Dot-probe evaluation of selective attentional processing of pain cues in patients with chronic headaches

Abstract 

Evidence supporting the notion that patients with chronic pain are characterized by attentional biases for sensory and affect pain words, and that such biases are mediated by fear of pain, is mixed. The present investigation was an attempt to replicate and extend initial findings obtained with the dot-probe task. Thirty patients with chronic headache and 19 healthy controls were tested using a dot-probe task including affect pain, sensory pain, and neutral words. Individual difference variables, including fear of pain measures, were assessed and considered in analyses. Selective attention was denoted using the bias index, congruency index, and incongruency index. There were no significant between-group differences or interactions between group and word type observed for any of the indices of selective attention. Across groups there was evidence for a significant association between anxiety sensitivity and the bias index for sensory pain words, and between affective description of current pain and the incongruency index for affect pain words. These results do not provide convincing evidence that patients with chronic headache selectively attend to affect or sensory pain cues when compared to healthy controls. The significant cross-groups associations between anxiety sensitivity and current pain description and indices of selective attention are consistent with the notion that attentional biases may be influenced by fear propensity and current concerns. Implications of the findings and future research directions are discussed.

Keywords: Chronic pain, Headache, Selective attention, Dot-probe task, Fear of pain, Anxiety sensitivity