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Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials

Sharpe, Louisea,*; Ianiello, Melissaa; Dear, Blake F.b; Perry, Kathryn Nicholsonc; Refshauge, Kathrynd; Nicholas, Michael K.e

doi: 10.1016/j.pain.2011.12.014
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Summary Attention bias modification resulted in positive outcomes compared to placebo in 2 randomised, controlled trials in patients with acute and chronic pain.

Potential applications of attention bias modification (ABM) for acute and chronic pain patients are investigated. In study 1, 54 acute back pain patients (46 of whom completed the study) were recruited at their initial physiotherapy session and randomised to receive 1 session of ABM or placebo. Patients were followed up 3 months later. Participants who were randomised to receive ABM reported less average (P = 0.001) and current pain (P = 0.008) and experienced pain for fewer days (P = 0.01) than those who received placebo. In study 2, 34 chronic pain patients were recruited and randomly assigned to receive either 4 sessions of ABM (n = 22) or placebo (n = 12), followed by 8 sessions of cognitive behavioural treatment (CBT). After ABM, there was a significant group-by-time effect for disability. By 6-month follow-up, differences had emerged between the 2 training groups, such that the ABM group had shown greater reductions in anxiety sensitivity and disability than the placebo group. Although the results of these studies show that there is potential in the application of ABM to pain conditions, the mechanisms of treatment could not be established. Neither group showed an initial bias towards the word stimuli or a training effect, and only in the acute pain group were changes in biases related to outcome. Nonetheless, the fact that 2 independent samples showed a positive effect of ABM on clinical outcomes suggests that ABM is worthy of future study as an intervention for pain patients.

aClinical Psychology Unit, School of Psychology, University of Sydney, Sydney, Australia

bCentre for Emotional Health, Department of Psychology, C3B 518, Macquarie University, NSW 2109, Australia

cSchool of Psychology, University of Western Sydney, Sydney, Australia

dDepartment of Physiotherapy, University of Sydney, Sydney, Australia

ePain Management Research Institute, University of Sydney, Sydney, Australia

*Corresponding author. Address: School of Psychology A17, The University of Sydney, NSW 2006, Australia.

E-mail: louises@psych.usyd.edu.au

Submitted May 12, 2011; revised December 14, 2011; accepted December 15, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.
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