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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

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      Is Open Access

      Attentional Bias Toward Cupping Therapy Marks: An Eye-Tracking Study

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          Abstract

          Objective

          Despite the many medical benefits, cupping therapy can be difficult for some patients due to unpleasant marks on the skin. As patients are afraid of the potential painful sensation from cupping therapy, the skin reactions might produce vigilance for treatment as pain-related information. We investigated whether individuals show negative emotions and attentional bias toward pain-related residual marks from cupping therapy on the body using an eye-tracking method.

          Methods

          Fifty pain-free volunteers were presented with four different kinds of visual stimulation, such as the back or face region and with or without cupping marks on the skin. A cupping and a control image were presented on one screen with one image on the left side of the screen and the other on the right (locations of the images were counterbalanced across participants). The eye movements of the participants were measured while they viewed the pictures. They completed the Empathy Quotient questionnaire before the experiment and evaluated the unpleasantness level to each image during the task.

          Results

          Images of the back and face with cupping marks were rated significantly more unpleasant and showed a significant attentional bias (significantly longer percentage fixation time) than the control images (attentional bias score: Back + cupping: 48.1 ± 2.8%; Back: −0.7 ± 3.4%; Face + cupping: 34.5 ± 2.5%; Face: −2.2 ± 2.9%). Individuals with greater empathy exhibited significantly higher unpleasantness ( r = 0.323, p < 0.05) and less attentional bias ( r = −0.279, p < 0.05) to the images with cupping marks.

          Conclusion

          The skin reactions caused by cupping therapy evoked negative emotional responses as well as attentional bias to the reaction sites. Our findings suggest that the emotional and attentional responses to cupping therapy might reflect potential reluctance to this therapy.

          Most cited references28

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          Empathy for pain involves the affective but not sensory components of pain.

          Our ability to have an experience of another's pain is characteristic of empathy. Using functional imaging, we assessed brain activity while volunteers experienced a painful stimulus and compared it to that elicited when they observed a signal indicating that their loved one--present in the same room--was receiving a similar pain stimulus. Bilateral anterior insula (AI), rostral anterior cingulate cortex (ACC), brainstem, and cerebellum were activated when subjects received pain and also by a signal that a loved one experienced pain. AI and ACC activation correlated with individual empathy scores. Activity in the posterior insula/secondary somatosensory cortex, the sensorimotor cortex (SI/MI), and the caudal ACC was specific to receiving pain. Thus, a neural response in AI and rostral ACC, activated in common for "self" and "other" conditions, suggests that the neural substrate for empathic experience does not involve the entire "pain matrix." We conclude that only that part of the pain network associated with its affective qualities, but not its sensory qualities, mediates empathy.
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            Attentional bias to pain-related information: a meta-analysis.

            This meta-analysis investigated whether attentional bias, that is, the preferential allocation of attention to information that is related to pain, is a ubiquitous phenomenon. We also investigated whether attentional bias effects are related to the methodological quality of the study, to procedural differences in their measurement, or to individual differences in pain severity, pain-related fear, anxiety, and depression. Results indicated that individuals who experience chronic pain (n=1023) display an attentional bias towards pain-related words or pictures, but this bias was of a small effect size (d=0.134), and did not differ from that in control groups (d=0.082; n=1398). No evidence was found for an attentional bias towards pain-related words and pictures for acute pain (d=0.049), procedural pain (d=0.142), and experimental pain (d=0.069). However, research in which attentional bias towards signals of impending experimental pain in healthy volunteers was investigated, revealed an attentional bias of medium effect size (d=0.676). Moderator analyses in the chronic pain group identified important procedural variables that affected the presence and magnitude of an attentional bias towards pain-related words and pictures, that is, type and exposure time of pain-related information. None of the individual difference variables affected the magnitude of the attentional bias. Implications of current findings and future directions are discussed.
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              BRIEF REPORT Time course of attentional bias for threat scenes: Testing the vigilance‐avoidance hypothesis

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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                JPR
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                18 May 2020
                2020
                : 13
                : 1041-1047
                Affiliations
                [1 ]Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
                Author notes
                Correspondence: Younbyoung Chae Email ybchae@khu.ac.kr
                [*]

                These authors contributed equally to this work

                Article
                252675
                10.2147/JPR.S252675
                7244446
                32547169
                d1db5c29-ea7d-4bf8-b1cb-908b5369a819
                © 2020 Hong et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 05 March 2020
                : 05 May 2020
                Page count
                Figures: 3, References: 34, Pages: 7
                Categories
                Original Research

                Anesthesiology & Pain management
                attentional bias,cupping,emotion,empathy,eye-tracking
                Anesthesiology & Pain management
                attentional bias, cupping, emotion, empathy, eye-tracking

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