Is high fear of pain associated with attentional biases for pain-related or general threat? A categorical reanalysis.

UNLABELLED: The purpose of this investigation was to clarify mixed findings reported in selective attention investigations. To accomplish this, recently published dot-probe data from 36 patients with chronic musculoskeletal pain and 29 healthy control participants were reanalyzed with consideration of fear of pain (FOP) as a categorical variable. FOP groups were identified by using a variety of strategies and represented differing conceptualizations of the FOP construct. Selective attention for sensory pain, affect pain, and health catastrophe words was assessed by using raw dot-probe detection latencies and the bias, congruency, and incongruency indices. Analysis of the raw detection latencies revealed no significant interactions that permit inferences regarding attentional shifts to or away from specific word types. Analyses of the attention indices revealed no evidence of pain-related selective attention as a function of FOP or the interaction between clinical status and FOP, regardless of the FOP categorization method used; however, for FOP groups derived by using the cluster method, participants with high FOP--all patients--exhibited hypervigilance for all word types on the dot-probe task when compared with those with low FOP. Implications for various categorical conceptualizations of FOP and future research directions are discussed. PERSPECTIVE: Fear of pain can be used to categorize people into groups more or less vulnerable to disabling effects of pain. When fear of pain groups are derived by using measures of general and pain-specific fearfulness, people with high fear of pain are likely to selectively attend all potentially threatening stimuli in their environment.