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

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          Abstract

          Background

          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.

          Methods

          Participants in experiment 1 (n=41) and experiment 2 (n=52) were equally assigned to acceptance or distraction protocols. Further, half the participants in each group generated examples from their own lives in which they had pursued a valued objective, while the other half did not. In experiment 2, the values focus was enhanced to examine the impact on pain tolerance.

          Results

          There were no significant differences overall between the acceptance and distraction groups on pain tolerance in either experiment. However, in experiment 2, individuals classified as accepting in terms of general coping style and who were assigned to the acceptance strategy showed significantly better pain tolerance than accepting individuals who were in the distraction condition. Across both experiments, those with strong goal-driven values in both protocols were more tolerant of pain. Participants appeared to have more difficulty adhering to acceptance than to distraction as a strategy.

          Conclusion

          Acceptance may be associated with better tolerance of pain, but may also be more difficult to operationalize than distraction in experimental studies. Matching coping style and coping strategy may be most effective, and enhancement of goal-driven values may assist in pain coping.

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          Most cited references 29

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

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

            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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              • Article: not found

              Delayed costs of suppressed pain.

              The study demonstrates that the rebound effect of thought suppression (Wegner, 1989) has an analog in the experience of somatic discomfort. During a cold-pressor pain induction, 63 Ss were instructed either to concentrate on their room at home (distraction), to pay close attention to their hand sensations (monitoring), or to remove awareness of those sensations from mind (suppression). Two min of postpressor pain ratings showed that monitoring produced the most rapid recovery from the pain and that suppression produced the slowest. Suppression also contaminated the interpretation of a subsequent somatic stimulation; later in the experimental hour, Ss who had suppressed their cold-pressor discomfort rated an innocuous vibration as more unpleasant than did other Ss. The strategies are discussed for their necessarily distinct processes of goal evaluation and their possibly differential drain on perceived coping capacities.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2015
                17 March 2015
                : 8
                : 139-151
                Affiliations
                [1 ]School of Psychology, National University of Ireland, Galway, Ireland
                [2 ]Department of Psychology, National University of Ireland, Maynooth, Ireland
                [3 ]Centre for Pain Research, National University of Ireland, Galway, Ireland
                Author notes
                Correspondence: Brian E McGuire, Clinical Psychology Programme, School of Psychology and Centre for Pain Research, National University of Ireland, Galway, Ireland, Tel +353 9149 3266, Fax +353 9153 4930, Email brian.mcguire@ 123456nuigalway.ie
                Article
                jpr-8-139
                10.2147/JPR.S58559
                4370922
                25834464
                © 2015 Moore et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

                Anesthesiology & Pain management

                coping, pain, acceptance, values

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