Attentional control moderates the relationship between pain catastrophizing and selective attention to pain faces on the antisaccade task

Ranjbar, Seyran; Mazidi, Mahdi; Sharpe, Louise; Dehghani, Mohsen; Khatibi, Ali · 2020 · OpenAlex-citations

DOI: 10.1038/s41598-020-69910-2

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Summary

This study investigates the relationship between pain catastrophizing and attentional bias toward pain-related stimuli, specifically addressing why previous meta-analyses have failed to find consistent links between these constructs. Cognitive models of chronic pain suggest that pain catastrophizing fuels attentional bias, yet empirical evidence has been inconsistent. The authors hypothesize that attentional control acts as a moderator, meaning the relationship between catastrophizing and attentional bias depends on an individual’s capacity to regulate attention. To test this, the researchers utilized the antisaccade task, which measures the ability to inhibit reflexive attention toward a stimulus, using ecologically valid dynamic facial expressions rather than static images or words. The study involved 110 pain-free undergraduate participants who completed the antisaccade task while viewing dynamic faces depicting pain, anger, happiness, or neutrality. Participants also completed self-report questionnaires measuring pain catastrophizing (Pain Catastrophizing Scale), attentional control (Attentional Control Scale), anxiety, depression, and fear of pain. Participants were categorized into high or low pain catastrophizing groups based on a median split. The antisaccade task required participants to look away from a peripheral face stimulus, measuring error rates and reaction times as indices of inhibitory control and attentional shifting. Results indicated that participants with high pain catastrophizing exhibited significantly higher error rates on antisaccade trials involving pain faces compared to angry or happy faces, suggesting a specific difficulty in disinhibiting attention toward painful expressions. Crucially, moderation analyses revealed that attentional control moderated the relationship between pain catastrophizing and attentional bias to pain faces. Post-hoc analyses specified that this effect was driven by the "shifting" component of attentional control, rather than "focusing." A significant relationship between catastrophizing and attentional bias was observed only among individuals with high self-reported ability to shift attention. These findings suggest that attentional control is a necessary condition for the association between pain catastrophizing and attentional bias to manifest. This explains the inconsistent results in prior literature, which often failed to account for individual differences in attentional control capacity. By demonstrating that the link between catastrophizing and bias is contingent on the ability to shift attention, the study supports cognitive models of pain while highlighting the importance of methodological rigor, such as using dynamic stimuli and tasks that isolate specific attentional components like inhibition and shifting.

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• attention selective divided