title: Attentional bias to pain and social threat in pediatric patients with functional abdominal pain and pain-free youth before and after performance evaluation.
abstract: This study investigated attentional biases for pain and social threat versus neutral stimuli in 54 youth with functional abdominal pain (FAP) and 53 healthy control subjects (ages 10 to 16 years). We assessed attentional bias using a visual probe detection task (PDT) that presented pain and social threat words in comparison to neutral words at conscious (1250 ms) and preconscious (20 ms) presentation rates. We administered the PDT before and after random assignment of participants to a laboratory stressor--failure versus success feedback regarding their performance on a challenging computer game. All analyses controlled for trait anxiety. At the conscious rate of stimulus presentation, FAP patients exhibited preferential attention toward pain compared with neutral stimuli and compared with the control group. FAP patients maintained preferential attention toward conscious pain stimuli after performance feedback in both failure and success conditions. At the preconscious rate of stimulus presentation, FAP patients' attention was neutral at baseline but increased significantly toward pain stimuli after performance feedback in both failure and success conditions. FAP patients' somatic symptoms increased in both failure and success conditions; control youth's somatic symptoms only increased after failure. Regarding social threat, neither FAP nor control youth exhibited attentional bias toward social threat compared with neutral stimuli at baseline, but both FAP and control youth in the failure condition significantly increased attention away from social threat after failure feedback. Results suggest that FAP patients preferentially attend to pain stimuli in conscious awareness. Moreover, performance evaluation may activate their preconscious attention to pain stimuli.
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, TN, USA Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
authors.forename: Joy E
authors.initials: JE
authors.lastname: Beck
authors.forename: Tricia A
authors.initials: TA
authors.lastname: Lipani
authors.forename: Kari F
authors.initials: KF
authors.lastname: Baber
authors.forename: Lynette
authors.initials: L
authors.lastname: Dufton
authors.forename: Judy
authors.initials: J
authors.lastname: Garber
authors.forename: Craig A
authors.initials: CA
authors.lastname: Smith
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Walker
mesh_terms: D015746:Abdominal Pain / Q000503:physiopathology* / Q000523:psychology*; D000293:Adolescent; D000704:Analysis of Variance; D001007:Anxiety / Q000503:physiopathology; D001288:Attention / Q000502:physiology*; D001364:Awareness; D015982:Bias; D017028:Caregivers / Q000523:psychology; D002648:Child; D003657:Decision Making / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D017603:Signal Detection, Psychological; D012931:Social Environment; D013315:Stress, Psychological / Q000503:physiopathology; D014825:Vocabulary