Threat and fear of pain induces attentional bias to pain words : an eye-tracking study

Background: This study aimed to investigate the effects of fear of pain (FOP) and threat on attentional biases, using eye-tracking methods. Method: One hundred and seven undergraduate students were randomized to receive threatening or reassuring information about the cold pressor task; and divided into high and low FOP groups. Participants completed the dot-probe task, while their eye movements were tracked. Results: Results showed that those who received threatening information were less likely to have their first fixation on pain words, particularly affective pain words. Furthermore, under conditions of high threat, the high FOP group who did fixate on affective pain words, fixated more quickly than for sensory pain words, whereas the opposite was the case under low threat. In regression analyses, initial vigilance towards affective pain words was a significant predictor of reporting pain more quickly on the cold pressor. Conclusions: Taken together, these results suggest that initial vigilance of affective pain stimuli predicts actual hypervigilance to an acute experimental pain task. However, under conditions of high threat, participants show evidence of avoidance of affective pain words, even though when they do fixate on these stimuli, the high FOP group does so more quickly. These results confirm that attentional processes, characterized by vigilance avoidance, appear important. Significance: Interventions that change attention towards pain to reduce vigilance and subsequent avoidance may be indicated to improve pain outcomes