Trying to Fix a Painful Problem: The Impact of Pain Control Attempts on the Attentional Prioritization of a Threatened Body Location

• Pain control attempts may result in heightened attention to pain-related information.
• Pain control attempts should thus bias attention to the pain-relevant location.
• A tactile change detection task was presented to pain control and comparison groups.
• Comparison group shows an attentional bias for the pain location when under threat.
• Pain control group shows similar attentional bias irrespective of threat.

Motivational accounts of pain behavior and disability suggest that persisting attempts to avoid or control pain may paradoxically result in heightened attention to pain-related information. We investigated whether attempts to control pain prioritized attention to the location where pain was expected, using a tactile change detection paradigm. Thirty-seven undergraduate students had to detect changes between 2 consecutively presented patterns of tactile stimuli at various body locations. One of the locations was made threatening by occasionally administering a pain-eliciting stimulus. Half of the participants (pain control group) were encouraged to actively avoid the administering of pain by pressing a button as quickly as possible, whereas the other participants (comparison group) were not. The actual amount of painful stimuli was the same in both groups. Results showed that in the comparison group, the anticipation of pain resulted in better detection of tactile changes at the pain location than at the other locations, indicating an attentional bias for the threatened location. Crucially, the pain control group showed a similar attentional bias, but also when there was no actual presence of threat. This suggests that although threat briefly prioritized the threatened location, the goal to control pain did so in a broader, more context-driven manner.PerspectiveThis study investigates the impact of attempts to control pain on somatosensory processing at the pain location. It provides further insight into the motivational mechanisms of pain-related attention. It also points to the negative consequences of trying to control uncontrollable pain, such as is often the case in chronic pain.