scholarly journals Executive and Attentional Functions in Chronic Pain: Does Performance Decrease with Increasing Task Load?

2012 ◽  
Vol 17 (3) ◽  
pp. 159-165 ◽  
Author(s):  
Joukje M Oosterman ◽  
Laura C Derksen ◽  
Albert JM van Wijck ◽  
Roy PC Kessels ◽  
Dieuwke S Veldhuijzen
Keyword(s):  
Chronic Pain ◽  
Executive Function ◽  
Sustained Attention ◽  
Attentional Control ◽  
Pain Catastrophizing ◽  
Psychomotor Speed ◽  
Psychomotor Slowing ◽  
Mental Flexibility ◽  
Attention Performance ◽  
Pain Patients

BACKGROUND: Diminished executive function and attentional control has been reported in chronic pain patients. However, the precise pattern of impairment in these aspects of cognition in chronic pain remains unclear. Moreover, a decline in psychomotor speed could potentially influence executive and attentional control performance in pain patients.OBJECTIVE: To examine different aspects of executive and attentional control in chronic pain together with the confounding role of psychomotor slowing.METHODS: Neuropsychological tests of sustained attention, planning ability, inhibition and mental flexibility were administered to 34 participants with chronic pain and 32 control participants.RESULTS: Compared with the controls, participants with chronic pain took longer to complete tests of sustained attention and mental flexibility, but did not perform worse on inhibition or planning tasks. The decreased performance on the mental flexibility task likely reflects a reduction in psychomotor speed. The pattern of performance on the sustained attention task reveals a specific decline in attention, indicated by a disproportionate decline in performance with an increase in task duration and by increased fluctuations in attention during task performance. No additional effect was noted of pain intensity, pain duration, pain catastrophizing, depressive symptoms, reduced sleep because of the pain or opioid use.CONCLUSIONS: Executive and attention functions are not uniformly affected in chronic pain. At least part of the previously reported decline in executive function in this group may reflect psychomotor slowing. Overall, limited evidence was found that executive and attention performance is indeed lower in chronic pain. Therefore, it can be concluded that in chronic pain sustained attention performance is diminished while mental flexibility, planning and inhibition appear to be intact.

scholarly journals Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study

2019 ◽  
pp. 204946371986687 ◽  
Author(s):  
Mahdi Mazidi ◽  
Mohsen Dehghani ◽  
Louise Sharpe ◽  
Behrooz Dolatshahi ◽  
Seyran Ranjbar ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Attentional Bias ◽  
Facial Expressions ◽  
Attentional Control ◽  
Time Course ◽  
Pain Catastrophizing ◽  
Moderation Effect ◽  
Significant Difference ◽  
The Relationship ◽  
Pain Patients

Introduction: This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional bias in chronic pain patients. Methods: A total of 28 patients with chronic pain and 29 pain-free individuals observed pictures of pain, happy and neutral facial expressions while their gaze behaviour was recorded. Pain intensity and duration, anxiety, depression, stress, attentional control and pain catastrophizing were assessed by questionnaires. Results: In all subjects, the pattern of attention for pain faces was characterized by initial vigilance, followed by avoidance. No significant difference was found between the two groups in terms of orientation towards the stimuli, the duration of first fixation, the average duration of fixation or number of fixations on the pain stimuli. Attentional control moderated the relationship between catastrophizing and overall dwell time for happy faces in pain patients, indicating that those with high attentional control and high catastrophizing focused more on happy faces, whereas the reverse was true for those with low attentional control. Conclusion: This study supported the vigilance–avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients.

scholarly journals Biopsychosocial baseline values of 15 000 patients suffering from chronic pain: Dutch DataPain study

2020 ◽  
Vol 45 (10) ◽  
pp. 774-782
Author(s):  
Brigitte Brouwer ◽  
Sophie Waardenburg ◽  
Christian Jacobs ◽  
Marjori Overdijk ◽  
Carsten Leue ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Daily Practice ◽  
Integrated Treatment ◽  
Pain Severity ◽  
Numerical Rating ◽  
Treatment Plans ◽  
Pain Center ◽  
Pain Patients

Background and objectivesChronic pain affects many adults. To improve our daily practice, we need to understand multidisciplinary approaches, integrated treatment plans and the biopsychosocial context of these patients. To date, almost 15 000 chronic pain patients have been referred to the Maastricht University Pain Center in the Netherlands.MethodsThis study describes 11 214 of these patients suffering from chronic pain. Chronic pain was analyzed using relevant Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials instruments.ResultsMost patients were female (59.3%). The prevalence of low education was 59%, and unemployment/disability was 35.9%. The mean age was 55.6 years. Severe pain (Numerical Rating Sale score 7–10) was reported by 71.9% of the patients; psychological and quality of life values deteriorated when pain severity increased. Approximately 36% of patients showed severe signs of depression or anxiety, and 39% displayed high pain catastrophizing. Of all patients, 17.8% reported high values for pain severity, catastrophizing and anxiety or depression.ConclusionsBased on baseline biopsychosocial values, this study shows the complexity of patients referred to pain centers. Pain management with a biopsychosocial approach in an integrated multidisciplinary setting is indispensable. Above all, adjusted education on chronic pain and attention to its biopsychosocial aspects are deemed necessary.

Evaluation of Using the Sphygmomanometer Test to Assess Pain Sensitivity in Chronic Pain Patients vs Normal Controls

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2903-2912
Author(s):  
Seth Butler ◽  
Kyle Draleau ◽  
Ross Heinrich ◽  
Liem Nguyen ◽  
David Shbeeb ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Sensitivity ◽  
Pain Catastrophizing ◽  
Sensitivity Test ◽  
Heat Sensitivity ◽  
Nociceptive Response ◽  
Sensitivity Tests ◽  
Pressure Algometer ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstract Objectives Objectively measuring pain sensitivity has not been easy in primary care clinics. A sphygmomanometer test (a sensory test that measures an individual’s nociceptive response to pressure using a standard blood pressure cuff) has recently been established to test pain sensitivity. Here, we examined the feasibility of using the sphygmomanometer test with chronic pain patients. Design Population, observational study. Settings A community hospital multidisciplinary Pain Center and a private nonprofit university. Subjects Healthy controls and chronic pain patients were recruited. Methods All subjects underwent four pain sensitivity tests: a pressure algometer test, a cold pressure test, a heat sensitivity test, and a sphygmomanometer test. Participants then completed four established surveys for evaluating depression (Patient Health Questionnaire–9), anxiety (General Anxiety Disorder–7), fatigue (Fatigue Severity Scale), and pain catastrophizing (Pain Catastrophizing Scale). Results Although pain patients had significantly higher levels of depression, anxiety, fatigue, and pain catastrophizing, as well as reported pain scores, no significant differences in pain sensitivity were detected via any of the pain sensitivity tests. In the control but not the patient group, results from all pain sensitivity tests including the sphygmomanometer test were significantly correlated with each other. Unlike other pain sensitivity tests, the sphygmomanometer test did not correlate with measures of depression, anxiety, fatigue, or pain catastrophizing characteristics. Conclusions Our results indicate the unique characteristics of the sphygmomanometer test as a pain sensitivity test, particularly when utilized for individuals with chronic pain. Multiple pain sensitivity tests that assess various sensory modalities are needed to evaluate pain sensitivities in chronic pain patients.

scholarly journals Validation of the French Version of the “Patterns of Activity Measure” in Patients with Chronic Musculoskeletal Pain

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Charles Benaim ◽  
Bertrand Léger ◽  
Philippe Vuistiner ◽  
François Luthi
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Activity Patterns ◽  
Intraclass Correlation ◽  
Depression Scale ◽  
Brief Pain Inventory ◽  
Validity And Reliability ◽  
French Speaking ◽  
Pain Patients ◽  
Activity Measure

Background. The “Patterns of Activity Measure” (POAM-P) is a self-administered questionnaire that assesses “avoidance”, “pacing” and “overdoing” activity patterns in chronic pain patients.Objectives. To adapt the POAM-P to French (“POAM-P/F”) and test its validity and reliability in Chronic Musculo-Skeletal Pain patients (CMSP).Methods. We followed the recommended procedure for translation of questionnaires. Five hundred and ninety five inpatients, admitted to a tertiary rehab center in the French-speaking part of Switzerland for chronic pain after orthopedic trauma, were included (sex ratio M/F = 4.36, mean age43±12). Face, content and criterion validities, internal consistency and reliability were assessed. Data included: TAMPA Scale for Kinesiophobia (TSK), Chronic Pain Coping Inventory (CPCI), Pain Catastrophizing Scale (PCS), Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS).Results. Face and content validities were checked during the translation process. Correlations between POAM-P/F-avoidance and TSK, POAM-P/F-pacing and CPCI-pacing, POAM-P/F-overdoing and CPCI-task persistence were highly significant (r>0.3,p<10-2). The three subscales demonstrated excellent homogeneity (Cronbach’s alpha coefficients > 0.8) and test-retest reliability (Intraclass Correlation Coefficients > 0.8). They correlated very differently with the other scales.Discussion and Conclusion. The three POAM-P/F subscales clearly assess different behaviors in CMSP. The POAM-P/F is a suitable questionnaire for classifying French speaking CMSP into avoiders, pacers or overdoers.

scholarly journals Distraction Analgesia in Chronic Pain Patients

2014 ◽  
Vol 121 (6) ◽  
pp. 1292-1301 ◽  
Author(s):  
Kristin L. Schreiber ◽  
Claudia Campbell ◽  
Marc O. Martel ◽  
Seth Greenbaum ◽  
Ajay D. Wasan ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Temporal Summation ◽  
Pain Catastrophizing ◽  
Pain Modulation ◽  
Analysis Of Covariance ◽  
Noxious Stimulation ◽  
Conditioned Pain Modulation ◽  
Opioid Use ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstract Background: Diverting attention away from noxious stimulation (i.e., distraction) is a common pain-coping strategy. Its effects are variable across individuals, however, and the authors hypothesized that chronic pain patients who reported higher levels of pain catastrophizing would derive less pain-reducing benefit from distraction. Methods: Chronic pain patients (n = 149) underwent psychometric and quantitative sensory testing, including assessment of the temporal summation of pain in the presence and absence of a distracting motor task. Results: A simple distraction task decreased temporal summation of pain overall, but, surprisingly, a greater distraction analgesia was observed in high catastrophizers. This enhanced distraction analgesia in high catastrophizers was not altered when controlling for current pain scores, depression, anxiety, or opioid use (analysis of covariance [ANCOVA]: F = 8.7, P &lt; 0.005). Interestingly, the magnitude of distraction analgesia was inversely correlated with conditioned pain modulation (Pearson R = −0.23, P = 0.005). Conclusion: Distraction produced greater analgesia among chronic pain patients with higher catastrophizing, suggesting that catastrophizing’s pain-amplifying effects may be due in part to greater attention to pain, and these patients may benefit from distraction-based pain management approaches. Furthermore, these data suggest that distraction analgesia and conditioned pain modulation may involve separate underlying mechanisms.

scholarly journals Executive Function in Chronic Pain Patients and Healthy Controls: Different Cortical Activation During Response Inhibition in Fibromyalgia

2011 ◽  
Vol 12 (12) ◽  
pp. 1219-1229 ◽  
Author(s):  
Jennifer M. Glass ◽  
David A. Williams ◽  
Maria-Luisa Fernandez-Sanchez ◽  
Anson Kairys ◽  
Paloma Barjola ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Executive Function ◽  
Response Inhibition ◽  
Cortical Activation ◽  
Healthy Controls ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Chronic Pain Patients’ Gaze Patterns toward Pain-Related Information: Comparison between Pictorial and Linguistic Stimuli

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 530 ◽  
Author(s):  
Lee ◽  
Beom ◽  
Choi ◽  
Lee ◽  
Lee
Keyword(s):  
Chronic Pain ◽  
Eye Tracking ◽  
Attentional Bias ◽  
Pain Catastrophizing ◽  
Pain Clinic ◽  
Related Information ◽  
Chronic Pain Patients ◽  
Attentional Engagement ◽  
Pain Patients

Background and Objectives: The attentional bias and information processing model explained that individuals who interpret pain stimuli as threatening may increase their attention toward pain-related information. Previous eye tracking studies found pain attentional bias among individuals with chronic pain; however, those studies investigated this phenomenon by using only one stimulus modality. Therefore, the present study investigated attentional engagement to pain-related information and the role of pain catastrophizing on pain attentional engagement to pain-related stimuli among chronic pain patients by utilizing both linguistic and visual stimulus. Materials and Methods: Forty chronic pain patients were recruited from the rehabilitation center, the back pain clinic, and the rheumatology department of Chung-Ang University Hospital in Seoul, Korea. Patients observed pictures of faces and words displaying pain, presented simultaneously with neutral expressions, while their eye movements were measured using the eye tracking system. A t-test and ANOVA were conducted to compare stimulus pairs for the total gaze duration. Results revealed that chronic pain patients demonstrated attentional preference toward pain words but not for pain faces. An ANOVA with bias scores was conducted to investigate the role of pain catastrophizing on attentional patterns. Results indicated that chronic pain patients with high pain catastrophizing scores gazed significantly longer at pain- and anger-related words than neutral words compared to those with low pain catastrophizing scores. The same patterns were not observed for the facial expression stimulus pairs. Conclusions: The results of the present study revealed attentional preference toward pain-related words and the significant role of pain catastrophizing on pain attentional engagement to pain-related words. However, different patterns were observed between linguistic and visual stimuli. Clinical implications related to use in pain treatment and future research suggestions are discussed.

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