Do people with acute low back pain have an attentional bias to threat-related words?
Author:
Skinner Ian123, Hübscher Markus23, Lee Hopin245, Traeger Adrian C.236, Moseley G. Lorimer27, Wand Benedict M.8, Gustin Sylvia M.29, McAuley James H.210
Affiliation:
1. School of Community Health , Charles Sturt University , Port Macquarie , NSW , Australia 2. Neuroscience Research Australia , Sydney , NSW , Australia 3. Prince of Wales Clinical School , University of New South Wales , Sydney , NSW , Australia 4. School of Medicine and Public Health , University of Newcastle , Newcastle , NSW , Australia 5. Centre for Rehabilitation Research, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences , University of Oxford , Oxford , UK 6. School of Public Health, Faculty of Medicine and Health , The University of Sydney , Sydney , NSW , Australia 7. IIMPACT in Health, University of South Australia , Adelaide , SA , Australia 8. School of Physiotherapy , The University of Notre Dame Australia , Fremantle , WA , Australia 9. School of Psychology , University of New South Wales , Sydney , NSW , Australia 10. School of Health Sciences, Faculty of Medicine , University of New South Wales , Sydney , NSW , Australia
Abstract
Abstract
Objectives
It has been hypothesised that attentional bias to environmental threats can contribute to persistent pain. It is unclear whether people with acute low back pain (LBP) have an attentional bias to environmental threats. We investigated if attentional bias of threat related words is different in people with acute LBP and pain-free controls.
Methods
People with acute LBP and pain-free people completed a free viewing eye tracking task. Participants were simultaneously presented with two words, a threat related word and a neutral control word. Threat related words were general threat, affective pain and sensory pain. We conducted linear mixed models to detect differences between acute LBP and pain-free participants on five eye tracking outcome measures (dwell time, first fixation, latency to first fixation, first run dwell time and number of fixations). We calculated absolute reliability, (standard error of measure), and relative reliability (intraclass correlation coefficients [ICC 2,1]) for each eye tracking outcome measures.
Results
We recruited 65 people with acute LBP and 65 pain-free controls. Participants with acute LBP had a higher proportion of fixations towards the affective pain words (M=0.5009, 95% CI=0.4941, 0.5076) than the pain-free controls had (M=0.4908, 95% CI=0.4836, 0.4979), mean between group difference = −0.0101, 95% CI [−0.0198, −0.0004], p=0.0422. There was no difference between acute LBP and pain-free controls for the remaining eye tracking outcome measures (all p>0.05). The only outcome measure that had an ICC of more than 0.7 was the latency to first fixation (affective pain words ICC=0.73, general threat words ICC=0.72).
Conclusions
When compared with pain-free controls, people with acute LBP looked more often at affective pain words relative to neutral control words. This may indicate a form of engagement bias for people with acute LBP. Attentional bias was not consistent across outcome measures or word groups. Further research is needed to investigate the potential role of attentional bias in the development of persistent pain.
Publisher
Walter de Gruyter GmbH
Subject
Anesthesiology and Pain Medicine,Neurology (clinical)
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