The impact of modifying attentional bias on vulnerability to pain

The preferential deployment of attention to noxious versus benign information in the internal and external environment - “attentional bias” - is thought to confer vulnerability to pain. The current thesis tested this putative mechanism by modifying the bias using the visual-probe task (attentional bias modification; ABM) and examining effects of this experimental manipulation on attentional bias and critical pain outcomes. Drawing on recent evidence that the impact of pain on attentional bias varies across its temporal components, this thesis additionally tested the component stages of attentional bias implicated in pain experience by manipulating the duration for which visual-probe stimuli were presented. Study 1 confirmed that both rapid and slower attentional orienting was biased in individuals with persistent musculoskeletal pain. Results from Studies 2 and 3 indicated that acute experimentally-induced pain modified the faster bias and that participants whose fast bias was modified had reduced vulnerability to cold pressor pain, in comparison with control participants. This suggested that mechanisms of initial orienting were more active in the acute pain experience. Studies 4 and 5 revealed that concurrently retraining fast and slower bias was optimal for persistent musculoskeletal pain. Results of a systematic review and meta-analysis indicated a small overall statistical effect of ABM on pain severity. Critically, however, whereas ABM had been effective at reducing acute pain severity, this was not the case for persistent pain. Overall, these findings suggest that the faster bias influenced vulnerability to acute pain, indicating a potential therapeutic target for future research. However, retraining the earlier stage of attention alone did not influence persistent pain outcomes, where there appeared to be greater involvement of the slower bias. It was concluded that not only could attentional bias influence critical pain outcomes, but that the optimal timings may vary across temporal pain classifications.

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

University of East Anglia

Year dc:date.issued

2015

Author dc:creator

• Bowler, Jennifer

Language dc:language

en