Researchers have previously identified thought suppression as a risk factor in chronic pain. Data from studies on the role of attentional bias in chronic pain support the idea of a relationship more complex than predicted by the fear-avoidance model. Thought suppression may be a pathway, alternate to attentional fixation, following attentional bias to pain-related information. The purpose of this web-based study was to explore the relationship between attentional bias and thought suppression in adults with chronic pain. It was hypothesized that participants with chronic pain would exhibit higher pain-related attentional bias and thought suppression than would pain-free participants, and that thought suppression will be positively correlated with both pain-related attentional bias and pain interference. Participants (N = 298) with and without chronic pain were recruited via Mechanical Turk, and were asked to complete the following: a modified Stroop task, an online questionnaire comprising the White Bear Thought Suppression Inventory, the PROMIS Pain Interference Short Form-8a, the CDC Health-Related Quality of Life measure, and questions regarding demographics and pain location/intensity. A modified Stroop task was used to capture pain-related attentional bias. The task involved quickly responding to neutral and pain-related words in different font colors by pressing keys corresponding to font color. Mann-Whitney U test was performed to compare differences in pain-related attentional bias between groups, and results suggest that individuals with chronic pain (N = 189) experience higher pain-related attentional bias (p = .045) compared to non-pain individuals (N = 109), as indicated by higher number of milliseconds taken to respond to pain-related stimuli but not to neutral stimuli on the modified Stroop task. Mann-Whitney U test was also performed to compare differences in thought suppression between groups, and results suggest that individuals with chronic pain utilized thought suppression significantly more than did pain-free individuals (p = .037). Multiple hierarchical regression to explore predictive relationships between thought suppression and pain-related attentional bias was not significant (p = .171). The relationships between pain-related attentional bias, thought suppression, and health-related quality of life were also explored.
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