Imagery and likelihood cognitive bias in pain

Area of Science:

• Cognitive Psychology
• Pain Research
• Clinical Psychology

Background:

• Distressing intrusive images are common in chronic and acute pain.
• These images correlate with increased anxiety, threat perception, and a belief that the imagined event may occur.
• A cognitive likelihood bias, where negative cognitions increase the probability of negative events, is observed in psychological disorders and may affect pain sufferers.

Purpose of the Study:

• To investigate the occurrence of a cognitive likelihood bias in acute and chronic pain sufferers related to imagery.
• To examine the relationship between this cognitive bias and psychological characteristics.
• To assess the association of the bias with four key cognitive responses to index images.

Main Methods:

• Fifty-nine pain sufferers completed the Image-Event-Fusion-pain (IEF-p) questionnaire to assess cognitive likelihood bias.
• The psychometric properties of the IEF-p scale were evaluated for internal consistency, reliability, factor structure, and validity.
• Participants also completed psychological measures for anxiety, depression, PTSD symptoms, and mental defeat.

Main Results:

• The IEF-p demonstrated robust psychometric properties, including satisfactory reliability and validity.
• The IEF-p scores significantly correlated with cognitive appraisals of index images (responsibility, likelihood, premonition, threat), independent of depression in some cases.
• Higher cognitive bias scores were significantly associated with elevated anxiety, depression, PTSD symptoms, and mental defeat.

Conclusions:

• Pain-related index images are significantly associated with cognitive bias, increased threat perception, and an overestimation of event likelihood.
• The findings suggest a prevalent cognitive bias in pain imagery, similar to Thought-Action-Fusion in OCD.
• This bias is linked to significant psychological distress in pain sufferers.