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

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

Cognitive biases in pain: current challenges, future directions and treatment opportunities

Cognitive biases are a core component of contemporary cognitive-affective models that try to explain pain experience, distress and disability in children and adults experiencing pain. The idea that children and adults with pain show cognitive biases for pain-related information, i.e. they selectively attend to pain-related information at the cost of other information (attentional bias), interpret ambiguous stimuli as pain-related (interpretation bias) or have biased memories for painful events (memory bias), has been particularly influential in this context. Notwithstanding the considerable progress made in the understanding of cognitive biases related to pain and threat, a number of questions remains unanswered and future challenges linger. A first challenge is to further delineate the characteristics of cognitive biases, including their content specificity and dynamics. A second challenge relates to the understanding of how cognitive biases interrelate with each other and possibly reinforce one another. A third challenge relates to the translation of findings on cognitive biases for pain into clear strategies and recommendations to optimize and evaluate pain treatment programs. Presenters in this symposium will address each of the above-mentioned lingering challenges by both critically reviewing the available evidence on cognitive biases in children and/ or adults experiencing pain and presenting novel research using innovative study set-ups and unique methods for assessing and modifying cognitive biases in children and adults experiencing pain

Pain and Attention: Towards a Motivational Account

Attention plays a pivotal role in the experience of pain and its impact upon daily activities. Accordingly, research on the interplay between attention and pain has a long scientific history. Within this chapter, we discuss the theoretical frameworks that aim to explain the relationship between attention and pain. We argue for a motivational perspective on pain that highlights the critical role of cognitive, affective and contextual factors in explaining the interplay between attention and pain. To substantiate this argument, we provide an overview of available research addressing the bottom-up capture of attention by pain and the top-down modulation (both inhibition and facilitation) of attention for pain. We conclude this chapter with guidelines and suggestions for future research and discuss clinical implications of adopting a motivational perspective on pain

A jigsaw puzzle framework for homogenization of high porosity foams

An approach to homogenization of high porosity metallic foams is explored. The emphasis is on the \Alporas{} foam and its representation by means of two-dimensional wire-frame models. The guaranteed upper and lower bounds on the effective properties are derived by the first-order homogenization with the uniform and minimal kinematic boundary conditions at heart. This is combined with the method of Wang tilings to generate sufficiently large material samples along with their finite element discretization. The obtained results are compared to experimental and numerical data available in literature and the suitability of the two-dimensional setting itself is discussed.Comment: 11 pages, 7 figures, 3 table

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

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 = − 0.21, 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

Multidimensional screening for predicting pain problems in adults: a systematic review of screening tools and validation studies

Abstract Screening tools allowing to predict poor pain outcomes are widely used. Often these screening tools contain psychosocial risk factors. This review (1) identifies multidimensional screening tools that include psychosocial risk factors for the development or maintenance of pain, pain-related distress, and pain-related disability across pain problems in adults, (2) evaluates the quality of the validation studies using Prediction model Risk Of Bias ASsessment Tool (PROBAST), and (3) synthesizes methodological concerns. We identified 32 articles, across 42 study samples, validating 7 screening tools. All tools were developed in the context of musculoskeletal pain, most often back pain, and aimed to predict the maintenance of pain or pain-related disability, not pain-related distress. Although more recent studies design, conduct, analyze, and report according to best practices in prognosis research, risk of bias was most often moderate. Common methodological concerns were identified, related to participant selection (eg, mixed populations), predictors (eg, predictors were administered differently to predictors in the development study), outcomes (eg, overlap between predictors and outcomes), sample size and participant flow (eg, unknown or inappropriate handli