Colloquium: Speaker Professor LOUISE SHARPE (University of Sydney) The role of attentional biases in the development and management of pain

The literature investigating attentional biases in chronic pain has been mixed, however, a recent meta-analysis has confirmed the presence of attentional biases in chronic pain patients that are similar to those observed in patients with anxiety disorders. However, unlike the anxiety disorders, there is relatively little evidence that has assessed the role of attentional biases prospectively as a predictor of subsequent pain. Indeed, although all four studies that have assessed attentional biases as a predictor of future pain have found that biases predict subsequent, clinically meaningful pain, the nature of biases that predict pain in these studies has been different to the pattern of biases that are found in patients with chronic pain. That is, while chronic pain patients show a bias towards sensory pain words, it has been a bias away from affective pain words or towards happy words that has been associated in prospective studies with chronic pain. These results seem to support the role of vigilance-avoidance hypothesis of attention in the development of chronic painful conditions. Understanding the attentional mechanisms associated with the development of chronic pain is important because interventions, such as attention bias modification (ABM) have shown good preliminary results in the management of anxiety disorders. Indeed, results of two laboratory based studies and two field studies in the area of pain will be presented to demonstrate that ABM has considerable potential in the management of pain conditions also. However, the results of recent prospective work have important implications for optimizing ABM protocols specifically for pain patients, which will be discussed.