.1016/j.jpain.2013.04.017]
37. Yang, Z., Jackson, T., Gao, X., & Chen, H. (2012). Identifying selective visual attention biases related to fear of pain by tracking eye movements within a dot-probe paradigm. Pain, 153(8), 1742–1748. doi: 10.1016/j.pain.2012.05.011 [DOI:10.1016/j.pain.2012.05.011]

Add your comments about this article : Your username or Email:

Send email to the article author

© 2020 All Rights Reserved | Basic and Clinical Neuroscience

Designed & Developed by : Yektaweb