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Pain Interrupts Attention and Activities

Posted on: 01/18/2007
Pain has a way of getting our attention. It sets off alarms in the nervous system. But when pain becomes chronic, the human may become overalert for pain. This is called hypervigilance. The patient with chronic pain becomes overalert to pain and fearful of it.

Thinking and expecting the worst is called catastrophizing. Being hypervigilant, overalert and catastrophizing can interrupt our attention and distract us from activities. This is called attentional interference.

In this study 40 patients with chronic whiplash syndrome (CWS) are compared to 40 healthy adults (the control group). Various surveys were given to the groups to measure disability, pain catastrophizing, and fear of movement or reinjury. How often pain interrupts activities (attentional interference) was also measured.

While sitting at a computer, the subjects were instructed to click a button in response to a high or low tone coming from the speakers. In different trials, the subjectís neck was placed in a brace to position it either in an extended or a rotated position. Both of these positions are perceived as threatening to patients with CWS. In other trials, the neck was free of any required position.

Reaction times (RTs) to the tones were measured for both groups in all trials. The results showed that the patients had increased RTs during threat positions. At first they could get back to their baseline RTs when the threat was removed.

But by the third trial, their RTs remained slow even when their neck was free to move normally. The results showed that activities perceived as threatening distract chronic pain patients. Their attention is disrupted from the task at hand.

The authors were unable to tell if the reduced RTs were caused by actual pain sensation or by the feeling of threat perceived by the patients. It may be there is an interplay of both factors. Future studies will look into this.

Karoline Vangronsveld, et al. An Experimental Investigation on Attentional Interference By Threatening Fixations of the Neck in Patients with Chronic Whiplash Syndrome. In Pain. January 2007. Vol. 127. No. 1-2. Pp. 121-128.

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