Pain-related attentional biases: the importance of the personal relevance and ecological validity of stimuli

The literature regarding pain-related attentional biases is currently marked by considerable inconsistency. The primary aim of the present study was to examine whether 2 stimulus-related factors may be important to the detection of pain-related attentional biases: 1) the personal relevance of stimuli; and 2) their ecological validity. To do this, the present research compared the ability of a word-based dot-probe task (ie, lower ecological validity) and picture-based dot-probe task (ie, higher ecological validity) to detect attentional biases using generally selected (ie, lower personal relevance) and idiosyncratically selected stimuli (ie, higher personal relevance). To do this, the present study used a large sample of chronic pain patients and matched pain-free individuals. Attentional biases were found among both chronic pain patients and pain-free individuals for idiosyncratically selected pictorial stimuli (ie, highest ecological validity and personal relevance) but not for generally selected pictorial stimuli or for pain-related word stimuli, irrespective of whether they were idiosyncratically or generally selected. These biases were found to stem from vigilance for pain-related stimuli. Overall, the findings of the present study suggest that similar pain-related attentional biases can be found among both pain-free individuals and chronic pain patients and that stimulus-related factors may be important to the detection of those biases.

Perspective: To date, research examining pain-related attentional biases has yielded inconsistent results. The present study sought to examine 2 stimulus-related factors often identified for their potential to influence the consistency of findings. The findings of this study highlight the importance of considering stimulus-related factors when designing and interpreting pain-related dot-probe research.