Attentional bias in breakthrough pain and the moderating effect of gender: a preliminary study

  • S. Bae
  • B. Jin
  • T. Jeong
  • J. Choi
  • S. Cho


Background: Attentional bias to pain-related stimuli varies according to its threat value. Breakthrough pain is temporary and considerably severe. Thus, patients with breakthrough pain are more likely to perceive pain-related stimuli as a threat than those without breakthrough pain. In addition, gender is also a factor affecting the perception of pain-related stimuli as a threat. This study examined the effects of breakthrough pain and gender on attentional bias. Methods: This study recruited 11 and 13 patients with and without breakthrough pain, respectively, among patients with chronic pain at a university hospital in Suwon, South Korea. The participants’ eye movements were recorded using an eye tracker during a free viewing task that features sensory pain-neutral, affective pain-neutral, and neutral-neutral word pairs. Three-way ANOVA was conducted on the attentional bias indices. Findings: For females, the breakthrough pain group had a longer first fixation time and average fixation time on neutral words than sensory-pain words, whereas the non-breakthrough pain group had a longer first fixation time and average fixation time on sensory-pain words than neutral words. However, there was no significant difference in the affective-pain words, regardless of the group. For males, there was no significant difference in the attentional bias indices, regardless of the group and word type. Discussion: This study revealed different attention patterns for pain-related stimuli depending on the breakthrough pain and gender. These findings suggest that females with breakthrough pain tend to avoid pain-sensory words, whereas those without breakthrough pain tend to have difficulty in disengaging from pain-sensory words.
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