Attention to pain: Does it help to think about Hawaii? - How pain control strategies shape attentional biases towards pain
Final Report Abstract
The project was concerned with attention towards pain. The main question was, whether this pain-related attention can be influenced by cognitive pain control strategies. In other words: Can our thoughts influence our attention towards pain? Healthy participants used two cognitive pain control strategies during a cold pain induction: thought suppression (“do not think about pain!”) and focused distraction (“think about your home!”). Thought suppression can be beneficial short-term, in the form of an immediate enhancement effect, in which the unwanted thoughts are actually suppressed. However, there is also a rebound effect, which shows increased frequency of the unwanted thoughts in the long term. Focused distraction does not show any of these effects. The project is the first to examine the influence of these cognitive strategies on attention towards pain. Participants were randomly sorted in the thought suppression and focused distraction condition. First, they filled out questionnaires, and their baseline attention towards pain was tested with a dot-probe task and an attentional blink task. Then, they spent 2 minutes with their hand in a cold pressor at 12°C, and a subsequent 2 minutes resting. During these 4 minutes total, they used either thought suppression or focused distraction to deal with the pain. After that, they answered some more questions, and their attention towards pain was again tested with the dot-probe task and the attentional blink task. The results showed both an immediate enhancement effect as well as a rebound effect. The immediate enhancement was suggested in a significantly lower maximum pain intensity in the thought suppression group, as compared to the focused distraction group. Likewise, the thought suppression group also reported the perceived threat of the pain as lower than the focused distraction group, although this difference was slightly above the significance level. The rebound effect was indicated in the dot-probe data. Between the pre- and post-test, participants in the thought suppression condition showed a significant change towards attention towards pain, while the participants in the focused distraction group did not. The attentional blink data did not differ between the two conditions. Both groups equally showed heightened attention towards pain after the pain induction. Thus, the project has shown that cognitive pain control strategies can influence attention towards pain. It has also demonstrated that thought suppression can be a detrimental strategy. The results can be used to further investigate the harmful nature of thought suppression in particular, and endurance in general, in pain development and exacerbation. There were very few problems and surprises in the process of the study. Delays occurred around developing and implementing further improvements of the study procedure, which were very worthwhile in the end, and helped the study greatly. The hypotheses were mainly confirmed, so the only surprise was that anxiety, contrary to the expectation, did not have a significant influence on the outcomes.
