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Biased interpretations of ambiguous bodily threat information in adolescents with chronic pain.

Authors
  • Heathcote, L C1
  • Jacobs, K
  • Eccleston, C
  • Fox, E
  • Lau, J Y F
  • 1 1Department of Experimental Psychology, University of Oxford, United Kingdom 2Department of Anesthesiology, Pain, and Perioperative Medicine, Stanford University, United States 3Oxford Centre for Children and Young People in Pain (OxCCYP), Nuffield Orthopaedic Centre, United Kingdom 4Centre for Pain Research, University of Bath, United Kingdom 5Department of Clinical and Health Psychology, Ghent University, Belgium 6Department of Psychology, King's College London, United Kingdom. , (Belgium)
Type
Published Article
Journal
Pain
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Jan 06, 2017
Identifiers
DOI: 10.1097/j.pain.0000000000000781
PMID: 28067692
Source
Medline
License
Unknown

Abstract

Adult chronic pain patients are consistently shown to interpret ambiguous health and bodily information in a pain-related and threatening way. This interpretation bias may play a role in the development and maintenance of pain and disability. However, no studies have yet investigated the role of interpretation bias in adolescent pain patients, despite that pain often first becomes chronic in youth. We administered the Adolescent Interpretations of Bodily Threat (AIBT) task to adolescents with chronic pain (N=66) and adolescents without chronic pain (N=74). Adolescents were 10-18 years old and completed the study procedures either at the clinic (patient group) or at school (control group). We found that adolescents with chronic pain were less likely to endorse benign interpretations of ambiguous pain and bodily-threat information than adolescents without chronic pain, particularly when reporting on the strength of belief in those interpretations being true. These differences between patients and controls were not evident for ambiguous social situations, and they could not be explained by differences in anxious or depressive symptoms. Further, this interpretation pattern was associated with increased levels of disability among adolescent patients, even after controlling for severity of chronic pain and pain catastrophizing. The current findings extend our understanding of the role and nature of cognition in adolescent pain, and provide justification for employing the AIBT task in longitudinal and training studies to further investigate causal associations between interpretation bias and chronic pain.

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