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Attentional bias towards pain-related information diminishes the efficacy of distraction

Van Ryckeghem, Dimitri M.L.*; Crombez, Geert; Van Hulle, Lore; Van Damme, Stefaan

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doi: 10.1016/j.pain.2012.07.032
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Summary People who display a large attentional bias towards predictive cues of pain or who initially experience the pain as more painful benefit less from distraction during subsequent pain induction.

ABSTRACT Distraction is a strategy that is commonly used to cope with pain. Results concerning the efficacy of distraction from both experimental and clinical studies are variable, however, and indicate that its efficacy may depend on particular circumstances. Several models propose that distraction may be less effective for people who display a large attentional bias towards pain-related information. This hypothesis was tested in an experimental context with 53 pain-free volunteers. First, attentional bias towards cues signalling the occurrence of pain (electrocutaneous stimuli) and towards words describing the sensory experience of this painful stimulus was independently assessed by means of 2 behavioural paradigms (respectively, spatial cueing task and dot-probe task). This was followed by a subsequent distraction task during which the efficacy of distraction, by directing attention away from the electrocutaneous stimuli, was tested. In addition, state–trait anxiety, catastrophic thinking, and initial pain intensity were measured. Results indicated that people who display a large attentional bias towards predictive cues of pain or who initially experience the pain as more painful benefit less from distraction on a subsequent test. No effects were found between attentional bias towards pain words, state–trait anxiety, catastrophic thinking, and the efficacy of distraction. Current findings suggest that distraction should not be used as a ‘one size fits all’ method to control pain, but only under more specific conditions.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium

*Corresponding author. Tel.: +32 9 264 86 11; fax: +32 9 264 64 89.

E-mail address:Dimitri.VanRyckeghem@ugent.be

Article history: Received 31 October 2011; Received in revised form 30 May 2012; Accepted 30 July 2012.

© 2012 Lippincott Williams & Wilkins, Inc.
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