Advertisement

The Effect of Induced and Chronic Pain on Attention

      Highlights

      • Patients with fibromyalgia and healthy controls performed a battery of attention tasks.
      • Participants completed the tasks once during induced cuff pain and once without.
      • Pain induction primarily affected attention span performance.
      • Patients with fibromyalgia had poorer performance on the divided attention task.
      • Chronic pain and induced acute pain have different effects on attention.

      Abstract

      Pain has well-established effects on attention. At present, parallel literatures exist that have examined the effects of experimentally induced pain and consider cognitive performance in patients with chronic pain states. However, no study to date as attempted to examine the combined or differing effects of these 2 manifestations of pain in a single study. Twenty-four participants with fibromyalgia (aged 43.00 ± 28.28 years) and 26 healthy controls (aged 36.07 ± 11.93 years) completed an n-back task, an attentional switching task, and a divided attention task, once during induced, moderately intense pressure pain, and once without induced pain. Pain induction had selective effects on the n-back task and an overall decrease in accuracy on the attentional switching task. Conversely, patients with fibromyalgia were selectively impaired in performance on the divided attention task. These data therefore suggest that the effects of pain are not summative and rather that the mechanisms that underlie the negative effects of pain on performance in acute and chronic states may differ. More research is needed to examine these mechanisms and how these negative effects can be ameliorated to treat cognitive symptoms in pain.

      Perspective

      This article presents a study to examine the effects of an acute, induced pain model on cognitive performance in both patients with fibromyalgia and healthy control populations. We established that the effects of acute and chronic pain on attention are different, suggesting that different models need to be developed to understand these phenomena.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Altmann EM
        • Gray WD
        An integrated model of cognitive control in task switching.
        Psychol Rev. 2008; 115: 602-639
        • Attridge N
        • Noonan D
        • Eccleston C
        • Keogh E
        The disruptive effects of pain on n-back task performance in a large general population sample.
        Pain. 2015; 156: 1885-1891
        • Bell T
        • Trost Z
        • Buelow MT
        • Clay O
        • Younger J
        • Moore D
        • Crowe M
        Meta-analysis of cognitive performance in fibromyalgia.
        J Clin Exp Neuropsychol. 2018; : 1-17
        • Bennett RM
        Clinical manifestations and diagnosis of fibromyalgia.
        Rheum Dis Clin North Am. 2009; 35: 215-232
        • Berryman C
        • Stanton TR
        • Bowering KJ
        • Tabor A
        • McFarlane A
        • Moseley GL
        Evidence for working memory deficits in chronic pain: A systematic review and meta-analysis.
        Pain. 2013; 154: 1181-1196,
        • Berryman C
        • Stanton TR
        • Bowering KJ
        • Tabor A
        • McFarlane A
        • Moseley GL
        Do people with chronic pain have impaired executive function? A meta-analytical review.
        Clin Psychol Rev. 2014; 34: 563-579
      1. Boselie JJ, Vancleef LM, Smeets T, Peters MLJP: Increasing optimism abolishes pain-induced impairments in executive task performancePain155:334-340, 2014

        • Cella D
        • Riley W
        • Stone A
        • Rothrock N
        • Reeve B
        • Yount S
        • Amtmann D
        • Bode R
        • Buysse D
        • Choi S
        The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008.
        J Clin Epidemiol. 2010; 63: 1179-1194
        • Clark-Carter D
        Quantitative Psychological Research: A Student's Handbook.
        Psychology Press, Hove, UK2004
        • Crombez G
        • Eccleston C
        • Baeyens F
        • Eelen P
        Attentional disruption is enhanced by the threat of pain.
        Behav Res Ther. 1998; 36: 195-204
        • D'Eon JL
        • Harris CA
        • Ellis JA
        Testing factorial validity and gender invariance of the pain catastrophizing scale.
        J Behav Med. 2004; 27: 361-372
        • de Tommaso M
        • Federici A
        • Santostasi R
        • Calabrese R
        • Vecchio E
        • Lapadula G
        • Iannone F
        • Lamberti P
        • Livrea P
        Laser-evoked potentials habituation in fibromyalgia.
        J Pain. 2011; 12: 116-124
        • Donaldson CC
        • Sella G
        • Mueller HH
        Fibromyalgia: A retrospective study of 252 consecutive referrals.
        Can J Clin Med. 1998; 5: 116-127
        • Eccleston C
        • Crombez G
        Pain demands attention: A cognitive–affective model of the interruptive function of pain.
        Psychol Bull. 1999; 125: 356-366
        • Edwards RR
        • Mensing G
        • Cahalan C
        • Greenbaum S
        • Narang S
        • Belfer I
        • Schreiber KL
        • Campbell C
        • Wasan AD
        • Jamison RN
        Alteration in pain modulation in women with persistent pain after lumpectomy: Influence of catastrophizing.
        J Pain Symptom Manage. 2013; 46: 30-42
        • Forsythe LP
        • Thorn B
        • Day M
        • Shelby G
        Race and sex differences in primary appraisals, catastrophizing, and experimental pain outcomes.
        J Pain. 2011; 12: 563-572
        • Goldenberg DL
        • Bradley LA
        • Arnold LM
        • Glass JM
        • Clauw DJ
        Understanding fibromyalgia and its related disorders.
        Prim Care Companion J Clin Psychiatry. 2008; 10: 133-144
        • Katz P
        • Pedro S
        • Michaud K
        Performance of the Patient‐Reported Outcomes Measurement Information System 29‐Item Profile in Rheumatoid Arthritis, Osteoarthritis, Fibromyalgia, and Systemic Lupus Erythematosus.
        Arthritis Care Res. 2017; 69: 1312-1321
        • Keogh E
        • Cavill R
        • Moore DJ
        • Eccleston C
        The effects of menstrual-related pain on attentional interference.
        Pain. 2014; 155: 821-827
        • Kim J
        • Loggia ML
        • Cahalan CM
        • Harris RE
        • Beissner F
        • Garcia RG
        • Kim H
        • Barbieri R
        • Wasan AD
        • Edwards RR
        The somatosensory link in fibromyalgia: Functional connectivity of the primary somatosensory cortex is altered by sustained pain and is associated with clinical/autonomic dysfunction.
        Arthritis Rheumatol. 2015; 67: 1395-1405
        • Lawrence RC
        • Felson DT
        • Helmick CG
        • Arnold LM
        • Choi H
        • Deyo RA
        • Gabriel S
        • Hirsch R
        • Hochberg MC
        • Hunder GG
        Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II.
        Arthritis Rheum. 2008; 58: 26-35
        • Leavitt F
        • Katz RS
        • Mills M
        • Heard AR
        Cognitive and dissociative manifestations in fibromyalgia.
        JCR J Clin Rheumatol. 2002; 8: 77-84
        • Lezak MD
        • Howieson DB
        • Loring DW
        Neuropsychological Assessment,.
        4th ed. Oxford University Press, New York2004
        • Mease P
        Fibromyalgia syndrome: Review of clinical presentation, pathogenesis, outcome measures, and treatment.
        J Rheumatol. 2005; 75: 6-21
        • Meints SM
        • Wang V
        • Edwards RR
        Sex and race differences in pain sensitization among patients with chronic low back pain.
        J Pain. 2018; 19: 1461-1470
        • Meiran N
        Reconfiguration of processing mode prior to task performance.
        J Exp Psychol. 1996; 22: 1423-1442
        • Moore D
        • Heavey L
        • Reidy J
        Attentional processing of faces in ASD: A dot-probe study.
        J Autism Dev Disord. 2012; 42: 2038-2045
        • Moore DJ
        • Eccleston C
        • Keogh E
        Cognitive load selectively influences the interruptive effect of pain on attention.
        Pain. 2017; 158: 2035-2041
        • Moore DJ
        • Keogh E
        • Eccleston C
        Identifying experimental methods to determine the effect of pain on attention: A review of pain, caffeine, alcohol and nicotine studies.
        Human Psychopharmacol Clin Exp. 2009; 24: 601-618
        • Moore DJ
        • Keogh E
        • Eccleston C
        The interuptive effect of pain on attention.
        Q J Exp Psychol. 2012; 65: 565-586
        • Moore DJ
        • Keogh E
        • Eccleston C
        The effect of threat on attentional interruption by pain.
        Pain. 2013; 154: 82-88
        • Moore DJ
        • Keogh E
        • Eccleston C
        Headache impairs attentional performance.
        Pain. 2013; 154: 1840-1845
        • Moore DJ
        • Law A
        The disruptive effects of pain on multitasking in a virtual errands task.
        Scand J Pain. 2017; 93: 385-404
        • Moriarty O
        • McGuire BE
        • Finn DP
        The effect of pain on cognitive function: A review of clinical and preclinical research.
        Prog Neurobiol. 2011; 93: 385-404
        • Osman A
        • Barrios FX
        • Gutierrez PM
        • Kopper BA
        • Merrifield T
        • Grittmann L
        The Pain Catastrophizing Scale: Further psychometric evaluation with adult samples.
        J Behav Med. 2000; 23: 351-365
        • Osman A
        • Barrios FX
        • Kopper BA
        • Hauptmann W
        • Jones J
        • O'neill E
        Factor structure, reliability, and validity of the Pain Catastrophizing Scale.
        J Behav Med. 1997; 20: 589-605
        • Peters ML
        • Vlaeyen JWS
        • Kunnen AMW
        Is pain-related fear a predictor of somatosensory hypervigilance in chronic low back pain patients?.
        Behav Res Ther. 2002; 40: 85-103
        • Piovesan A
        • Mirams L
        • Poole H
        • Moore DJ
        • Ogden RS
        The relationship between physiological arousal and perceived duration; differential effects of task relevant and task-irrelevant arousal.
        Emotion. 2018 Sep 27; ([Epub ahead of print])
        • Polianskis R
        • Graven-Nielsen T
        • Arendt-Nielsen L
        Pressure-pain function in desensitized and hypersensitized muscle and skin assessed by cuff algometry.
        J Pain. 2002; 3: 28-37
        • Sallinen M
        • Mengshoel AM
        “I just want my life back!”-Men's narratives about living with fibromyalgia.
        Disabil Rehabil. 2019; 41: 422-429
        • Schmidt-Wilcke T
        • Clauw DJ
        Fibromyalgia: From pathophysiology to therapy.
        Nat Rev Rheumatol. 2011; 7: 518-527
        • Schneider W
        • Eschman A
        • Zuccolotto A
        E-Prime User's Guide.
        Psychology Software Tools, Inc, Pittsburgh2001
        • Schreiber KL
        • Loggia ML
        • Kim J
        • Cahalan CM
        • Napadow V
        • Edwards RR
        Painful after-sensations in fibromyalgia are linked to catastrophizing and differences in brain response in the medial temporal lobe.
        J Pain. 2017; 18: 855-867
        • Smith BW
        • Tooley EM
        • Montague EQ
        • Robinson AE
        • Cosper CJ
        • Mullins PG
        Habituation and sensitization to heat and cold pain in women with fibromyalgia and healthy controls.
        Pain. 2008; 140: 420-428
        • Snijders TJ
        • Ramsey NF
        • Koerselman F
        • Van Gijn J
        Attentional modulation fails to attenuate the subjective pain experience in chronic, unexplained pain.
        Eur J Pain. 2010; 14 (e281-282. e210): 282
        • Staud R
        • Weyl EE
        • Riley III, JL
        • Fillingim RB
        Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
        PloS One. 2014; 9: e89086
        • Stein KF
        • Miclescu A
        Effectiveness of multidisciplinary rehabilitation treatment for patients with chronic pain in a primary health care unit.
        Scand J Pain. 2013; 4: 190-197
        • Stevens J
        Applied Multivariate Statistics in the Social Sciences.
        3rd ed. Routledge, LEA, New Jersey1996
        • Sullivan MJL
        • Bishop SR
        • Pivik J
        The Pain Catastrophizing Scale: Development and validation.
        Psychol Assess. 1995; 7: 524-532
        • Tiemann L
        • Schulz E
        • Winkelmann A
        • Ronel J
        • Henningsen P
        • Ploner M
        Behavioral and neuronal investigations of hypervigilance in patients with fibromyalgia syndrome.
        PloS One. 2012; 7: e35068
        • Turk DC
        • Dworkin RH
        • Revicki D
        • Harding G
        • Burke LB
        • Cella D
        • Cleeland CS
        • Cowan P
        • Farrar JT
        • Hertz S
        Identifying important outcome domains for chronic pain clinical trials: An IMMPACT survey of people with pain.
        Pain. 2008; 137: 276-285
        • Van Ryckeghem DM
        • Rost S
        • Kissi A
        • Vögele C
        • Crombez G
        Task interference and distraction efficacy in patients with fibromyalgia: An experimental investigation.
        Pain. 2018; 159: 1119-1126
        • Vancleef LMG
        • Peters ML
        The Interruptive Effect of Pain on Attention.
        J Pain. 2006; 7: 21-22
        • Vancleef LMG
        • Peters ML
        Pain Catastrophizing, but not injury/illness sensitivity or anxiety sensitivity, enhances attentional interference by pain.
        J Pain. 2006; 7: 23-30
        • Williamson DJG
        • Scott JG
        • Adams RI
        Traumatic brain injury.
        in: Adams R.L. Parsons O.A. Culbertson J.L. Nixon SJ Neuropsychology for clinical practice Etiology, assessment and treatment of common neurological disorders. American Psychological Association, Washington, DC1996: 9-64
        • Wolfe F
        • Clauw D
        • Fitzcharles M
        • Goldenberg D
        • Katz R
        • Mease P
        La fibromialgia.
        Arthritis Care Res (Hoboken). 2010; 62: 600-610
        • Wolfe F
        • Clauw DJ
        • Fitzcharles MA
        • Goldenberg DL
        • Katz RS
        • Mease P
        • Russell AS
        • Russell IJ
        • Winfield JB
        • Yunus MB
        The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity.
        Arthritis Care Res (Hoboken). 2010; 62: 600-610