A Longitudinal Examination of Attentional Biases in Pediatric Chronic Pain: Nature, Theorized Antecedents, and Consequences
Date
2020-07-03
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Abstract
ObjectiveChronic pain is common in childhood and adolescence, and is associated with significant functional impairment, lower quality of life, and high psychiatric comorbidities. Theoretical models of chronic pain suggest a key role for attentional biases in the development, maintenance, and progression of chronic pain and co-occurring psychiatric symptoms. Despite their prominence in theoretical models, attentional biases for pain remain understudied and poorly understood, particularly in youth. The objective of this dissertation was to assess the nature of attentional bias for pain-related information in a clinical sample of youth with chronic pain and to examine its relationship with theorized antecedents and pain and mental health symptoms. MethodsParticipants consisted of a sample of 102 youth aged 10-18 years with chronic pain (71% female) and 53 youth without chronic pain (the control group; 50% female). Participants completed a questionnaire battery assessing pain characteristics, mental health symptoms, theorized antecedents of pediatric chronic pain, and attentional control. To assess attentional bias for pain, participants completed an eye-tracking task in which they viewed pairs of images of children depicting pain expressions of varying intensity and a neutral facial expression. Participants also completed a behavioural measure of attentional control. Pain outcomes and mental health symptoms in youth with chronic pain were assessed again at 3-month follow-up.ResultsAcross the sample, youth exhibited attentional bias for pain expressions, regardless of chronic pain status. Within-group differences in attending to varying levels of pain expressiveness were found. Attentional bias was not significantly associated with theorized antecedents, pain-related outcomes, or mental health symptoms at baseline or 3-month follow-up in youth with chronic pain. There was no evidence in support of a moderating effect of attentional control. ConclusionsThe results of this dissertation support the existence of an attentional bias for pain facial expressions in both youth with chronic pain and youth without chronic pain. Unexpectedly, attentional bias was not associated with key theorized antecedents or pain-related outcomes. These findings have significant implications for future research examining the theoretical and clinical utility of attentional biases in pediatric chronic pain.
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attentional bias, cognitive, eye-tracking, pediatric, youth, chronic pain, anxiety, depression, posttraumatic stress, pain catastrophizing, anxiety sensitivity, fear of pain, attentional control
Citation
Soltani, S. (2020). A Longitudinal Examination of Attentional Biases in Pediatric Chronic Pain: Nature, Theorized Antecedents, and Consequences (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.