The way in which individuals attend to pain-related stimuli is thought to affect their pain experience. Early and late stages of processing, with shifts from attentional engagement to disengagement (avoidance), have been identified, but rarely investigated in the same protocol. Therefore, the present study aimed to consider 2 time frames that might be indicative of attentional engagement and disengagement. One hundred pain-free individuals performed a modified dot-probe task with pictorial stimuli displaying affective facial expressions (ie, pain, anger, joy, neutral face), presented either for 100 ms or for 500 ms. Because fear of pain has been found to moderate attentional processing of pain stimuli, the Fear of Pain Questionnaire (FPQ III) was also administered. Results indicated both early attentional engagement and later disengagement (avoidance) for negative facial expressions (anger, pain). This pattern was most prominent for pain faces and among those participants high in pain-related fear. Taken together, these findings provide evidence that the dot-probe task is suitable to investigate different stages of attentional processing for pain-related stimuli. In accordance with the vigilance-avoidance hypothesis, pain-related stimuli seem to attract attention quickly, but attentional avoidance may occur shortly after. Perspective: We focused on different stages of attentional processing of pain faces in pain-free individuals. Results highlight the importance of distinguishing between early (engagement) and later (disengagement) components of attention, as well as considering the role that fear of pain has in understanding the nature of these effects.
Baum, C., Schneider, R., Keogh, E., & Lautenbacher, S. (2013). Different stages in attentional processing of facial expressions of pain: A dot-probe task modification. Journal of Pain, 14(3), 223-232. https://doi.org/10.1016/j.jpain.2012.11.001