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Attention to pain and signals of impending pain: a cognitive-affective approach

(2004)
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(UGent)
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Abstract
In this dissertation, attention to pain and signals of impending pain was investigated from a cognitive-affective approach. The first chapter offers a theoretical approach of the concept “hypervigilance for pain”. It is argued that hypervigilance emerges as the working of normal attentional mechanisms in abnormal situations such as chronic pain, in which the threat value of pain is very high. In the second chapter, a psychometric investigation of the Pain Catastrophizing Scale (Sullivan et al., 1995), an instrument measuring the threat value of pain, showed strong internal validity in pain patients and healthy individuals. Next, an experimental investigation of attentional biases to pain and pain signals is presented. Three components of attention were examined: (1) initial shifting, (2) engagement (focussing), and (3) disengagement (directing away). In a first research line, the attentional demand of pain information at the cost of information in other sensory modalities was investigated, using a crossmodal cueing paradigm (chapters 3 to 5). In all studies, attentional biases to pain or cues predicting pain were demonstrated in all components: rapid shifting to, strong engagement to, and retarded disengagement from pain information compared with other sensory information. However, it was demonstrated that only the bias in disengagement was specific for pain, whereas other biases were general for the somatosensory modality. Particularly participants high in catastrophic thinking about pain had difficulty disengaging attention from pain information. In a second research line, the modulation of spatial attention by signals of impending pain was investigated, using a spatial cueing paradigm (chapters 6 to 8). Again, evidence was found for biases in all components of spatial attention: attention was shifted rapidly to, engaged strongly to, and disengaged slowly from signals of impending pain compared with non-threatening signals. However, again it was demonstrated that only the bias in disengagement was specific for pain and affected by catastrophic thinking about pain. In conclusion, strong evidence was found for evolutionary adaptive attentional biases to pain. Difficulty disengaging attention from pain information consistently emerged as the only pain-specific and threat-related component. Finally, theoretical and clinical implications of these findings are extensively discussed.

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MLA
Van Damme, Stefaan. Attention to Pain and Signals of Impending Pain: A Cognitive-Affective Approach. Ghent, Faculty of Psychology and Educational Sciences, 2004.
APA
Van Damme, S. (2004). Attention to pain and signals of impending pain: a cognitive-affective approach. Ghent, Faculty of Psychology and Educational Sciences, Ghent, Belgium.
Chicago author-date
Van Damme, Stefaan. 2004. “Attention to Pain and Signals of Impending Pain: A Cognitive-Affective Approach.” Ghent, Belgium: Ghent, Faculty of Psychology and Educational Sciences.
Chicago author-date (all authors)
Van Damme, Stefaan. 2004. “Attention to Pain and Signals of Impending Pain: A Cognitive-Affective Approach.” Ghent, Belgium: Ghent, Faculty of Psychology and Educational Sciences.
Vancouver
1.
Van Damme S. Attention to pain and signals of impending pain: a cognitive-affective approach. [Ghent, Belgium]: Ghent, Faculty of Psychology and Educational Sciences; 2004.
IEEE
[1]
S. Van Damme, “Attention to pain and signals of impending pain: a cognitive-affective approach,” Ghent, Faculty of Psychology and Educational Sciences, Ghent, Belgium, 2004.
@phdthesis{2062140,
  abstract     = {{In this dissertation, attention to pain and signals of impending pain was investigated from a cognitive-affective approach. The first chapter offers a theoretical approach of the concept “hypervigilance for pain”. It is argued that hypervigilance emerges as the working of normal attentional mechanisms in abnormal situations such as chronic pain, in which the threat value of pain is very high. In the second chapter, a psychometric investigation of the Pain Catastrophizing Scale (Sullivan et al., 1995), an instrument measuring the threat value of pain, showed strong internal validity in pain patients and healthy individuals. Next, an experimental investigation of attentional biases to pain and pain signals is presented. Three components of attention were examined: (1) initial shifting, (2) engagement (focussing), and (3) disengagement (directing away). In a first research line, the attentional demand of pain information at the cost of information in other sensory modalities was investigated, using a crossmodal cueing paradigm (chapters 3 to 5). In all studies, attentional biases to pain or cues predicting pain were demonstrated in all components: rapid shifting to, strong engagement to, and retarded disengagement from pain information compared with other sensory information. However, it was demonstrated that only the bias in disengagement was specific for pain, whereas other biases were general for the somatosensory modality. Particularly participants high in catastrophic thinking about pain had difficulty disengaging attention from pain information. In a second research line, the modulation of spatial attention by signals of impending pain was investigated, using a spatial cueing paradigm (chapters 6 to 8). Again, evidence was found for biases in all components of spatial attention: attention was shifted rapidly to, engaged strongly to, and disengaged slowly from signals of impending pain compared with non-threatening signals. However, again it was demonstrated that only the bias in disengagement was specific for pain and affected by catastrophic thinking about pain. In conclusion, strong evidence was found for evolutionary adaptive attentional biases to pain. Difficulty disengaging attention from pain information consistently emerged as the only pain-specific and threat-related component. Finally, theoretical and clinical implications of these findings are extensively discussed.}},
  author       = {{Van Damme, Stefaan}},
  language     = {{eng}},
  publisher    = {{Ghent, Faculty of Psychology and Educational Sciences}},
  school       = {{Ghent University}},
  title        = {{Attention to pain and signals of impending pain: a cognitive-affective approach}},
  year         = {{2004}},
}