A role for attentional bias in cognitive deficits in chronic pain?

<p>This thesis extends current understanding of cognitive deficits in people with chronic pain, specifically those related to attention. Researchers have proposed that attentional capacity is allocated to pain sensation, and away from current tasks and goals, leading to broad cognitive deficits (deficit-view). However, an attentional bias to pain-related information has also been observed in people with chronic pain, suggesting that attention is motivated towards information in the environment that is pain-related, and away from information that is not. Such an attentional bias away from information not related to pain may contribute to the cognitive deficits observed on tasks using neutral stimuli (motivated attention hypothesis). In testing the deficit-view and motivated attention accounts of cognitive deficits in chronic pain, I focused on how people attend to rapidly presented information (temporal attention) and the ability to control attention in the face of distraction. To assess how chronic pain affects temporal attention, I used a phenomenon known as the attentional blink, which is a failure to detect a second target that appears soon after a first. Participants viewed a stream of briefly displayed words in which two target words (indicated by their colour) were embedded, with a manipulation of the time between the first and second target. They were required to report the two targets. In one experiment the first target was either pain-related or neutral (to assess how pain-relatedness affects the induction of the blink), and in other experiments this manipulation was applied to the second target (to assess how pain-relatedness affects how targets overcome the blink). In undergraduate participants, both induction and overcoming of the attentional blink was modulated by pain-relatedness. I then compared the effects of manipulating the second target in people with and without chronic pain. If people with chronic pain have general deficits in temporal attention, a deeper attentional blink (relative to control participants) for both kinds of targets should be observed. If motivated attention describes processing in people with chronic pain, a shallower attentional blink for pain related targets than neutral targets (an attentional bias) should be observed. Critically, this bias should be larger in participants with chronic pain. Contrary to both the deficit and motivated attention views, the attentional blink in participants with chronic pain did not differ from that in controls for either pain-related or neutral targets. Furthermore, neither group showed an attentional bias for pain-related targets, and a follow-up experiment failed to replicate the attentional bias observed in undergraduate students as well. Collectively, these findings suggested that attentional bias, as assessed by modulation of the attentional blink, was not reliable. A stronger test of the deficit-view and motivated attention hypothesis was needed. I shifted focus to another attentional domain, the control of distraction. To assess how chronic pain affects attentional control, I used an emotional distraction task, in which participants identified a target letter in an array that flanked irrelevant distractor images that were either intact or scrambled. Intact images depicted either extreme threat to body-tissue, or benign scenes. Distraction is indicated by slowing on intact relative to scrambled distractor trials. If people with chronic pain have general deficits in attentional control, they should show greater distraction from both kinds of images (relative to controls). If motivated attention describes processing in people with chronic pain, greater distraction from body-threat images than neutral images (relative to controls) should be observed. While all participants were more distracted by images depicting extreme threat to body-tissue, people with chronic pain were not more distracted than control participants for either image type. Findings fail to support either a deficit or motivated attention view of attentional control in chronic pain. Although these experiments do not provide evidence that chronic pain affects attentional processing, across experiments people with chronic pain reported that they experience deficits in attention, and they showed behavioural evidence of psychomotor slowing. These findings suggest that, as is repeatedly reported in the literature, people in chronic pain feel like they have attentional deficits, and that some aspects of cognitive and/or motor processing are impacted. Careful consideration is given to what specific cognitive functions might be impaired in chronic pain. The outcome of this discussion suggests pertinent research directions to further understanding of cognition in chronic pain experience.</p>

A role for attentional bias in cognitive deficits in chronic pain?

<p>This thesis extends current understanding of cognitive deficits in people with chronic pain, specifically those related to attention. Researchers have proposed that attentional capacity is allocated to pain sensation, and away from current tasks and goals, leading to broad cognitive deficits (deficit-view). However, an attentional bias to pain-related information has also been observed in people with chronic pain, suggesting that attention is motivated towards information in the environment that is pain-related, and away from information that is not. Such an attentional bias away from information not related to pain may contribute to the cognitive deficits observed on tasks using neutral stimuli (motivated attention hypothesis). In testing the deficit-view and motivated attention accounts of cognitive deficits in chronic pain, I focused on how people attend to rapidly presented information (temporal attention) and the ability to control attention in the face of distraction. To assess how chronic pain affects temporal attention, I used a phenomenon known as the attentional blink, which is a failure to detect a second target that appears soon after a first. Participants viewed a stream of briefly displayed words in which two target words (indicated by their colour) were embedded, with a manipulation of the time between the first and second target. They were required to report the two targets. In one experiment the first target was either pain-related or neutral (to assess how pain-relatedness affects the induction of the blink), and in other experiments this manipulation was applied to the second target (to assess how pain-relatedness affects how targets overcome the blink). In undergraduate participants, both induction and overcoming of the attentional blink was modulated by pain-relatedness. I then compared the effects of manipulating the second target in people with and without chronic pain. If people with chronic pain have general deficits in temporal attention, a deeper attentional blink (relative to control participants) for both kinds of targets should be observed. If motivated attention describes processing in people with chronic pain, a shallower attentional blink for pain related targets than neutral targets (an attentional bias) should be observed. Critically, this bias should be larger in participants with chronic pain. Contrary to both the deficit and motivated attention views, the attentional blink in participants with chronic pain did not differ from that in controls for either pain-related or neutral targets. Furthermore, neither group showed an attentional bias for pain-related targets, and a follow-up experiment failed to replicate the attentional bias observed in undergraduate students as well. Collectively, these findings suggested that attentional bias, as assessed by modulation of the attentional blink, was not reliable. A stronger test of the deficit-view and motivated attention hypothesis was needed. I shifted focus to another attentional domain, the control of distraction. To assess how chronic pain affects attentional control, I used an emotional distraction task, in which participants identified a target letter in an array that flanked irrelevant distractor images that were either intact or scrambled. Intact images depicted either extreme threat to body-tissue, or benign scenes. Distraction is indicated by slowing on intact relative to scrambled distractor trials. If people with chronic pain have general deficits in attentional control, they should show greater distraction from both kinds of images (relative to controls). If motivated attention describes processing in people with chronic pain, greater distraction from body-threat images than neutral images (relative to controls) should be observed. While all participants were more distracted by images depicting extreme threat to body-tissue, people with chronic pain were not more distracted than control participants for either image type. Findings fail to support either a deficit or motivated attention view of attentional control in chronic pain. Although these experiments do not provide evidence that chronic pain affects attentional processing, across experiments people with chronic pain reported that they experience deficits in attention, and they showed behavioural evidence of psychomotor slowing. These findings suggest that, as is repeatedly reported in the literature, people in chronic pain feel like they have attentional deficits, and that some aspects of cognitive and/or motor processing are impacted. Careful consideration is given to what specific cognitive functions might be impaired in chronic pain. The outcome of this discussion suggests pertinent research directions to further understanding of cognition in chronic pain experience.</p>

The Impact of Negative Mood on Event-Related Potentials When Viewing Pornographic Pictures

Background: Negative affective states may increase the risk for problematic pornography use. Underlying neurophysiological mechanisms are, however, not completely understood. Previous research suggests that the participants' emotional state may affect neural processing of sexual stimuli. The aim of this study was to investigate neural correlates of negative affect-induced alterations in sexual cue reactivity in healthy men. The moderating effects of habitual porn consumption, trait sexual motivation, and symptoms of cybersex addiction were also considered.Method: Sixty-four healthy men engaged in a sexual cue reactivity task (passive viewing of explicit sexual pictures and neutral pictures depicting scenes of social interaction) during negative (n = 32) vs. neutral affect (n = 32), induced via tailored feedback on a performance task. Self-reported sexual arousal and event-related brain potentials indicated cue reactivity and motivated attention. Symptoms of cybersex addiction and trait sexual motivation were assessed with the help of the short Internet Addiction Test, adapted to online sexual activities, and the Trait Sexual Motivation Questionnaire.Results: Negative feedback increased negative affect after the performance task. While sexual pictures compared to neutral pictures elicited significantly larger P300 and late positive potential (LPP) amplitudes, there was no general effect of negative feedback on sexual stimuli-related P300 and LPP amplitudes. In the negative feedback group, men with higher solitary sexual motivation levels showed higher P300/LPP difference amplitudes for sexual stimuli compared to men with lower levels of solitary sexual motivation. The opposite effect was found in the group with neutral feedback. There was no link to other aspects of trait sexual motivation and symptoms of cybersex addiction.Conclusions: Results suggest that higher levels of solitary sexual motivation may enhance motivated attention toward sexual stimuli among men receiving negative performance feedback. Other characteristics of sexual behaviors and traits provided no exploratory value. Future studies extending onto men suffering from compulsive sexual behavior disorder will have to closer look at the neurophysiological bases of why and when some men develop an addictive pornography consumption.

Intact Differentiation of Responses to Socially-Relevant Emotional Stimuli Across Psychotic Disorders: An Event-Related Potential (ERP) Study

Event-related potential (ERP) studies of motivated attention in schizophrenia typically show intact sensitivity to affective vs. non-affective images depicting diverse types of content. However, it is not known whether this ERP pattern: 1) extends to images that solely depict social content, (2) applies across a broad sample with diverse psychotic disorders, and (3) relates to self-reported trait social anhedonia. We examined late positive potential (LPP) amplitudes to images involving people that were normatively pleasant (affiliative), unpleasant (threatening), or neutral in 97 stable outpatients with various psychotic disorders and 38 healthy controls. Both groups showed enhanced LPP to pleasant and unpleasant vs. neutral images to a similar degree, despite lower overall LPP in patients. Within the patients, there were no significant LPP differences among subgroups (schizophrenia vs. other psychotic disorders; affective vs. non-affective psychosis) for the valence effect (pleasant/unpleasant vs. neutral). Higher social anhedonia showed a small, significant relation to lower LPP to pleasant images across all groups. These findings suggest intact motivated attention to social images extends across psychotic disorder subgroups. Dimensional transdiagnostic analyses revealed a modest association between self-reported trait social anhedonia and an LPP index of neural sensitivity to pleasant affiliative images.

The Coupled Brains of Captivated Audiences

Suspense not only creates a strong psychological tension within individuals, but it does so reliably across viewers who become collectively engaged with the story. Despite its prevalence in media psychology, limited work has examined suspense from a media neuroscience perspective, and thus the biological underpinnings of suspense remain unknown. Here we examine continuous brain responses of 494 viewers watching a suspenseful movie. To create a time-resolved measure of the degree to which a movie aligns audience-wide brain responses, we computed dynamic inter-subject correlations of functional magnetic resonance imaging (fMRI) time series among all viewers using sliding-window analysis. In parallel, we captured in-the-moment reports of suspense in an independent sample via continuous response measurement (CRM). We found that dynamic inter-subject correlations over the course of the movie tracked well with the reported suspense in the CRM sample, particularly in regions associated with emotional salience and higher cognitive processes. These results are compatible with theoretical views on motivated attention and psychological tension. The finding that fMRI-based audience response measurement relates to audience reports of suspense creates new opportunities for research on the mechanisms of suspense and other entertainment phenomena and has applied potential for measuring audience responses in a nonreactive and objective fashion.

The Role of Attentional Control in Cognitive Deficits Associated With Chronic Pain

Cognitive deficits in chronic pain are often attributed to difficulties in attentional control. According to the deficit view, these difficulties stem from a reduction in attentional capacity driven by attentional focus on pain experience; alternatively, according to the motivated-attention view, attentional biases toward pain-relevant threats in the environment reduce attention available for everyday tasks and goals. We tested both accounts using a task in which 72 people with chronic pain and 72 without chronic pain performed a simple perceptual task while attempting to ignore pain-relevant images of body mutilations or neutral scenes. They also completed a common test of attentional control. Although people with chronic pain reported subjective difficulty with attentional control and were slower on both tasks, groups did not differ on behavioral measures of attentional control. Findings suggest that attentional control may not be an optimal target for interventions intended to improve cognitive function in chronic pain.

Negative and Positive Reappraisal After a Romantic Break-Up

This study compared negative reappraisal of an ex-partner and positive reappraisal of a situation after a break-up. Negative reappraisal was expected to reduce love, increase unpleasantness, reduce upsetness about the break-up, and reduce motivated attention to the ex-partner as measured by the late positive potential (LPP) compared to positive reappraisal. In this study, twenty-four participants who were upset about a break-up viewed pictures of their ex-partner in two reappraisal conditions and a no reappraisal condition. In the negative reappraisal condition, participants thought about negative aspects of their ex-partner. In the positive reappraisal condition, participants thought about positive aspects of the situation. Subsequently, participants viewed ex-partner pictures and the LPP was measured. Participants rated infatuation, attachment, valence, and upsetness about the break-up. Even though numerical differences were in line with our hypotheses, we found no evidence of significant differences between conditions for infatuation, attachment, valence, upsetness, or LPP amplitude in the preregistered analyses.

Neurobehavioral Correlates of How Time-on-task and Sleep Deprivation Modulate Deployment of Cognitive Effort

Sustaining attention is highly demanding and can falter if there is a shift in willingness to exert effort. Motivated attentional performance and effort preference were tracked in relation to increasing time-on-task (Experiment 1) and sleep deprivation (Experiment 2). Performance decrement with time-on-task was attenuated with reward, while preference to deploy effort decreased with longer task duration. Sleep deprivation, accentuated performance decline with time-on-task, and was accompanied by greater effort-discounting. Motivated attention performance was associated with higher fronto-parietal activation, in both normal and sleep deprived conditions. However, after sleep deprivation modulation of activation by reward was reduced in the anterior cingulate cortex (ACC) and left anterior insula (aIns). Together, these results depict how motivational decline affects performance when one gets tired after sustained task performance and/or sleep deprivation.