Comparison of acceptance and distraction strategies in coping with experimentally induced pain.

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Comparison of acceptance and distraction strategies in coping with experimentally induced pain.

Author(s): Hazel Moore ¹ , Ian Stewart ¹ , Dermot Barnes-Holmes ² , Yvonne Barnes-Holmes ² , Brian E McGuire ³

Publication date (Electronic): 2015

Journal: Journal of pain research

Publisher: Informa UK Limited

Keywords: acceptance, coping, pain, values

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Abstract

This study compared an acceptance-based strategy with a control-based strategy (distraction) in terms of the ability of participants to tolerate a painful stimulus, across two experiments. In addition, participants were either actively encouraged, or not, to link pain tolerance with pursuit of valued goals to examine the impact of pursuing a personally meaningful goal or value on the extent to which pain will be tolerated.

Most cited references 29

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Keeping pain in mind: a motivational account of attention to pain.

Geert Crombez, Julia Vogt, Valéry Legrain … (2010)

Attention is a key concept in many theories of pain perception. A clinically popular idea is that pain is more intense in persons who are hypervigilant for or bias their attention to pain information. So far, evidence for such bias in pain patients as compared to healthy persons is inconclusive. Furthermore, studies investigating the effects of distracting attention away from pain have shown contradictory results. In this review, we present a motivational perspective on attentional processing of pain that accounts for these inconclusive research findings. We argue that pain always has to be considered within a context of goal pursuit. From this perspective, two largely unexplored theoretical assumptions are introduced. First, when pain occurs during the pursuit of a certain goal, it may unintentionally capture attention although it is not relevant for the goal. Whether such unintentional attentional capture happens is not only dependent upon the characteristics of the pain but also on the characteristics of the focal goal. Second, attention to pain and pain-related information might be driven by a focal goal related to pain. Attentional processing of pain information will be particularly enhanced when the focal goal is related to pain management (e.g., attempting to gain control). Future research should systematically investigate the role of motivation and goal pursuit in the attentional processing of pain-related information. This motivational perspective offers a powerful framework to explain inter- and intra-individual differences in the deployment of attention to pain-related information.

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Validation of the chronic pain acceptance questionnaire (CPAQ) in an Internet sample and development and preliminary validation of the CPAQ-8.

Jon R Fish, Michael F. Hogan, T Morrison … (2010)

This study investigated the psychometric properties of the Chronic Pain Acceptance Questionnaire (CPAQ) in a mixed chronic pain, Internet sample and sought to develop a valid and reliable short form. Questionnaires were completed by 428 respondents, comprising a sample accessed via the Internet (n=319) and a sample who completed a paper and pencil version of the measures (n=109). Using confirmatory factor analysis (CFA) the two-factor structure of the CPAQ in the Internet sample was supported, though a good model fit was only achieved following the removal of one item. The resultant 19 item CPAQ demonstrated good reliability and evidence of validity was obtained for this sample. Data from the Internet sample were used to derive an eight-item short form. The two four-item factors (activity engagement [AE] and pain willingness [PW]) were confirmed using CFA and found to be invariant across both samples with good scale reliability. Higher CPAQ-8 and subscale scores were correlated with less depression and anxiety, pain severity and pain interference, and fewer medical visits for pain. Using structural equation modelling both subscales were found to partially mediate the impact of pain severity on pain interference and emotional distress. In this model AE had stronger associations with outcomes while PW accounted for a small portion of the variance in pain interference and anxiety, but not depression. This study confirmed the two-factor structure of the CPAQ in a mixed chronic pain Internet sample and provides preliminary evidence for the psychometric soundness of the CPAQ-8.

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Attentional bias towards pain-related information in chronic pain; a meta-analysis of visual-probe investigations.

Daniel E Schoth, Vanessa Nunes, Christina Liossi (2012)

Research investigating the presence of attentional bias in chronic pain has produced mixed results. The purpose of this review is to summarise former research using the visual-probe task to explore attentional bias in pain populations, and meta-analyse the results of controlled investigations comparing individuals with chronic pain to healthy controls. Ten eligible studies were included in this analysis (chronic pain n=515, control n=314). Overall, individuals with chronic pain were found to show significantly greater bias towards pain-related information compared to controls, with an effect size of .36 (Hedges' adjusted g). The time-course of attentional bias was also explored, with evidence found for significant bias during stages of initial orienting of attention (effect size .29) and maintained attention (effect size .42). Bias therefore appears more pronounced during later stages of attention, possibly arising from processes of rumination. It is important for future research to fully explore the role attentional bias plays in the causation and maintenance of chronic pain, and the potential consequences bias may have upon quality of life.

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Author and article information

Journal

Journal ID (iso-abbrev): J Pain Res

Title: Journal of pain research

Publisher: Informa UK Limited

ISSN: 1178-7090

ISSN (Print): 1178-7090

Publication date (Electronic): 2015

Volume: 8

Affiliations

[1 ] School of Psychology, National University of Ireland, Galway, Ireland.

[2 ] Department of Psychology, National University of Ireland, Maynooth, Ireland.

[3 ] School of Psychology, National University of Ireland, Galway, Ireland ; Centre for Pain Research, National University of Ireland, Galway, Ireland.