The role of executive functioning in children's attentional pain control: an experimental analysis.
Directing attention away from pain is often used in children's pain treatment programs to control pain. However, empirical evidence concerning its effectiveness is inconclusive. We therefore sought to understand other influencing factors, including executive function and its role in the pain experience. This study investigates the role of executive functioning in the effectiveness of distraction. School children (n=164) completed executive functioning tasks (inhibition, switching, and working memory) and performed a cold-pressor task. One half of the children simultaneously performed a distracting tone-detection task; the other half did not. Results showed that participants in the distraction group were engaged in the distraction task and were reported to pay significantly less attention to pain than controls. Executive functioning influenced distraction task engagement. More specifically, participants with good inhibition and working memory abilities performed the distraction task better; participants with good switching abilities reported having paid more attention to the distraction task. Furthermore, distraction was found to be ineffective in reducing pain intensity and affect. Executive functioning did not influence the effectiveness of distraction. However, a relationship was found between executive functioning and pain affect, indicating that participants with good inhibition and working memory abilities experienced the cold-pressor task as less stressful and unpleasant. Our findings suggest that distraction as a process for managing pain is complex. While it appears that executive function may play a role in adult distraction, in this study it did not direct attention away from pain. It may instead be involved in the overall pain experience.
KHLeuven Departement Gezondheidszorg en Technologie, Leuven 3000, Belgium Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada Department of Psychiatry, University of Alberta, Edmonton, AB, Canada Centre for Pain Research, University of Bath, Bath, UK Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent 9000, Belgium.
Katrien
K
Verhoeven
Bruce
B
Dick
Christopher
C
Eccleston
Liesbet
L
Goubert
Geert
G
Crombez
D001288:Attention / Q000502:physiology*; D002648:Child; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D011597:Psychomotor Performance / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology
Attention; Distraction; Executive functioning; Inhibition; Switching; Working memory