Retrospec*ve pain ra*ngs: How to create or avoid bias? Marta Walentynowicz1, Filip Raes2, Ilse Van Diest1, Omer Van den Bergh1 1Health Psychology, 2 Learning and Experimental Psychology, University of Leuven, Belgium
Background and aims
-‐ Retrospec?ve symptom ra?ngs, commonly used in clinical prac?ce and research, are frequently overes?mated and suscep?ble to emo?onal and cogni?ve biases. -‐ ADen?onal focus can modulate symptom percep?on, encoding, and memory.
Aim of this pilot study: The effect of interocep?ve focus (IF) on sensory-‐perceptual vs. affec?ve responses during encoding on biased symptom reports. Distrac?on by external s?muli served as control condi?on. Sensory focus à focus on sensory-‐perceptual aspects of sensa?ons Affec?ve focus à focus on feelings about sensa?ons and emo?onal distress
Hypothesis: Affec?ve IF will lead to increased symptom ra?ngs and affec?ve responses to s?muli compared to sensory IF.
Methods
Par*cipants: 47 healthy students (12 male/35 female) Procedure:
Self-‐report measures: -‐ Pain ra?ngs (0-‐100 visual analogue scale) on four measurement moments -‐ State nega?ve affect (NA), state anxiety: baseline/aXer each trial -‐ Trait: Fear of Pain (FPQ-‐III)
Results
Conclusions
¿ Symptom and unpleasantness ra?ngs: no difference between two IF condi?ons: -‐ Localized and specific pain did not evoke strong nega?ve emo?ons à focus on mildly
nega?ve affec?ve responses could serve as a distrac?on from pain -‐ More aversive symptom induc?on needed to examine the effects of aDen?onal focus
¿ Distrac?on was related to lower emo?onal distress and average/peak pain ra?ngs ¿ Fear of pain modulated ambiguous pain experience (when painful sensa?ons were ambiguous or low), but had less influence during more intense pain experiences (peak)
Two pain induc*on trials 3x3 cm thermode (Medoc Pathway) Ventral surface of dominant forearm
AXer trial
Immediate
AXer 2 weeks
FU-‐2
AXer 4 weeks
FU-‐4
AXer 8 weeks
FU-‐8
60s 60s 5s 60s
32ºC 2ºC 32ºC 0.5ºC/s 0.5ºC/s
baseline cold phase recovery phase
ATen*onal direc*on
(within-‐subjects) External: Distrac*on Neutral film clip & recogni?on task
Internal: Interocep*ve focus (between-‐subjects)
Sensory IF Focus on the sensa,ons in
a neural way
Affec*ve IF Focus on the emo,ons and
immerse in them
Design -‐ Lower state NA and unpleasantness in distrac?on condi?on
-‐ Affec?ve IF – highest state NA
0
5
10
15
20
25
Sensory IF Distrac?on Affec?ve IF Distrac?on
State NA Direc?on *** Direc?on x IF **
1
3
5
7
9
Sensory IF Distrac?on Affec?ve IF Distrac?on
Unpleasantness 1-‐9 Direc?on ***
Affec*ve responses
0
10
20
30
40
50
60
immediate FU2 FU4 FU8 immediate FU2 FU4 FU8
Average pa
in
Direc?on***
0
20
40
60
80
immediate FU2 FU4 FU8 immediate FU2 FU4 FU8
Peak pain
Sensory IF Affec?ve IF Distrac?on
Direc?on*** Direc?on x IF x Time*
Sensory IF Affec?ve IF Distrac?on
0
10
20
30
40
50
immediate FU2 FU4 FU8 immediate FU2 FU4 FU8
End pa
in
Sensory IF Affec?ve IF Distrac?on
Time *
Including Fear of Pain (FPQ) as a covariate: é FPQ é average & end ra?ngs, but no effect on peak ra?ngs
ê average ra?ngs in distrac?on condi?on
ê peak ra?ngs in distrac?on condi?on
î over ?me in affec?ve IF
end ra?ngs ì over ?me
