Automatic and strategic processing of threat cues in patients with chronic pain: a modified stroop evaluation.
OBJECTIVE
The goal of this study was to clarify whether patients with chronic pain selectively attend to syndrome-specific (i.e., pain-related) information and, if so, to determine whether this occurs at the conscious (i.e., strategic) or unconscious (i.e., automatic) level.


METHODS
This study was conducted at a tertiary care rehabilitation center.


METHODS
Thirty-three patients with chronic back and/or neck pain and 33 healthy volunteers matched for age, sex, and education participated in this study.


METHODS
A computerized version of a modified Stroop color-naming task, with unmasked and masked conditions, was used to assess strategic and automatic information processing of words related to sensory pain, affect pain, physical threat, social threat, and neutral themes.


RESULTS
A repeated-measures ANOVA indicated that patients with chronic pain but not healthy volunteers had delayed color-naming latencies to both sensory and affect pain words in the unmasked condition. Color-naming latency differences were not evident for other word types in the unmasked condition or for any word types in the masked condition. Correlational and regression analyses indicated that the delayed color-naming latencies to pain words in the unmasked condition observed for the chronic pain patients were, in part, associated with high pain-specific cognitive anxiety and interference and lower levels of anxiety sensitivity.


CONCLUSIONS
Individuals with chronic pain selectively process pain-related cues at the strategic level but not at the automatic level. Implications of the findings and future research directions are discussed.
Snider
B S
BS
Regina Health District, University of Regina, Saskatchewan, Canada.
Asmundson
G J
GJ
Wiese
K C
KC
D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D001288:Attention / Q000502:physiology*; D002908:Chronic Disease / Q000523:psychology; D003116:Color; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology*; D012647:Self-Assessment; D014705:Verbal Behavior / Q000502:physiology*; D014936:Word Association Tests