Comparing the effects of thought suppression and focused distraction on pain-related attentional biases in men and women

Increasing attentional focus away from pain can affect pain experience, suggesting that cognitive strategies that move attentional allocation may be a moderator of pain. In a pre-post-design, the present study examined the effects of 2 cognitive strategies used in pain contexts, thought suppression and focused distraction, on subsequent pain-related attention. Thought suppression was hypothesized to increase pain-related attention, whereas focused distraction was expected to reduce it. Influences of both anxiety and sex were also considered, as secondary questions. 139 (86 women, 53 men) healthy, pain-free participants were randomly assigned to use either thought suppression or focused distraction during a mild cold pressor test (CPT). Pain-related attention was examined using a dot-probe and an attentional blink task, pre-and post-CPT. Questionnaires about relevant cognitive and emotional aspects, demographics, and pain were completed. Results showed no difference in the effect of the 2 pain inhibition strategies on pain-related attention. The hypothesized rebound effect in thought suppression on pain-related attention did not emerge. However, thought suppression showed a short-term benefit in comparison to focused distraction regarding reported pain and perceived threat during the cold pressor test. Few sex differences were found. Thus, the cognitive strategies affected pain outcomes, but did not influence pain-related attention. Perspective: Cognitive strategies could help with pain through changing attention allocation. In this study, the effects of the 2 cognitive strategies thought suppression and focused distraction on pain-related attention in men and women were examined. Elucidating mechanisms that lie behind pain strategies that focus on changing attention may help improve treatments.</p

Psychometric Properties of an Arabic Pain Anxiety Symptoms Scale-20 (PASS-20) in Healthy Volunteers and Patients Attending a Physiotherapy Clinic.

PURPOSE: The aim of this study was to cross-culturally adapt the PASS-20 questionnaire for use in Libya. METHODS: Participants were 71 patients (42 women) attending the physiotherapy clinic, Ibn Sina Hospital, Sirt, Libya for management of persistent pain and 137 healthy unpaid undergraduate students (52 women) from the University of Sirt, Libya. The English PASS-20 was translated into Arabic. Patients completed the Arabic PASS-20 and the Arabic Pain Rating Scales on two occasions separated by a 14-day interval. Healthy participants completed the Arabic PASS-20 on one occasion. RESULTS: The internal consistency (ICC) for pain patient and healthy participant samples yielded a good reliability for the total score, cognitive anxiety, fear of pain, and physiological anxiety. The test-retest reliability of the Arabic PASS-20 score showed high reliability for the total score (ICC = 0.93, p < 0.001), escape/avoidance (ICC = 0.93, p < 0.001), fear of pain (ICC = 0.94, p < 0.001), and physiological anxiety subscales (ICC = 0.96, p < 0.001) and good reliability for the cognitive anxiety (ICC = 0.85, p < 0.001). Inspection of the Promax rotation showed that each factor comprised of five items were consistent with the theoretical constructs of the original PASS-20 subscales. CONCLUSION: The Arabic PASS-20 retained internal consistency and reliability with the original English version and can be used to measure pain anxiety symptoms in both pain and healthy individual samples in Libya

Angst und Furcht bei Patienten mit chronischem Rückenschmerz

Im Rahmen dieser Arbeit wurden zunächst deutsche Versionen zweier Fragebögen für Schmerzangst (Pain Anxiety Symptoms Scale, PASS-20) bzw. Furcht vor (Wieder-)Verletzung (Tampa Scale for Kinesiophobia, TSK) validiert. Beide Instrumente zeigten sich als reliabel und valide. Die beiden zugrundeliegenden Konzepte Schmerzangst und Schmerzfurcht, die sowohl gemeinsame als auch distinkte Aspekte aufweisen, wurden differenziert. Im Anschluss an diese konzeptuelle Untersuchung wurde die Interaktion zwischen Schmerz und Schmerzangst (PASS-20) bzw. Schmerzfurcht (TSK) auf Geschlechtsunterschiede untersucht. Dabei zeigte sich das Geschlecht in der Beziehung von Schmerzangst/-furcht und Schmerz als Moderator: Bei Männern interagierte nur Schmerzangst mit der Schmerzintensität, bei Frauen interagierte nur Schmerzfurcht mit der Schmerzintensität. Höhere Werte waren dabei mit stärkeren Schmerzen verknüpft. Die Ergebnisse wurden in Bezug zur Literatur gesetzt und diskutiert.First, two German versions of questionnaires for pain anxiety (Pain Anxiety Symptoms Scale, PASS-20) and fear of (re)injury (Tampa Scale for Kinesiophobia, TSK) were validated. Both instruments were shown as reliable and valid. The underlying concepts of pain anxiety and fear of pain, which have common as well as distinct aspects, were differentiated. Following this conceptual analysis, the interaction between pain and pain anxiety/fear of pain was examined for sex differences. Sex was shown as a moderator in the relationship between pain and pain anxiety/fear of pain: In men, only pain anxiety interacted with pain intensity. In women, only fear of pain interacted with pain intensity. Higher scores were linked with higher pain intensity. The results were discussed in light of the existing literature