The effect of attentional re-training and threat expectancy in response to acute pain

This study aimed to investigate the efficacy of implicit attention re-training (AR) on pain ratings, threshold and tolerance during the cold-pressor task and to determine whether the effectiveness of AR was affected by threat expectancy. One hundred and four undergraduate psychology students were randomly assigned to receive either threat-alleviating or threat-inducing information about the task. Participants were then re-randomized to receive an AR that either trained them to implicitly attend to neutral and ignore pain-related stimuli (neutral training) or to attend towards pain-related stimuli (pain training). Hence, the present study had a 2 (threat expectancy: high vs low) × 2 (AR: pain vs neutral) design. Manipulation checks confirmed that the threat manipulation was effective in increasing threat expectancy and the training paradigm shifted attentional biases in predicted directions. Results showed that, relative to neutral re-training, those in the pain re-training group reported higher levels of pain 30 s into the cold pressor task and registered pain more quickly. There was no difference in tolerance between the groups, nor pain at tolerance. This was the same pattern of results found for the threat induction. For initial pain ratings, there was an interaction that closely approached significance (p = 0.053). These results show that AR affects individual's perceptions of and their responses to pain during an experimental task in a similar way to increasing the threat expectancy of the task. Future research should trial AR in real-life settings to determine whether these results can be generalized.