Greater response interference to pain faces under low perceptual load conditions in adolescents with impairing pain: A role for poor attention control mechanisms in pain disability?

TY - JOUR

T1 - Greater response interference to pain faces under low perceptual load conditions in adolescents with impairing pain

T2 - A role for poor attention control mechanisms in pain disability?

AU - Lau, Jennifer Y.F.

AU - Sprecher, Eva

AU - Haas, Sara

AU - Lisk, Stephen

AU - Pagliaccio, David

AU - Sharpe, Louise

AU - Bar-Haim, Yair

AU - Pine, Daniel S.

PY - 2018/10/29

Y1 - 2018/10/29

N2 - Persistent pain in young people in the community is common but individuals vary in how much pain impacts daily life. Information-processing accounts of chronic pain partly attribute the fear and avoidance of pain, and associated interference to a set of involuntary biases, including the preferential allocation of attention resources towards potential threats. Far less research has focused on the role of voluntary goal-directed attention control processes, the ability to flexibly direct attention towards and away from threats, in explaining pain-associated interference. Using a visual search task, we explored a poor attention control account of pain interference in young people with persistent pain from the community. One hundred and forty five young people aged 16-19 categorised as non-chronic pain (n=68), low interfering persistent pain (n=40), and moderate-to-high interfering persistent pain (n=22) provided data to support our hypotheses that only adolescents with moderate-to-high interfering persistent pain were affected by pain (than neutral faces) presented before a visual search than the other two groups of adolescents, but only under low perceptual load conditions. Because low perceptual load conditions are thought to require more strategic attention resources to suppress the interfering effects of pain face primes, our findings are consistent with a poor attention control account of pain interference in young people. Analyses further showed that these differences in task performance were not explained by confounding effects of anxiety. If replicated, these findings may have implications for understanding and managing pain-associated disability in adolescent chronic pain. Perspective Young people with moderately/highly interfering pain responded slower on an easy search task after seeing a pain face than a neutral face. If replicated, these findings could mean that boosting the ability to control attention towards and away from threatening cues is an effective strategy for managing interference from pain.

AB - Persistent pain in young people in the community is common but individuals vary in how much pain impacts daily life. Information-processing accounts of chronic pain partly attribute the fear and avoidance of pain, and associated interference to a set of involuntary biases, including the preferential allocation of attention resources towards potential threats. Far less research has focused on the role of voluntary goal-directed attention control processes, the ability to flexibly direct attention towards and away from threats, in explaining pain-associated interference. Using a visual search task, we explored a poor attention control account of pain interference in young people with persistent pain from the community. One hundred and forty five young people aged 16-19 categorised as non-chronic pain (n=68), low interfering persistent pain (n=40), and moderate-to-high interfering persistent pain (n=22) provided data to support our hypotheses that only adolescents with moderate-to-high interfering persistent pain were affected by pain (than neutral faces) presented before a visual search than the other two groups of adolescents, but only under low perceptual load conditions. Because low perceptual load conditions are thought to require more strategic attention resources to suppress the interfering effects of pain face primes, our findings are consistent with a poor attention control account of pain interference in young people. Analyses further showed that these differences in task performance were not explained by confounding effects of anxiety. If replicated, these findings may have implications for understanding and managing pain-associated disability in adolescent chronic pain. Perspective Young people with moderately/highly interfering pain responded slower on an easy search task after seeing a pain face than a neutral face. If replicated, these findings could mean that boosting the ability to control attention towards and away from threatening cues is an effective strategy for managing interference from pain.

KW - Attention control

KW - adolescent pain

KW - interference

KW - cognitive model

U2 - 10.1016/j.jpain.2018.10.005

DO - 10.1016/j.jpain.2018.10.005

M3 - Article

SN - 1526-5900

JO - JOURNAL OF PAIN

JF - JOURNAL OF PAIN

ER -