Attentional Bias Toward Pain-Related Pictorial Stimuli Among Individuals With Migraine Following Negative Mood Induction

Migraine is associated with significant reductions in daily functioning and quality of life and is the 19th largest cause of disability globally. The fear-avoidance model of chronic pain details potential pathways for the development of pain disability and affective distress and provides a platform for understanding the dynamic relationship between psychological factors and migraine. Consistent with the fear-avoidance model, a growing body of research provides support for the role of selective attentional biases toward threat-related stimuli among chronic pain patients. However, the few studies to examine the role of selective attentional biases in migraine demonstrate mixed findings, and the exact nature of this relationship remains unclear. The current study examined effects of components of the fear-avoidance model (i.e., fear of pain, negative affectivity, and anxiety sensitivity) on attentional biases to pain-related pictorial stimuli among individuals with migraine. A mood-induction procedure was used to experimentally manipulate negative affectivity. Contrary to hypotheses, neither fear of pain (b = -0.55, p = .38), nor negative affect (b = -0.17, p = .65), nor anxiety sensitivity (b = -0.20, p = .70) significantly predicted attentional processing of headache-related threat stimuli. Although the negative affect mood manipulation was successful, those who completed the negative mood induction and experienced heightened negative affect did not differ from controls (i.e., neutral mood condition) in attentional biases to threat stimuli (f (1, 64) = 0.06, p = .81). Anxiety emerged as the only significant predictor of attentional bias to threat stimuli (b = 1.28, p = .04). Findings contribute to a growing body of research examining attentional bias in headache and suggest that individuals who experience migraine with moderate frequency do not selectively attend to headache-related facial expressions, even when in a negative mood state