More than meets the eye: visual attention biases in individuals reporting chronic pain

Investigating attention toward pain-related cues in an Arabic-speaking population with and without chronic pain

There is some evidence for attentional biases in individuals with chronic pain (CP). Cultural and linguistic differences might affect the manifestation of these processes across populations. However, such attentional biases have not been explored in the Arabic-speaking population. The current study investigated these attentional biases and possible associations with resilience. Two matched groups of Arabic-speaking participants with (58) and without (58) CP were recruited from Jordan and the United Kingdom. They completed emotionally modified versions of the Posner cueing and Stroop tasks, alongside questionnaires. Significant group differences were found for the Posner task, with the CP group exhibiting disengagement revealed by the inhibition of return (IOR) effect for sensory pain-related cues compared to delayed disengagement for the other cue types. The control group showed IOR across cue types. No group differences were found on the Stroop task. The CP group had lower resilience scores than healthy controls, and resilience moderated performance on the Posner task. The study provides preliminary evidence about the attentional processes in the Arabic population; the speed of disengagement is affected in the CP group with early disengagement for sensory pain-related information compared to affect pain and neutral stimuli. Furthermore, resilience levels in the CP and control group moderated the performance on the Posner task, suggesting that it influences attentional allocation. This study can help in understanding how the phenomenon of attention bias intertwines with the cultural and linguistic factors. Future research should further explore attentional dynamics across different time points in this population and the modulatory effect of resilience.

Development and Evaluation of Linguistic Stimuli for Pain Research

Linguistic stimuli are commonly used in research to investigate the processing of pain. To provide researchers with a dataset of pain-related and non-pain-related linguistic stimuli, this research investigated 1) the associative strength between pain-related words and the pain construct; 2) the pain-relatedness ratings of pain words; and 3) the variability in the relatedness of pain words within pain word classifications (eg, sensory pain words). In Study 1, 194 pain-related and matched non-pain-related words were retrieved by reviewing the pain-related attentional bias literature. In Study 2, adults with (n = 85) and without (n = 48) self-reported chronic pain completed a speeded word categorization paradigm and rated the pain-relatedness of a subset of pain words. Analyses revealed that 1) despite differences in associative strength of 11.3% of the words between chronic and non-chronic pain groups, no overall group difference was found, 2) the chronic pain group rated the pain words as more pain-related compared to the non-chronic pain group, and 3) there was variability in the relatedness of pain words within pain word classifications. The findings highlight the importance of validating linguistic pain stimuli. The resulting dataset is openly accessible and new published sets can be added to the Linguistic Materials for Pain (LMaP) Repository. PERSPECTIVE: This article presents the development and preliminary evaluation of a large pool of pain-related and non-pain-related words in adults with and without self-reported chronic pain. Findings are discussed and guidelines are offered to select the most suitable stimuli for future research.

What can we learn about selective attention processes in individuals with chronic pain using reaction time tasks? A systematic review and meta-analysis

ABSTRACT

Information-processing biases such as attentional, interpretation, and memory biases are believed to play a role in exacerbating and maintaining chronic pain (CP). Evidence suggests that individuals with CP show attentional bias toward pain-related information. However, the selective attentional processes that underpin this bias are not always well outlined in the literature. To improve current understanding, a systematic review was performed using a descriptive synthesis of reaction time-based studies. A random-effects meta-analysis was added to explore whether the results of previous meta-analyses would be confirmed using studies with a larger sample size. For this review, 2008 studies were screened from 4 databases, of which 34 (participant n = 3154) were included in the review and a subset of 15 (participant n = 1339) were included in the meta-analysis. Review results were summarised by producing a descriptive synthesis for all studies. Meta-analysis results indicated a mild significant attentional bias toward sensory pain-related information (k = 15, g = 0.28, 95% CI [0.16, 0.39], I2 = 43.2%, P = 0.038), and preliminary evidence of significant moderate bias towards affective pain-related information (k = 3, g = 0.48, 95% CI [0.23, 0.72], I2 = 7.1%, P = 0.341) for CP groups compared with control groups. We explored the main tasks, stimuli, and CP subtypes used to address attentional biases and related processes. However, variation across studies did not allow for a decisive conclusion about the role of stimulus, task type, or related attentional processes. In addition, a table of CP attention-related models was produced and tested for reliability. Finally, other results and recommendations are discussed.

Sedentary Behavior and Pain after Physical Activity in Women with Fibromyalgia-The Influence of Pain-Avoidance Goals and Catastrophizing

BACKGROUND

Fibromyalgia is characterized by chronic pain and fatigue that triggers a functional disability caused by the lack of activity. Pain catastrophizing may contribute to avoiding activity with the intention of managing pain levels. Based on the sedentary behavior with fibromyalgia, the present study assessed the preference of pain-avoidance goals and pain catastrophizing as mediator and moderator variables, respectively, that influence pain perception after a 6-min-walking test.

METHODS

The sample was composed of 76 women with fibromyalgia (mean age = 55.05, SD = 7.70). Previous sedentary behavior, preference for pain-avoidance goals, and pain catastrophizing were evaluated before starting the walking-test. Subsequently, pain perception was evaluated.

RESULTS

A significant moderated-mediation model was found in which pain-avoidance goals mediated the relationship between sedentarism and pain after a walking-test, and pain catastrophizing moderated the relationship between the preference for pain-avoidance goals and pain perception. Specifically, high levels of pain catastrophizing contributed to increased pain perceptions after completing the test (B = 0.570, p = 0.03, CI 95% (0.09, 0.11)].

CONCLUSIONS

The results suggest that motivational interventions can improve the symptoms because their objectives are focused on managing conflict goals. These interventions should focus on catastrophic cognitions considering that pain catastrophizing is deemed to be one of the major inhibitors of physical activity in fibromyalgia.

Association between attentional bias to experimentally induced pain and to pain-related words in healthy individuals: the moderating role of interpretation bias

ABSTRACT

Attentional bias to pain-related information may contribute to chronic pain maintenance. It is theoretically predicted that attentional bias to pain-related language derives from attentional bias to painful sensations; however, the complex interconnection between these types of attentional bias has not yet been tested. This study aimed to investigate the association between attentional bias to pain words and attentional bias to the location of pain, as well as the moderating role of pain-related interpretation bias in this association. Fifty-four healthy individuals performed a visual probe task with pain-related and neutral words, during which eye movements were tracked. In a subset of trials, participants were presented with a cold pain stimulus on one hand. Pain-related interpretation and memory biases were also assessed. Attentional bias to pain words and attentional bias to the pain location were not significantly correlated, although the association was significantly moderated by interpretation bias. A combination of pain-related interpretation bias and attentional bias to painful sensations was associated with avoidance of pain words. In addition, first fixation durations on pain words were longer when the pain word and cold pain stimulus were presented on the same side of the body, as compared to on opposite sides. This indicates that congruency between the locations of pain and pain-related information may strengthen attentional bias. Overall, these findings indicate that cognitive biases to pain-related information interact with cognitive biases to somatosensory information. The implications of these findings for attentional bias modification interventions are discussed.

Attentional processing of pain faces and other emotional faces in chronic pain-an eye-tracking study

Altered attentional processing of pain-associated stimuli-which might take the form of either avoidance or enhanced vigilance-is thought to be implicated in the development and maintenance of chronic pain. In contrast to reaction time tasks like the dot probe, eye tracking allows for tracking the time course of visual attention and thus differentiating early and late attentional processes. Our study aimed at investigating visual attention to emotional faces in patients with chronic musculoskeletal pain (N = 20) and matched pain-free controls (N = 20). Emotional faces (pain, angry, happy) were presented in pairs with a neutral face for 2000 ms each. Three parameters were determined: First fixation probabilities, fixation durations (overall and divided in four 500 ms intervals) and a fixation bias score as the relative fixation duration of emotional faces compared to neutral faces. There were no group differences in any of the parameters. First fixation probabilities were lower for pain faces than for angry faces. Overall, we found longer fixation duration on emotional compared to neutral faces ('emotionality bias'), which is in accord with previous research. However, significant longer fixation duration compared to the neutral face was detected only for happy and angry but not for pain faces. In addition, fixation durations as well as bias scores yielded evidence for vigilant-avoidant processing of pain faces in both groups. These results suggest that attentional bias towards pain-associated stimuli might not generally differentiate between healthy individuals and chronic pain patients. Exaggerated attentional bias in patients might occur only under specific circumstances, e.g., towards stimulus material specifically relating to the specific pain of the patients under study or under high emotional distress.

Do people with acute low back pain have an attentional bias to threat-related words?

OBJECTIVES

It has been hypothesised that attentional bias to environmental threats can contribute to persistent pain. It is unclear whether people with acute low back pain (LBP) have an attentional bias to environmental threats. We investigated if attentional bias of threat related words is different in people with acute LBP and pain-free controls.

METHODS

People with acute LBP and pain-free people completed a free viewing eye tracking task. Participants were simultaneously presented with two words, a threat related word and a neutral control word. Threat related words were general threat, affective pain and sensory pain. We conducted linear mixed models to detect differences between acute LBP and pain-free participants on five eye tracking outcome measures (dwell time, first fixation, latency to first fixation, first run dwell time and number of fixations). We calculated absolute reliability, (standard error of measure), and relative reliability (intraclass correlation coefficients [ICC 2,1]) for each eye tracking outcome measures.

RESULTS

We recruited 65 people with acute LBP and 65 pain-free controls. Participants with acute LBP had a higher proportion of fixations towards the affective pain words (M=0.5009, 95% CI=0.4941, 0.5076) than the pain-free controls had (M=0.4908, 95% CI=0.4836, 0.4979), mean between group difference = -0.0101, 95% CI [-0.0198, -0.0004], p=0.0422. There was no difference between acute LBP and pain-free controls for the remaining eye tracking outcome measures (all p>0.05). The only outcome measure that had an ICC of more than 0.7 was the latency to first fixation (affective pain words ICC=0.73, general threat words ICC=0.72).

CONCLUSIONS

When compared with pain-free controls, people with acute LBP looked more often at affective pain words relative to neutral control words. This may indicate a form of engagement bias for people with acute LBP. Attentional bias was not consistent across outcome measures or word groups. Further research is needed to investigate the potential role of attentional bias in the development of persistent pain.

The time course of attentional biases in pain: a meta-analysis of eye-tracking studies

ABSTRACT

Previous meta-analyses investigating attentional biases towards pain have used reaction time measures. Eye-tracking methods have been adopted to more directly and reliably assess biases, but this literature has not been synthesized in relation to pain. This meta-analysis aimed to investigate the nature and time course of attentional biases to pain-related stimuli in participants of all ages with and without chronic pain using eye-tracking studies and determine the role of task parameters and theoretically relevant moderators. After screening, 24 studies were included with a total sample of 1425 participants. Between-group analyses revealed no significant overall group differences for people with and without chronic pain on biases to pain-related stimuli. Results indicated significant attentional biases towards pain-related words or pictures across both groups on probability of first fixation (k = 21, g = 0.43, 95% confidence interval [CI] 0.15-0.71, P = 0.002), how long participants looked at each picture in the first 500 ms (500-ms epoch dwell: k = 5, g = 0.69, 95% CI 0.034-1.35, P = 0.039), and how long participants looked at each picture overall (total dwell time: k = 25, g = 0.44, 95% CI 0.15-0.72, P = 0.003). Follow-up analyses revealed significant attentional biases on probability of first fixation, latency to first fixation and dwell time for facial stimuli, and number of fixations for sensory word stimuli. Moderator analyses revealed substantial influence of task parameters and some influence of threat status and study quality. Findings support biases in both vigilance and attentional maintenance for pain-related stimuli but suggest attentional biases towards pain are ubiquitous and not related to pain status.

There Is an "Eye" in Team: Exploring the Interplay Between Emotion, Gaze Behavior, and Collective Efficacy in Team Sport Settings

Little is understood about the attentional mechanisms that lead to perceptions of collective efficacy. This paper presents two studies that address this lack of understanding. Study one examined participant's (N = 59) attentional processes relating to positive, neutral, or negative emotional facial photographs, when instructed to select their “most confident” or “least confident” team. Eye gaze metrics of first fixation duration (FFD), fixation duration (FD), and fixation count (FC) were measured alongside individual perceptions of collective efficacy and emotional valence of the teams selected. Participants had shorter FFD, longer FD, and more FC on positive faces when instructed to select their most confident team (p < 0.05). Collective efficacy and emotional valence were significantly greater when participants selected their most confident team (p < 0.05). Study two explored the influence of video content familiarity of team-based observation interventions on attentional processes and collective efficacy in interdependent team-sport athletes (N = 34). When participants were exposed to familiar (own team/sport) and unfamiliar (unknown team/sport) team-based performance video, eye tracking data revealed similar gaze behaviors for the two conditions in terms of areas of interest. However, collective efficacy increased most for the familiar condition. Study one results indicate that the emotional expressions of team members influence both where and for how long we look at potential team members, and that conspecifics' emotional expression impacts on our perceptions of collective efficacy. For Study two, given the apparent greater increase in collective efficacy for the familiar condition, the similar attentional processes evident for familiar and unfamiliar team footage suggests that differences in meaning of the observed content dictates collective efficacy perceptions. Across both studies, the findings indicate the importance of positive emotional vicarious experiences when using team-based observation interventions to improve collective efficacy in teams.

Attentional Bias for Imperfect Pictures in Perfectionism: An Eye-Movement Study

Background

Although dot-probe paradigms have been widely used in previous studies to investigate the attentional bias of perfectionists, the exact characteristics of this bias are still unclear.

Methods

In this study, eye-tracking technology was used to compare the attentional patterns of high perfectionists (HP) and low perfectionists (LP). The HP and LP groups (n = 39 vs 34) completed a visual attention task in which they observed perfect vs imperfect picture pairs, during which their eye movements (EMs) were recorded automatically using an EM tracking system.

Results

Both the HP and LP groups showed an overall attentional bias toward imperfect pictures, as indicated by the criteria of initial visual attention orientation and attentional maintenance. There were no significant differences between the HP and LP groups during the early and middle phases of attention: both groups exhibited a longer total fixation duration on imperfect pictures than on perfect pictures. However, during the late phase of attention, the participants in the HP group diverted their attention away from the imperfect pictures and began to pay more attention to the perfect pictures. By contrast, the participants in the LP group consistently exhibited longer fixation times for imperfect pictures than the HP group during the entire duration of the stimulus.

Conclusion

These findings indicate that the participants in the HP group tended to avoid imperfect stimuli during the late phase of attention; this may indicate that avoidance plays an important role in maintaining perfectionism. This study also shows that eye-tracking is a useful methodology for measuring the attentional biases of perfectionists.

Cognitive Biases Toward Pain: Implications for a Neurocognitive Processing Perspective in Chronic Pain and its Interaction With Depression

OBJECTIVES

Information-processing biases such as attentional, interpretation, and memory biases are supposed to play a role in the exacerbation and maintenance of chronic pain. Current research in the area of cognitive biases shows that all these biases seem to have an influence on attention to, interpretation of, and recall of pain and can lead to maladaptive strategies and the exacerbation of pain.

METHODS

We conducted a narrative literature review, considering evidence extracted from various databases including PubMed, MEDLINE, Science Direct, and ProQuest. Search terms included cognitive biases, neurocognitive processing, chronic pain, and depression.

RESULTS

The literature on attentional, interpretative, and memory biases in experimental and chronic pain, as well as their neuronal underpinnings, suggests that the depression of chronic pain patients may differ from the depression of patients without pain. Depressed pain patients show a recall bias for illness-related and health-related stimuli, whereas depressed patients without pain show a bias for depression-related stimuli. In addition, research has shown that catastrophizing, helplessness/hopelessness, and thought suppression as psychological responses to pain are mediators of the relationship between chronic pain and depression.

CONCLUSIONS

Current research supports the importance of individual diagnosis of chronic pain patients and their response patterns of pain, psychological processing, and information processing. This leads to the conclusion that depressed pain patients need other clinical interventions when compared with depressed patients without pain. Previous research showed that a combination of a cognitive-behavioral therapy with mindfulness meditation seems to be a promising approach.

The Impact of Cognitive Anxiety and the Rating of Pain on Care Processes in a Vigilance Task: The Important Part Played by Age

Chronic pain is a serious public health problem that has grown exponentially in recent years, which is why it has received the attention of numerous researchers. Most of the studies in the field of chronic pain have focused on care as a mediating variable on the perception of painful stimuli and emotions. Nevertheless, there are very few studies that have gone in the opposite direction. This study's aim is therefore to analyse the impact of emotional variables (anxiety and depression), the rating of pain, and age on vigilance processes in a sample of patients with chronic pain. To do so, the attentional performance of a cohort of 52 patients with chronic pain was measured through the use of a modified dot-probe task. Furthermore, all the participants were evaluated using the following self-report measures: Beck's Depression Inventory-II (BDI-II), the McGill Pain Questionnaire, and the Pain Anxiety Symptoms Scale-20 (PASS-20). Stepwise multiple linear regression analysis revealed a significant negative correlation between the pain rating index and the number of mistakes the participants made during the attention test. There was also a positive and significant correlation with age and another negative and significant correlation with cognitive anxiety regarding the overall performance times during the undertaking of the experimental task. These results point to the importance of a more in-depth understanding of the impact that the emotional variables and other variables such as age have on attentional processes and the rating of pain. Finally, the discussion focuses on the implications these results could have for clinical practice or for future research studies in this field.

Perspective-taking influences attentional deployment towards facial expressions of pain: an eye-tracking study

Empathetic perspective-taking (PT) may be critical in modulating attention and associated responses to another's pain. However, the differential effects of imagining oneself to be in the pain sufferer's situation ("Self-perspective") or imagining the negative impacts on the pain sufferer's experience ("Other-perspective") on attention have not been studied. The effects of observer PT (Self vs Other) and level of facial pain expressiveness (FPE) upon attention to another person's pain was investigated. Fifty-two adults were assigned to 1 of 3 PT conditions; they were instructed to view pairs of pain expressions and neutral faces and either (1) consider their own feelings (Self-perspective), (2) consider the feelings of the person in the picture (Other-perspective), or (3) received no further instructions (Control). Eye movements provided indices of early (probability and duration of first fixation) and later (total gaze duration) attentional deployment. Pain faces were more likely to be fixated upon first. A significant first fixation duration bias towards pain was observed, which increased with increasing levels of FPE, and was higher in the Self-PT than the Control condition. The proportion of total gaze duration on pain faces was higher in both experimental conditions than the Control condition. This effect was moderated by FPE in the Self-PT condition; there was a significant increase from low to high FPE. When observers attend to another's facial display of pain, top-down influences (such as PT) and bottom-up influences (such as sufferer's FPE) interact to control deployment and maintenance of attention.

Aberrant Thalamic-Centered Functional Connectivity in Patients with Persistent Somatoform Pain Disorder

PURPOSE

Recent task-based fMRI studies have shown that Persistent Somatoform Pain Disorder (PSPD) patients demonstrated aberrant activity in a wide range of brain regions associated with sensation, cognition and emotion. However, these specific task-based studies could not clearly uncover the alterations in the spontaneous brain networks that were associated with the general pain-related symptoms in PSPD.

PATIENTS AND METHODS

In the present study, 13 PSPD patients and 23 matched healthy controls (HCs) were enrolled. Resting state and 3D structural imaging data were collected during magnetic resonance imaging (MRI) scans. Ninety regions of interest (ROIs) were selected from the automated anatomical labeling (AAL) template. The functional connectivity toolbox "CONN" was used to calculate the functional connectivity (FC) coefficients.

RESULTS

Our results showed that PSPD patients exhibited increased FCs between the left thalamus and the right amygdala, the right hippocampus, and multiple sub-regions of the occipital lobe when compared to HCs. Correlation analysis revealed a negative correlation between the left thalamus-right amygdala FC and the level of anxiety in PSPD patients.

CONCLUSION

These findings suggest that the altered FC between thalamus and amygdala may be the neural mechanisms underlying the pain-related anxiety in PSPD.

Chronic Pain Patients’ Gaze Patterns toward Pain-Related Information: Comparison between Pictorial and Linguistic Stimuli

Background and Objectives: The attentional bias and information processing model explained that individuals who interpret pain stimuli as threatening may increase their attention toward pain-related information. Previous eye tracking studies found pain attentional bias among individuals with chronic pain; however, those studies investigated this phenomenon by using only one stimulus modality. Therefore, the present study investigated attentional engagement to pain-related information and the role of pain catastrophizing on pain attentional engagement to pain-related stimuli among chronic pain patients by utilizing both linguistic and visual stimulus. Materials and Methods: Forty chronic pain patients were recruited from the rehabilitation center, the back pain clinic, and the rheumatology department of Chung-Ang University Hospital in Seoul, Korea. Patients observed pictures of faces and words displaying pain, presented simultaneously with neutral expressions, while their eye movements were measured using the eye tracking system. A t-test and ANOVA were conducted to compare stimulus pairs for the total gaze duration. Results: Results revealed that chronic pain patients demonstrated attentional preference toward pain words but not for pain faces. An ANOVA with bias scores was conducted to investigate the role of pain catastrophizing on attentional patterns. Results indicated that chronic pain patients with high pain catastrophizing scores gazed significantly longer at pain- and anger-related words than neutral words compared to those with low pain catastrophizing scores. The same patterns were not observed for the facial expression stimulus pairs. Conclusions: The results of the present study revealed attentional preference toward pain-related words and the significant role of pain catastrophizing on pain attentional engagement to pain-related words. However, different patterns were observed between linguistic and visual stimuli. Clinical implications related to use in pain treatment and future research suggestions are discussed.

Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study

Introduction

This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional bias in chronic pain patients.

Methods

A total of 28 patients with chronic pain and 29 pain-free individuals observed pictures of pain, happy and neutral facial expressions while their gaze behaviour was recorded. Pain intensity and duration, anxiety, depression, stress, attentional control and pain catastrophizing were assessed by questionnaires.

Results

In all subjects, the pattern of attention for pain faces was characterized by initial vigilance, followed by avoidance. No significant difference was found between the two groups in terms of orientation towards the stimuli, the duration of first fixation, the average duration of fixation or number of fixations on the pain stimuli. Attentional control moderated the relationship between catastrophizing and overall dwell time for happy faces in pain patients, indicating that those with high attentional control and high catastrophizing focused more on happy faces, whereas the reverse was true for those with low attentional control.

Conclusion

This study supported the vigilance-avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients.

A systematic review of structural and functional MRI studies on pain catastrophizing

Objectives: Pain catastrophizing is reliably associated with pain reports during experimental pain in healthy, pain-free subjects and in people with chronic pain. It also correlates with self-reports of clinical pain intensity/severity in a variety of disorders characterized by chronic pain in adults, adolescents and children. However, processes, through which it exerts its effects are yet unclear. In this paper, our primary aim was to synthesize neuroimaging research to open a window to possible mechanisms underlying pain catastrophizing in both chronic pain patients and healthy controls. We also aimed to compare whether the neural correlates of pain catastrophizing are similar in these two groups.

Methods: PubMed and the Web of Science were searched for magnetic resonance imaging (MRI) studies that explored neural correlates of pain catastrophizing.

Results: Twenty articles met the inclusion criteria. The results of our review show a connection between pain catastrophizing and brain areas tightly connected to pain perception (including the somatosensory cortices, anterior insula, anterior cingulate cortex and thalamus) and/or modulation (eg, the dorsolateral prefrontal cortex). Our results also highlight that these processes - in relation to pain catastrophizing - are more pronounced in chronic pain patients, suggesting that structural and functional brain alterations (and perhaps mechanisms) related to pain catastrophizing may depend on prior and/or relatively stable/constant pain experience. However, we also found methodological issues and differences that could lead to divergent results.

Discussion: Based on our results, pain catastrophizing might be related to salience detection, pain processing, and top-down attentional processes. More research is recommended to explore neural changes to specific types of catastrophizing thoughts (eg, experimentally induced and/or state). Furthermore, we provide ideas regarding pain catastrophizing studies in the future for a more standardized approach.

Eye-movement behaviours when viewing real-world pain-related images

BACKGROUND

Pain-related cues are evolutionarily primed to capture attention, although evidence of attentional biases towards pain-related information is mixed in healthy individuals. The present study explores whether healthy individuals show significantly different eye-movement behaviours when viewing real-world pain-related scenes compared to neutral scenes. The effect of manipulating via written information the threat value of the pain-related scenes on eye-movement behaviours was also assessed.

METHODS

Participants were randomized to threatening (n = 28) and non-threatening (n = 27) information conditions. All completed a free-viewing task with real-world pain-related and neutral images while their eye movements were recorded.

RESULTS

Participants made significantly fewer fixations of significantly longer duration when viewing pain-related images compared to neutral images. No significant differences were found between threatening and non-threatening information groups in their pattern of eye movements.

CONCLUSIONS

This study shows that healthy individuals demonstrate attentional biases to pain-related real-world complex images compared to neutral images. Future research is needed to establish the implications of these biases, particularly in the context of acute pain, on the onset and/or subsequent maintenance of chronic pain conditions.

SIGNIFICANCE

Healthy individuals show different eye-movement behaviours when viewing pain-related scenes than neutral scenes, supporting evolutionary accounts of pain. Implications for the onset and/or maintenance of chronic pain need to be explored.

Attentional Engagement for Pain-Related Information among Individuals with Chronic Pain: The Role of Pain Catastrophizing

Although the evidence of the attentional bias of chronic pain individuals toward pain-related information is established in the literature, few studies examined the time course of attention toward pain stimuli and the role of pain catastrophizing on attentional engagement toward pain-related information. This study examined the time course of attention to pain-related information and the role of pain catastrophizing on attentional engagement for pain-related information. Participants were fifty young adult participants with chronic pain (35% male, 65% female; M = 21.8 years) who completed self-report questionnaires assessing pain catastrophizing levels (Pain Catastrophizing Scale (PCS)), depression (the Center for Epidemiologic Studies Depression Scale (CES-D)), anxiety (State-Trait Anxiety Inventory (STAI)), and pain disability (the Pain Disability Index: (PDI)). Attentional engagements to pain- and anger-related information were measured by the eye tracker. Significant interaction effects were found between (1) time and stimulus type for pain-related information (F (5, 245) = 11.55, p < 0.001) and (2) bias scores and pain catastrophizing (F (1, 48) = 6.736, p < 0.05). These results indicated that the degree of increase for pain bias scores were significantly greater than anger bias scores as levels of pain catastrophizing increased. Results of the present study provided the evidence for the attentional bias and information processing model which has clinical implications; high levels of pain catastrophizing may impair individuals' ability to cope with chronic pain by increasing attentional engagement toward pain-related information. The present study can add knowledge to attentional bias and pain research as this study investigated the time course of attention and the role of pain catastrophizing on attentional engagement toward pain-related information for adults with chronic pain conditions.

Seeing through rose-colored glasses: How optimistic expectancies guide visual attention

Optimism bias and positive attention bias have important highly similar implications for mental health but have only been examined in isolation. Investigating the causal relationships between these biases can improve the understanding of their underlying cognitive mechanisms, leading to new directions in neurocognitive research and revealing important information about normal functioning as well as the development, maintenance, and treatment of psychological diseases. In the current project, we hypothesized that optimistic expectancies can exert causal influences on attention deployment. To test this causal relation, we conducted two experiments in which we manipulated optimistic and pessimistic expectancies regarding future rewards and punishments. In a subsequent visual search task, we examined participants’ attention to positive (i.e., rewarding) and negative (i.e., punishing) target stimuli, measuring their eye gaze behavior and reaction times. In both experiments, participants’ attention was guided toward reward compared with punishment when optimistic expectancies were induced. Additionally, in Experiment 2, participants’ attention was guided toward punishment compared with reward when pessimistic expectancies were induced. However, the effect of optimistic (rather than pessimistic) expectancies on attention deployment was stronger. A key characteristic of optimism bias is that people selectively update expectancies in an optimistic direction, not in a pessimistic direction, when receiving feedback. As revealed in our studies, selective attention to rewarding versus punishing evidence when people are optimistic might explain this updating asymmetry. Thus, the current data can help clarify why optimistic expectancies are difficult to overcome. Our findings elucidate the cognitive mechanisms underlying optimism and attention bias, which can yield a better understanding of their benefits for mental health.

Stressing the feedback: attention and cardiac vagal tone during a cognitive stress task

OBJECTIVES

The present study examined relationships among gaze behaviour and cardiac vagal tone using a novel stress-inducing task.

METHODS

Participants' (N = 40) eye movements and heart rate variability (HRV) were measured during an unsolvable computer-based task randomly presenting feedback of "Right" and "Wrong" answers distinctly onscreen after each trial. Subgroups were created on the basis of more frequent eye movements to the right ("Correct"-Attenders; n = 23) or wrong ("Incorrect"-Attenders; n = 17) areas onscreen.

RESULTS

Correct-Attenders maintained HRV from baseline to the stress task. In contrast, Incorrect-Attenders spent significantly more time viewing "Wrong" feedback, exhibited a reduction in HRV during the stress condition (p < .01), and were more likely to negatively self-evaluate performance.

CONCLUSIONS

Results demonstrate that pervasive attention to negative feedback ("Wrong") elicits perseverative stress and negative self-evaluations among university students. This study highlights the potential for studying attentional biases and emotional distress through combined measures of gaze behaviour and cardiac vagal tone.

Students Wearing Police Uniforms Exhibit Biased Attention toward Individuals Wearing Hoodies

Police provide an essential public service and they often operate in difficult circumstances, requiring high-speed cognition. Recent incidents involving apparent profiling and aggressive behavior have led to accusations that the police are sometimes biased. Given that previous research has shown a link between clothing and cognition, we investigated the question of whether the police uniform itself might induce a bias in social attention. To address this question, and using a Canadian university student sample, we assessed whether wearing a police uniform biases attention toward black faces compared to white faces, and low-status individuals compared to high-status individuals. In Experiment 1 (n = 28), participants wore either a police-style uniform or mechanic overalls, and performed a shape categorization task in the presence of a distractor that could be either: a black face, a white face, a person wearing a hoodie (whom we propose will be associated with low SES), or a person wearing a suit (whom we propose will be associated with high SES). Participants wearing the police-style uniform exhibited biased attention, indexed by slower reaction times (RTs), in the presence of low-SES images. In Experiment 2 (n = 28), we confirmed this bias using a modified Dot-Probe task – an alternate measure of attentional bias in which we observed faster RTs to a dot probe that was spatially aligned with a low SES image. Experiment 3 (n = 56) demonstrated that attentional bias toward low-SES targets appears only when participants wear the police-style uniform, and not when they are simply exposed to it – by having it placed on the desk in front of them. Our results demonstrate that wearing a police-style uniform biases attention toward low-SES targets. Thus, wearing a police-style uniform may induce a kind of “status-profiling” in which individuals from low-status groups become salient and capture attention. We note that our results are limited to university students and that it will be important to extend them to members of the community and law-enforcement officers. We discuss how uniforms might exert their effects on cognition by virtue of the power and cultural associations they evoke in the wearer.

Keeping an eye on pain: investigating visual attention biases in individuals with chronic pain using eye-tracking methodology

Attentional biases to painful stimuli are evident in individuals with chronic pain, although the directional tendency of these biases (ie, toward or away from threat-related stimuli) remains unclear. This study used eye-tracking technology, a measure of visual attention, to evaluate the attentional patterns of individuals with and without chronic pain during exposure to injury-related and neutral pictures. Individuals with (N=51) and without chronic pain (N=62) completed a dot-probe task using injury-related and neutral pictures while their eye movements were recorded. Mixed-design analysis of variance evaluated the interaction between group (chronic pain, pain-free) and picture type (injury-related, neutral). Reaction time results showed that regardless of chronic pain status, participants responded faster to trials with neutral stimuli in comparison to trials that included injury-related pictures. Eye-tracking measures showed within-group differences whereby injury-related pictures received more frequent fixations and visits, as well as longer average visit durations. Between-group differences showed that individuals with chronic pain had fewer fixations and shorter average visit durations for all stimuli. An examination of how biases change over the time-course of stimulus presentation showed that during the late phase of attention, individuals with chronic pain had longer average gaze durations on injury pictures relative to pain-free individuals. The results show the advantage of incorporating eye-tracking methodology when examining attentional biases, and suggest future avenues of research.