TY - JOUR
T1 - Clinical relevance of attentional biases in pediatric chronic pain
T2 - an eye-tracking study
AU - Soltani, S.
AU - van Ryckeghem, D.M.L.
AU - Vervoort, T.
AU - Heathcote, L.C.
AU - Yeates, K.O.
AU - Sears, C.
AU - Noel, M.
N1 - Funding Information:
This research was supported by funding awarded to M. Noel by the Vi Riddell Pediatric Pain Initiative (RSO #1036777), the Alberta Children's Hospital Foundation and Research Institute (Shaikh Award; RSO #1042861), and funding from the Canadian Institutes of Health Research Strategy for Patient-Oriented Research (SPOR) “Chronic Pain Network” (RSO #1041605). This research was also supported by a SPOR Graduate Studentship and a Louise and Alan Edwards Foundation Postdoctoral Fellowship in Pediatric Pain Research awarded to S. Soltani. C. Sears and M. Noel contributed equally to this article.
Publisher Copyright:
© 2021 International Association for the Study of Pain
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Attentional biases have been posited as one of the key mechanisms underlying the development and maintenance of chronic pain and co-occurring internalizing mental health symptoms. Despite this theoretical prominence, a comprehensive understanding of the nature of biased attentional processing in chronic pain and its relationship to theorized antecedents and clinical outcomes is lacking, particularly in youth. This study used eye-tracking to assess attentional bias for painful facial expressions and its relationship to theorized antecedents of chronic pain and clinical outcomes. Youth with chronic pain (n = 125) and without chronic pain (n = 52) viewed face images of varying levels of pain expressiveness while their eye gaze was tracked and recorded. At baseline, youth completed questionnaires to assess pain characteristics, theorized antecedents (pain catastrophizing, fear of pain, and anxiety sensitivity), and clinical outcomes (pain intensity, interference, anxiety, depression, and posttraumatic stress). For youth with chronic pain, clinical outcomes were reassessed at 3 months to assess for relationships with attentional bias while controlling for baseline symptoms. In both groups, youth exhibited an attentional bias for painful facial expressions. For youth with chronic pain, attentional bias was not significantly associated with theorized antecedents or clinical outcomes at baseline or 3-month follow-up. These findings call into question the posited relationships between attentional bias and clinical outcomes. Additional studies using more comprehensive and contextual paradigms for the assessment of attentional bias are required to clarify the ways in which such biases may manifest and relate to clinical outcomes.
AB - Attentional biases have been posited as one of the key mechanisms underlying the development and maintenance of chronic pain and co-occurring internalizing mental health symptoms. Despite this theoretical prominence, a comprehensive understanding of the nature of biased attentional processing in chronic pain and its relationship to theorized antecedents and clinical outcomes is lacking, particularly in youth. This study used eye-tracking to assess attentional bias for painful facial expressions and its relationship to theorized antecedents of chronic pain and clinical outcomes. Youth with chronic pain (n = 125) and without chronic pain (n = 52) viewed face images of varying levels of pain expressiveness while their eye gaze was tracked and recorded. At baseline, youth completed questionnaires to assess pain characteristics, theorized antecedents (pain catastrophizing, fear of pain, and anxiety sensitivity), and clinical outcomes (pain intensity, interference, anxiety, depression, and posttraumatic stress). For youth with chronic pain, clinical outcomes were reassessed at 3 months to assess for relationships with attentional bias while controlling for baseline symptoms. In both groups, youth exhibited an attentional bias for painful facial expressions. For youth with chronic pain, attentional bias was not significantly associated with theorized antecedents or clinical outcomes at baseline or 3-month follow-up. These findings call into question the posited relationships between attentional bias and clinical outcomes. Additional studies using more comprehensive and contextual paradigms for the assessment of attentional bias are required to clarify the ways in which such biases may manifest and relate to clinical outcomes.
KW - Attentional bias
KW - Eye-tracking
KW - Pain facial expressions
KW - Chronic pain
KW - Youth
KW - Pediatric
KW - Pain catastrophizing
KW - Anxiety sensitivity
KW - Fear of pain
KW - Anxiety
KW - Depression
KW - Posttraumatic stress
KW - PTSD SYMPTOM SCALE
KW - POSTTRAUMATIC-STRESS-DISORDER
KW - COGNITIVE-BEHAVIORAL THERAPY
KW - CHRONIC MUSCULOSKELETAL PAIN
KW - FUNCTIONAL ABDOMINAL-PAIN
KW - REVISED CHILD ANXIETY
KW - FEAR-AVOIDANCE MODEL
KW - LOW-BACK-PAIN
KW - PSYCHOMETRIC PROPERTIES
KW - SELECTIVE ATTENTION
U2 - 10.1097/j.pain.0000000000002346
DO - 10.1097/j.pain.0000000000002346
M3 - Article
C2 - 34285155
SN - 0304-3959
VL - 163
SP - E261-E273
JO - Pain
JF - Pain
IS - 2
ER -