Interpretation bias and the transition from acute to chronic pain

The Role of Pain and Interpretation Bias in Fear of Disease Progression in People With Diabetes

Research indicates that fear of progression (FoP) may be a transdiagnostic construct underlying anxiety in people with chronic health conditions. Theories propose that the interpretation of illness-related symptoms (such as pain) might be an important mechanism driving the development of FoP. However, FoP has rarely been studied in diabetes. In this study, we assessed FoP, pain, health threat-related interpretation bias, emotional states, and treatment adherence in 198 participants with type 1 or type 2 diabetes and an age- and gender-matched control group. We hypothesized that 1) people with diabetes will be more likely to interpret ambiguous stimuli as health threat-related than people without diabetes; 2) among those with diabetes, pain severity and interpretation bias will be associated with more severe levels of FoP; and 3) interpretation bias will moderate the relationship between pain severity and FoP in people with diabetes, such that the positive association between pain and FoP will become stronger when people have greater interpretation bias. Our results confirmed that people with diabetes were more likely to interpret ambiguous information as health threat-related compared with people without diabetes, with a large effect (d = .84). Moreover, people with diabetes who reported persistent pain were more likely to interpret ambiguous stimuli as health threat-related (d = .49). Among people with diabetes, pain severity and interpretation bias were significantly associated with FoP. However, we did not find evidence that interpretation bias moderated the relationship between pain and FoP and these relationships could not be accounted for by general psychopathology. PERSPECTIVE: People with diabetes had greater health threat-related interpretation bias than people without diabetes, especially for those with persistent pain and more severe FoP. Both pain severity and interpretation bias were associated with greater FoP, but interpretation bias did not moderate the relationship between pain and FoP.

Benign or painful? The interpretation of pain and fear of progression in rheumatoid arthritis

ABSTRACT

People with chronic pain tend to interpret ambiguous information as health-related, more so than people without. In this study, we aimed to investigate whether people with rheumatoid arthritis (RA) exhibit this interpretation bias and whether it is associated with fear of disease progression (FoP). The interpretation biases of people with RA (n = 164) were compared with an age- and gender-matched control group. We hypothesized that (1) people with RA would have larger interpretation biases than people without; (2) those who scored in the clinical range for FoP would have larger interpretation bias than those who did not; (3) interpretation bias would moderate the relationship between pain severity and FoP; and (4) interpretation bias would explain variance in FoP above and beyond other established predictors. Our results confirmed that people with RA were more likely to interpret ambiguous information as health-related compared with people without RA. This effect was more pronounced for the RA subgroup with clinically significant FoP than those scoring in the normal range. We did not find evidence to suggest interpretation bias moderated the relationship between pain and FoP or that FoP added to the variance of other known predictors. Our results indicate that interpretation bias is common amongst people with RA and is associated with FoP. Further research is required to illuminate the exact nature of this relationship.

Assessing cognitive biases induced by acute formalin or hotplate treatment: an animal study using affective bias test

Pain, a universal and burdensome condition, influences numerous individuals worldwide. It encompasses sensory, emotional, and cognitive facets, with recent research placing a heightened emphasis on comprehending pain's impact on emotion and cognition. Cognitive bias, which encompasses attentional bias, interpretation bias, and memory bias, signifies the presence of cognitive distortions influenced by emotional factors. It has gained significant prominence in pain-related research. Human studies have shown that individuals experiencing pain exhibit cognitive bias. Similarly, animal studies have demonstrated cognitive bias in pain-induced states across various species and disease models. In this study, we aimed to investigate the memory bias displayed by rats experiencing acute pain, using the affective bias test (ABT) as a tool and administering either hotplate or formalin to induce acute pain. Our data showed that rats demonstrated a significant preference for the control treatment-related substrate over the substrate associated with formalin treatment (p < 0.001), an indication of the prominent memory bias stimulated by acute formalin injections. However, when exposed to substrates related to hotplate treatment and control treatment, the acute pain induced by the hotplate treatment failed to generate a statistically significant choice bias in rats (p = 0.674). Our study demonstrates that the negative emotions associated with acute pain can be reflected by memory bias in ABT, at least for formalin-induced acute pain. This finding will augment our comprehension of the emotional and cognitive aspects of acute pain.