Attention bias modification training for adolescents with chronic pain: a randomised placebo controlled trial

Journal article

Attention bias for pain-related information is theorised to maintain chronic pain, indicating that changing this bias could improve pain-related outcomes. Modifying attention biases in adolescents, when chronic pain often first emerges, may be particularly beneficial. We report here a randomized, placebo-controlled, parallel-group trial of Attention Bias Modification (ABM) training in adolescents with chronic non-cancer pain. Adolescent patients (N=66) were randomly assigned to complete multiple sessions of dot-probe ABM training (N=23), placebo training (N=22), or no training (waitlist; N=21) across a period of four weeks. Patients completed all assessments at a hospital-based pediatric pain clinic, and completed all training at home. We examined the relative effects of ABM on attention bias and attention control, as well as pain symptomatology (primary outcome), pain catastrophizing, anxiety and depression symptoms and functional disability (secondary outcomes) immediately after training and three months later. We found no evidence that ABM changed attention bias or attention control in comparison with placebo training or no training. We also found that pain and pain-related outcomes were no different for those undergoing ABM compared with placebo training or no training when tested immediately after training or three months later. Overall, we found no evidence to support the efficacy of dot-probe ABM for improving pain-related outcomes in adolescents with chronic pain.

Authors: Heathcote, L; Jacobs, K; Van Ryckeghem, D; Fisher, E; Eccleston, C

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Lippincott, Williams & Wilkins
• Journal: Pain
• Volume: 159
• Issue: 2
• Pages: 239–251
• Publication date: 2017-10-02
• Acceptance date: 2017-09-29
• DOI: 10.1097/j.pain.0000000000001084
• EISSN: 1872-6623
• ISSN: 0304-3959
• Keywords: cognitive bias; pediatric chronic pain; attention bias modification; randomized controlled trial