Towards a new model of attentional biases in the development, maintenance, and management of pain

Abstract

Individuals with chronic pain demonstrate attentional biases towards pain-related stimuli. However, the clinical importance of these biases is yet to be determined and a sound theoretical model for explaining the role of attentional biases in the development and maintenance of pain is lacking. Within this article, we (1) systematically review prospective and experimental research exploring attentional biases and pain outcomes in light of current theoretical models and (2) propose a theoretical framework for understanding attention bias in pain. Across prospective research, an attentional pattern of vigilance-avoidance was observed. Interventions targeting attentional biases were less consistent; however, there were promising findings amongst studies that found attentional training effects, particularly for laboratory research. The proposed Threat Interpretation Model suggests a relationship between threat, interpretation and stimuli in determining attentional processes, which whilst tentative generates important testable predictions regarding the role of attention in pain, and builds upon previous theoretical and empirical work in this area.