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S409 EXAMINING IMPLICIT INTERPRETATION BIAS IN RELATION WITH PAIN-RELATED ANXIETY AND PAIN RESPONSIVENESS
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POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
Participants were required to think of potential future experiences occurring over three different time periods within a given time limit, including a positive/negative condition. An additional coding scheme was devised to categorize positive/negative experiences into health-related versus not health-related future experiences. Results: Univariate effects revealed that depressed pain patients showed reduced anticipation of positive experiences and increased anticipation of negative experiences relative to non-depressed pain patients and control participants. As hypothesised, depressed pain patients generated higher scores for total negative health-related future experiences summed over the three time periods compared to non-depressed pain patients and controls. Conclusions: Our findings suggest that the cognitive processing of general future thinking in depressed pain patients is not different in chronic pain, but the focus of future experiences is more on negative health experiences compared to non-depressed patients. Further research is needed to examine the precise object of futurerelated anxieties and distress, and its impact on self-identity. Disclosure: None declared
S409 EXAMINING IMPLICIT INTERPRETATION BIAS IN RELATION WITH PAIN-RELATED ANXIETY AND PAIN RESPONSIVENESS L.M.G. Vancleef *, M.M. Hanssen, M.L. Peters. Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands Background and Aims: Relying on explicit measure of interpretation bias (IB) predominantly, prior studies demonstrated pain patients and healthy individuals high in pain-related anxiety to show a pain-directed IB. The present studies examined the association between pain-related anxiety and implicit IB towards physical health threat. Furthermore, the relation between IB and responses to experimentally induced pain was explored. Methods: Healthy participants perform a homograph priming task in which ambiguous primes are followed by a semantically related or unrelated target word that requires a lexical decision. In some trials, the target word is related to the prime in either a health threatening or a non-health threatening manner. IB is derived from RT to these trials. Pain related anxiety is assessed with self report instruments. For the assessment of pain responses, heat pain is induced at the lower wrist of the dominant arm, starting at 32°C and gradually increasing (1°C/s) until the participant breaks of the stimulus (pain tolerance). VAS scales assess pain intensity and pain unpleasantness. Results: In accordance with explicit IB studies, results demonstrate a positive correlation between pain anxiety levels and IB, and a negative correlation between IB and pain tolerance. Conclusions: These studies give evidence for the occurrence of implicit IB in function of pain anxiety, and for its relation with pain responsiveness. Further studies need to adress the differential value of explicit and implicit IB, and their relative contribution to pain responsiveness. This research is supported by Netherlands Organisation for Scientific Research (NWO-VI; 451–09–026) Disclosure: None declared
S410 A SUPRAMODAL REPRESENTATION OF THE BODY SURFACE F. Mancini1,2 *, M. Longo3 , G. Iannetti2 , P. Haggard2 . 1 University of Milan Bicocca, Milano, Italy; 2 UCL, 3 Birkbeck, University of London, London, UK Background and Aims: The ability to accurately localize both tactile and painful sensations on the body is one of the most important functions of the somatosensory system. Most accounts of localization refer to the systematic spatial relation between skin receptors and cortical neurons. The topographic organization of somatosensory neurons in the brain provides a map of the sensory surface. However, systematic distortions in perceptual localization
tasks suggest that localizing a somatosensory stimulus involves more than simply identifying specific active neural populations within a somatotopic map. Thus, perceptual localization may depend on both afferent inputs and other unknown factors. Methods: In four experiments, we investigated whether localization biases vary according to the specific skin regions and subset of afferent fibers stimulated. We represented localization errors as a ‘perceptual map’ of skin locations. We compared the perceptual maps of stimuli that activate Ab (innocuous touch), Ad (pinprick pain), and C fibers (non-painful heat) on both the hairy and glabrous skin of the left hand. Perceptual maps exhibited systematic distortions that strongly depended on the skin region stimulated. Results: We found systematic distal and radial biases in localization of touch, pain, and heat on the hand dorsum. A less consistent proximal bias was found on the palm. These distortions were independent of the population of afferent fibers stimulated, and also independent of the response modality used to report localization. Conclusions: We argue that these biases are likely to have a central origin, and result from a supramodal representation of the body surface. Disclosure: None declared
S411 PROBLEM SOLVING AND THE FEARED-FOR SELF IN CHRONIC PAIN C. Wells, S. Morley *. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK Background and Aims: Many patients with chronic pain persist in attempts to solve the problem of pain (assimilative problem solving) when there is no possible solution. Furthermore they fail to switch their problem solving strategies to other, more important life goals (accommodative problem solving). It is hypothesised that persistence with non-functional assimilative problem solving is associated with proximity to the person’s feared-for self and represents attempts to escape from the feared-for future. This study provides an initial test of this hypothesis. Methods: 58 chronic pain patients were assessed on two problem solving measures (PaSol questionnaire and the MEPSforPain task – which requires participants to generate solutions to a series of problems), a measure of the feared-for self, and several control measures (HAD, PDI, Word fluency, CPAQ). The PaSol assesses assimilative problem solving; the MEPSforPain measures assimilative and accommodative problem solving. Results: We present summary statistics of all measures. Inter-rater reliability of the MEPSforPain was good. As predicted both measures of assimilative problem solving were associated with proximity to the feared-for self. Participants who perceived themselves as enmeshed (trapped) by pain also reported more assimilative problem solving. In contrast participant who were further from their feared-for self and less enmeshed were more likely to engage in accommodative problem solving. Conclusions: There is preliminary evidence that proximity to the self is a relevant construct. The MEPSforPain is a plausible measure of problem solving. The direction of the effects can be tested by experimentally enhancing participants’ specific problem solving skills. Disclosure: None declared
S412 GOALS, MOOD AND COGNITIVE TASK PERFORMANCE DURING EXPERIMENTALLY INDUCED MECHANICAL PRESSURE PAIN P.A. Karsdorp1 *, R. Saskia1 , N. Saskia1 , J.W. Vlaeyen1,2 . 1 Maastricht University, Maastricht, The Netherlands; 2 University of Leuven, Leuven, Belgium Background and Aims: Pain-related fear has shown to predict behavioural performance in clinical and experimental pain. The
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
Participants were required to think of potential future experiences occurring over three different time periods within a given time limit, including a positive/negative condition. An additional coding scheme was devised to categorize positive/negative experiences into health-related versus not health-related future experiences. Results: Univariate effects revealed that depressed pain patients showed reduced anticipation of positive experiences and increased anticipation of negative experiences relative to non-depressed pain patients and control participants. As hypothesised, depressed pain patients generated higher scores for total negative health-related future experiences summed over the three time periods compared to non-depressed pain patients and controls. Conclusions: Our findings suggest that the cognitive processing of general future thinking in depressed pain patients is not different in chronic pain, but the focus of future experiences is more on negative health experiences compared to non-depressed patients. Further research is needed to examine the precise object of futurerelated anxieties and distress, and its impact on self-identity. Disclosure: None declared
S409 EXAMINING IMPLICIT INTERPRETATION BIAS IN RELATION WITH PAIN-RELATED ANXIETY AND PAIN RESPONSIVENESS L.M.G. Vancleef *, M.M. Hanssen, M.L. Peters. Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands Background and Aims: Relying on explicit measure of interpretation bias (IB) predominantly, prior studies demonstrated pain patients and healthy individuals high in pain-related anxiety to show a pain-directed IB. The present studies examined the association between pain-related anxiety and implicit IB towards physical health threat. Furthermore, the relation between IB and responses to experimentally induced pain was explored. Methods: Healthy participants perform a homograph priming task in which ambiguous primes are followed by a semantically related or unrelated target word that requires a lexical decision. In some trials, the target word is related to the prime in either a health threatening or a non-health threatening manner. IB is derived from RT to these trials. Pain related anxiety is assessed with self report instruments. For the assessment of pain responses, heat pain is induced at the lower wrist of the dominant arm, starting at 32°C and gradually increasing (1°C/s) until the participant breaks of the stimulus (pain tolerance). VAS scales assess pain intensity and pain unpleasantness. Results: In accordance with explicit IB studies, results demonstrate a positive correlation between pain anxiety levels and IB, and a negative correlation between IB and pain tolerance. Conclusions: These studies give evidence for the occurrence of implicit IB in function of pain anxiety, and for its relation with pain responsiveness. Further studies need to adress the differential value of explicit and implicit IB, and their relative contribution to pain responsiveness. This research is supported by Netherlands Organisation for Scientific Research (NWO-VI; 451–09–026) Disclosure: None declared
S410 A SUPRAMODAL REPRESENTATION OF THE BODY SURFACE F. Mancini1,2 *, M. Longo3 , G. Iannetti2 , P. Haggard2 . 1 University of Milan Bicocca, Milano, Italy; 2 UCL, 3 Birkbeck, University of London, London, UK Background and Aims: The ability to accurately localize both tactile and painful sensations on the body is one of the most important functions of the somatosensory system. Most accounts of localization refer to the systematic spatial relation between skin receptors and cortical neurons. The topographic organization of somatosensory neurons in the brain provides a map of the sensory surface. However, systematic distortions in perceptual localization
tasks suggest that localizing a somatosensory stimulus involves more than simply identifying specific active neural populations within a somatotopic map. Thus, perceptual localization may depend on both afferent inputs and other unknown factors. Methods: In four experiments, we investigated whether localization biases vary according to the specific skin regions and subset of afferent fibers stimulated. We represented localization errors as a ‘perceptual map’ of skin locations. We compared the perceptual maps of stimuli that activate Ab (innocuous touch), Ad (pinprick pain), and C fibers (non-painful heat) on both the hairy and glabrous skin of the left hand. Perceptual maps exhibited systematic distortions that strongly depended on the skin region stimulated. Results: We found systematic distal and radial biases in localization of touch, pain, and heat on the hand dorsum. A less consistent proximal bias was found on the palm. These distortions were independent of the population of afferent fibers stimulated, and also independent of the response modality used to report localization. Conclusions: We argue that these biases are likely to have a central origin, and result from a supramodal representation of the body surface. Disclosure: None declared
S411 PROBLEM SOLVING AND THE FEARED-FOR SELF IN CHRONIC PAIN C. Wells, S. Morley *. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK Background and Aims: Many patients with chronic pain persist in attempts to solve the problem of pain (assimilative problem solving) when there is no possible solution. Furthermore they fail to switch their problem solving strategies to other, more important life goals (accommodative problem solving). It is hypothesised that persistence with non-functional assimilative problem solving is associated with proximity to the person’s feared-for self and represents attempts to escape from the feared-for future. This study provides an initial test of this hypothesis. Methods: 58 chronic pain patients were assessed on two problem solving measures (PaSol questionnaire and the MEPSforPain task – which requires participants to generate solutions to a series of problems), a measure of the feared-for self, and several control measures (HAD, PDI, Word fluency, CPAQ). The PaSol assesses assimilative problem solving; the MEPSforPain measures assimilative and accommodative problem solving. Results: We present summary statistics of all measures. Inter-rater reliability of the MEPSforPain was good. As predicted both measures of assimilative problem solving were associated with proximity to the feared-for self. Participants who perceived themselves as enmeshed (trapped) by pain also reported more assimilative problem solving. In contrast participant who were further from their feared-for self and less enmeshed were more likely to engage in accommodative problem solving. Conclusions: There is preliminary evidence that proximity to the self is a relevant construct. The MEPSforPain is a plausible measure of problem solving. The direction of the effects can be tested by experimentally enhancing participants’ specific problem solving skills. Disclosure: None declared
S412 GOALS, MOOD AND COGNITIVE TASK PERFORMANCE DURING EXPERIMENTALLY INDUCED MECHANICAL PRESSURE PAIN P.A. Karsdorp1 *, R. Saskia1 , N. Saskia1 , J.W. Vlaeyen1,2 . 1 Maastricht University, Maastricht, The Netherlands; 2 University of Leuven, Leuven, Belgium Background and Aims: Pain-related fear has shown to predict behavioural performance in clinical and experimental pain. The