Effects of higher versus lower threat contexts on pain-related attention biases: An eye-tracking study

Threat is hypothesized to affect the degree to which pain captures attention but little is known about its impact on dynamic courses of attention towards pain. In this eye-tracking study, we evaluated pain-related visual attention biases during image pair presentations in comparatively lower versus higher threat conditions.

Gaze biases of healthy adults (47 women, 35 men) were assessed during image presentation phases standardized across (1) a modified visual dot-probe task featuring painful-neutral (pain) and neutral-neutral contrast (neutral) image pair blocks (lower threat context); and (2) an impending pain task wherein the same image pair blocks, respectively, cued potentially painful postoffset somatosensory stimuli (higher threat context) and its absence.

Across tasks, participants were more often oriented towards, gazed longer at, and fixated more times on pain images in pain block trials, although trait fear of pain was not related to any gaze biases. Critically, however, participants reported more state fear and displayed significantly fewer initial fixations, longer first and overall gaze durations, and more unique fixations on pain images when image pairs signalled possible postoffset pain stimulation.

Results underscored stronger overall attention maintenance on visual pain cues in a higher threat (impending pain) context.

Through considering gaze parameters during image presentation phases of dot-probe and impending pain tasks, possible effects of lower versus higher threat contexts on attention biases were elucidated. Participants reported more fear and gazed longer at painful than neutral images in the higher threat context whereby image pairs cued possible pain.