Patterns of Attentional Bias in Children with Recurrent Abdominal Pain and Pain-Free Children
Lipani, Tricia A.
Current models of chronic pain include attentional processing as an important component in the perception of pain sensations and in responses to pain such as coping (e.g., Compas & Boyer, 2001; Zeltzer, Bursch, & Walco, 1997). It has been suggested that recurrent abdominal pain (RAP), a common pain condition in children rarely associated with organic disease (Apley, 1975), is characterized by difficulties with regulating attention toward pain. In addition, theoretical and empirical literature suggests that the degree to which pain is perceived as threatening influences attentional processes involved in pain perception and response (e.g., Eccleston & Crombez, 1999; Lazarus & Folkman, 1984). The main goal of this study was to compare children with RAP with pain-free peers in their patterns of attentional orienting to physical threat words, and to determine whether they demonstrate attentional bias that is specific to physical threat. In addition, this study investigated psychological correlates of attentional orienting to threat. Patients with RAP and children and adolescents without pain completed a modified probe detection task to examine their attentional orienting toward physical and social threat words presented at supraliminal (1250 ms) and subliminal (20 ms) exposures levels. Participants and their parents also completed measures of state affect and somatic symptoms and trait anxiety/depression and somatic symptoms. When patterns of attentional orienting toward threat words were compared to a neutral attentional stance and to the attentional orienting of Well participants, patients with RAP demonstrated attentional bias toward supraliminal physical threat words. This attentional bias was greater than bias toward social threat words, which did not differ from a neutral attentional stance. The degree of attentional bias for physical threat words was inversely related to their reports of physical anxiety symptoms and to beliefs regarding the severity of their chronic pain condition. Findings are discussed in relation to current models of chronic pain, attention to threat, and implications for symptom maintenance and treatment of RAP.