Effects of chronic pain and pain-related fear on orienting and maintenance of attention: an eye movement study.

UNLABELLED: In this study, effects of chronic pain and pain-related fear on orienting and maintenance of attention toward pain stimuli were evaluated by tracking eye movements within a dot-probe paradigm. The sample comprised matched chronic pain (n = 24) and pain-free (n = 24) groups, each of which included lower and higher fear of pain subgroups. Participants completed a dot-probe task wherein eye movements were assessed during the presentation of sensory pain-neutral, health catastrophe-neutral, and neutral-neutral word pairs. Higher fear of pain levels were associated with biases in 1) directing initial gaze toward health catastrophe words and, among participants with chronic pain, 2) subsequent avoidance of threat as reflected by shorter first fixation durations on health catastrophe words compared to pain-free cohorts. As stimulus word pairs persisted for 2,000 ms, no group differences were observed for overall gaze durations or reaction times to probes that followed. In sum, this research identified specific biases in visual attention related to fear of pain and chronic pain during early stages of information processing that were not evident on the basis of later behavior responses to probes. PERSPECTIVE: Effects of chronic pain and fear of pain on attention were examined by tracking eye movements within a dot-probe paradigm. Heightened fear of pain corresponded to biases in initial gaze toward health catastrophe words and, among participants with chronic pain, subsequent gaze shifts away from these words. No reaction time differences emerged.