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Journal ArticleDOI

Cognitive biases in pain: an integrated functional-contextual framework.

01 Jul 2019-Pain (LIPPINCOTT WILLIAMS & WILKINS)-Vol. 160, Iss: 7, pp 1489-1493
TL;DR: This work aims to demonstrate the efforts towards in-situ applicability of EMT in the context of clinical practice and to provide a basis for future research in this area.
Abstract: 1 Section Experimental Health Psychology, Clinical Psychological Science, Departments, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands 2 Institute for Health and Behaviour, INSIDE, University of Luxembourg, Luxembourg 3 Department of Psychology, University of Calgary; Alberta Children’s Hospital Research Institute; Hotchkiss Brain Institute; Canada 4 Department of Psychology, Royal Holloway University of London, United Kingdom 5 School of Psychology, University of Sydney, Australia 6 Department of Experimental Clinical and Health Psychology, Ghent University, Belgium

Summary (3 min read)

1. Introduction

  • A revolution in biology has occurred as a result of recent advances in molecular biology, a field of science concerned with the study of chemical structures and processes of biological phenomenon at the molecular level.
  • As molecular biology has great influence in the studies of marine ecosystems, it becomes important to review how molecular tools can be applied for the advances in the marine sciences.
  • Sequencing total genomes of many organisms is a rapidly advancing research area.

2.1. Marine microbiology

  • Marine microbes have defined the chemistry of the oceans and atmosphere over evolutionary time (Redfield, 1958).
  • Molecular approach has also been used to detect the genes responsible for the production of different enzymes in marine bacteria (Ramaiah et al., 2000a and 2000b).
  • Environmental genomics is also revealing bacterial interactions with marine animals, and its influences on animal populations and ecosystem function (Thakur and Müller, 2005).
  • This project demonstrated that shotgun sequencing provides a wealth of phylogenetic markers that can be used to assess the phylogenetic diversity of a sample with more power than conventional PCRbased rRNA studies allow (Venter et al., 2004).
  • In the study of environmental microbiology, DNA microarray technology has also been introduced.

2.2. Marine invertebrate biology

  • Most of the animal phyla are either exclusively or predominantly marine but these organisms are not investigated extensively from their biological point of view.
  • Researchers are concentrating on few marine model organisms like sponges, corals, sea urchins, tunicates etc. to study their biological features.
  • Some interesting results are emerging (Davidson et al., 2003).
  • Microarray studies have been carried out to investigate development in Urochordate, as this group represents a quite simple model to study gene networks when compared with vertebrates (Azumi et al., 2003a).

2.3. Marine ecology

  • The genetic tools have shown to be of great significance in addressing novel questions in the fields of ecology.
  • Marine organisms, in general, have not been studied as extensively as their terrestrial counterparts, although studies of marine organisms have made major contributions to their fundamental understandings of ecological factors such as keystone species, predation and competition (Molecular biology in marine science, 1994).
  • Marine biologists have led the study of ecological interactions for several decades, but molecular techniques have been introduced recently in this field giving significant advances in their comprehension of complex systems of modes of action.
  • Understanding the control of spatial and temporal distributions of marine organisms is becoming increasingly important as the authors attempt to determine how natural and humancaused environmental changes affect population sizes, extinction and invasion of new species.
  • The applications of different molecular tools in the field of marine ecology have been discussed by several researchers (Burton, 1996; Rocha-Olivares, 1998).

2.4 Marine natural products

  • Marine organisms comprise approximately half of the total biodiversity on the earth and the marine ecosystem is the greatest source to discover useful therapeutics (Blunt et al., 2005; Faulkner, 2002).
  • The presence or absence of fragments, resulting from changes in recognition sites, is used to identify species or populations.
  • Several researchers have successfully isolated polyketide biosynthetic genes from marine bacteria and fungi, which have been cloned, sequenced and expressed in heterologous hosts.
  • Efforts are underway to identify, analyze and express a set of genes present in the genome of marine organism that encodes a chain of enzymes, which ultimately synthesize the bioactive compounds.

2.5. Material sciences

  • Biosilicification, the biological formation of opal-like amorphous hydrated silica, occurs on a globally vast scale in a wide variety of organisms, including diatoms, sponges, molluscs, and higher plants (reviewed in Bäuerlein, 2004).
  • Siliceous sponges are unique among silica forming organisms in their ability to catalyze silica formation using a specific enzyme termed silicatein (reviewed in Weaver and Morse 2003).
  • Silica is also an important material in nano (bio)technology.

2.6 Fisheries

  • Genome studies of different commercially important fish and the genetic variability of their populations has been reviewed earlier (Molecular biology in marine science, 1994).
  • Such information is essential for effective management of oceanic fish populations.
  • These studies demonstrate the promise of molecular techniques for addressing questions that were previously difficult to answer.
  • The identification of essentially self-recruiting populations as units for fisheries management is a prerequisite for the conservation and sustainable utilization of fish biodiversity.
  • Novel genetic technologies involving the use of DNA based tools are also under development for a range of aquaculture species.

2.7. Conservation and bio-invasion

  • Molecular markers provide valuable information on the status and the significance of endangered species and populations, and thus are vital for the identification of conservation priorities (Haig, 1997).
  • Numbers of molecular and quantitative genetics approaches have been combined to investigate and protect endangered marine species.
  • Marine bioinvasion is the introduction of marine organisms alien to local ecosystem through ship hulls and ballast water.
  • This process has serious consequences to native biota, fishery and general coastal ecosystem (Anil et al., 2002).
  • For the reliable monitoring of ships ballast, specific nested PCR-based tests for detection of the harmful species in environmental and ballast water samples have been developed recently (Deagle et al., 2003).

2.8. Biofouling and bioremediation

  • Characterization of biofilm structure using molecular approaches offer considerable potential for finding novel biofouling prevention strategies.
  • These problems include catastrophic spills of oil in harbors and shipping lanes and around oil platforms; movement of toxic chemicals from land, through estuaries, into the coastal oceans; disposal of sewage sludge, bilge waste, and chemical process wastes, etc.
  • During the last decades, major advances have been made in understanding the mechanisms of interactions between microorganisms and pollutants and in the application of specialized microorganisms for the in situ and ex situ treatment of organic xenobiotics, heavy metal and oil.
  • Molecular biological methods for the identification and characterization of bacteria and their specific properties have been used to assess the composition and activity of microbial communities at contaminated sites (Geets et al., 2003).
  • Molecular biology has great impact in the analysis of environmental quality as well.

3. Summary and outlook

  • Marine molecular biology is a discipline, which strives to define and solve the problems regarding the sustainable exploitation of marine life for human health and welfare, through the cooperation between scientists working in marine biology, molecular biology, microbiology and chemistry.
  • Such collaboration is now going on successfully in several laboratories world wide.
  • Several pioneering success stories of the application of molecular techniques in the field of marine biology are guiding further research in this area.
  • A mechanism is also needed to promote collaborative partnership of academic marine scientists with private industry and to permit appropriate research findings on marine organisms to be transferred rapidly to the private sector for commercialization.

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Citations
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Journal ArticleDOI
TL;DR: This study addresses the gap in understanding how having cancer shapes children's experience and meaning of pain after treatment has ended by exploring childhood cancer survivors' (CCS') experiences of pain from their perspective and the perspective of their parents.
Abstract: Objective Today, more than 80% of children diagnosed with cancer are expected to survive. Despite the high prevalence of pain associated with the diagnosis and treatment of childhood cancer, there is a limited understanding of how having cancer shapes children's experience and meaning of pain after treatment has ended. This study addresses this gap by exploring childhood cancer survivors' (CCS') experiences of pain from their perspective and the perspective of their parents. Methods Twenty semi-structured interviews were completed with CCS (50% female; mean age = 13.20 y, range = 8-17 y) and their parents (90% mothers). Data were analyzed using interpretive phenomenological analysis. Results Analyses revealed three superordinate themes present in the data: (a) pain is a changed experience after childhood cancer; (b) new or ambiguous pains may be interpreted by CCS and parents as a threat of disease recurrence, late effects, or a secondary cancer; and (c) pain interpretation occurs within the broader context of how CCS and parents appraise their cancer experience. Parents generally appraised their child's cancer and pain as more threatening and were influential in guiding their child's interpretations. Conclusions The cancer experience played an important role in shaping CCS' and their parents' experience and interpretation of pain in survivorship. This study provides novel data to inform the development and refinement of new and existing conceptual models of pain and symptom perception after cancer. The results also point to key areas for future investigation and clinical intervention to address the issue of pain in cancer survivorship.

25 citations

Journal ArticleDOI
TL;DR: The majority of studies suggest that people with and without chronic pain do not differ in their eye movements on pain-related stimuli, although there is preliminary evidence that gaze biases vary across subtypes of chronic pain and may be evident only for certain stimuli.

19 citations

Journal ArticleDOI
TL;DR: In taking a wide view of pain and action, this review places the relationship between pain, motivation and action at its core, unpicking a dynamic process that can become stuck.
Abstract: Background What is it that motivates our actions? As human beings, existing as part of complex societies, the actions we take are subject to multiple, often competing motives. Spanning non-conscious reflexes, cognitively derived choice as well as long- and short-term goals, our actions allow us to make sense of our environment. Pain disrupts action and hijacks our intentions. Whilst considered adaptive when temporary, pain that persists continues to interrupt and can threaten our ability to actively investigate a changing world. Objective This work is a narrative review. Results Drawing upon three complementary theoretical approaches to pain: an embodied framework, a motivational approach and the avoidance-endurance model, this review places the relationship between pain, motivation and action at its core, unpicking a dynamic process that can become stuck. Conclusions In taking a wide view of pain and action, we expose the nuances within drive to goal behaviour in the presence of pain. This has implications for the clinic, specifically in relation to assessing the multifactorial influences that shape action in pain. But it also seeks to go further, considering the broader environment in which we make decisions and the influence that other professionals, outside of typical healthcare roles, may play a part in the maintenance and resolution of pain.

16 citations

Journal ArticleDOI
TL;DR: Vigilance–avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients are supported.
Abstract: Introduction:This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional ...

16 citations

Journal ArticleDOI
TL;DR: It is confirmed that attentional control is necessary for an association between attentional bias and catastrophizing to be observed, which may explain the lack of relationships between attentionAL bias and individual characteristics, such as catastrophize, in prior research.
Abstract: Cognitive models of chronic pain emphasize the critical role of pain catastrophizing in attentional bias to pain-related stimuli. The aim of this study was (a) to investigate the relationship between pain catastrophizing and the ability to inhibit selective attention to pain-related faces (attentional bias); and (b) to determine whether attentional control moderated this relationship. One hundred and ten pain-free participants completed the anti-saccade task with dynamic facial expressions, specifically painful, angry, happy, and neutral facial expressions and questionnaires including a measure of pain catastrophizing. As predicted, participants with high pain catastrophizing had significantly higher error rates for antisaccade trials with pain faces relative to other facial expressions, indicating a difficulty disinhibiting attention towards painful faces. In moderation analyses, data showed that attentional control moderated the relationship between attentional bias to pain faces and pain catastrophizing. Post-hoc analyses demonstrated that it was shifting attention (not focusing) that accounted for this effect. Only for those with high self-reported ability to shift attention was there a significant relationship between catastrophizing and attentional bias to pain. These findings confirm that attentional control is necessary for an association between attentional bias and catastrophizing to be observed, which may explain the lack of relationships between attentional bias and individual characteristics, such as catastrophizing, in prior research.

14 citations

References
More filters
Journal ArticleDOI
01 Apr 2000-Pain
TL;DR: In this article, the authors reviewed the existing evidence for the mediating role of pain-related fear, and its immediate and long-term consequences in the initiation and maintenance of chronic pain disability.
Abstract: In an attempt to explain how and why some individuals with musculoskeletal pain develop a chronic pain syndrome, Lethem et al. (Lethem J, Slade PD, Troup JDG, Bentley G. Outline of fear-avoidance model of exaggerated pain perceptions. Behav Res Ther 1983; 21: 401-408).ntroduced a so-called 'fear-avoidance' model. The central concept of their model is fear of pain. 'Confrontation' and 'avoidance' are postulated as the two extreme responses to this fear, of which the former leads to the reduction of fear over time. The latter, however, leads to the maintenance or exacerbation of fear, possibly generating a phobic state. In the last decade, an increasing number of investigations have corroborated and refined the fear-avoidance model. The aim of this paper is to review the existing evidence for the mediating role of pain-related fear, and its immediate and long-term consequences in the initiation and maintenance of chronic pain disability. We first highlight possible precursors of pain-related fear including the role negative appraisal of internal and external stimuli, negative affectivity and anxiety sensitivity may play. Subsequently, a number of fear-related processes will be discussed including escape and avoidance behaviors resulting in poor behavioral performance, hypervigilance to internal and external illness information, muscular reactivity, and physical disuse in terms of deconditioning and guarded movement. We also review the available assessment methods for the quantification of pain-related fear and avoidance. Finally, we discuss the implications of the recent findings for the prevention and treatment of chronic musculoskeletal pain. Although there are still a number of unresolved issues which merit future research attention, pain-related fear and avoidance appear to be an essential feature of the development of a chronic problem for a substantial number of patients with musculoskeletal pain.

3,695 citations

Journal Article
30 Mar 2000-Brain
TL;DR: A review of the existing evidence for the mediating role of pain‐related fear, and its immediate and long‐term consequences in the initiation and maintenance of chronic pain disability, and the implications of the recent findings for the prevention and treatment of chronic musculoskeletal pain.
Abstract: &NA; In an attempt to explain how and why some individuals with musculoskeletal pain develop a chronic pain syndrome, Lethem et al.(Lethem J, Slade PD, Troup JDG, Bentley G. Outline of fear‐avoidance model of exaggerated pain perceptions. Behav Res Ther 1983; 21: 401‐408).ntroduced a so‐called ‘fear‐avoidance’ model. The central concept of their model is fear of pain. ‘Confrontation’ and ‘avoidance’ are postulated as the two extreme responses to this fear, of which the former leads to the reduction of fear over time. The latter, however, leads to the maintenance or exacerbation of fear, possibly generating a phobic state. In the last decade, an increasing number of investigations have corroborated and refined the fear‐avoidance model. The aim of this paper is to review the existing evidence for the mediating role of pain‐related fear, and its immediate and long‐term consequences in the initiation and maintenance of chronic pain disability. We first highlight possible precursors of pain‐related fear including the role negative appraisal of internal and external stimuli, negative affectivity and anxiety sensitivity may play. Subsequently, a number of fear‐related processes will be discussed including escape and avoidance behaviors resulting in poor behavioral performance, hypervigilance to internal and external illness information, muscular reactivity, and physical disuse in terms of deconditioning and guarded movement. We also review the available assessment methods for the quantification of pain‐related fear and avoidance. Finally, we discuss the implications of the recent findings for the prevention and treatment of chronic musculoskeletal pain. Although there are still a number of unresolved issues which merit future research attention, pain‐related fear and avoidance appear to be an essential feature of the development of a chronic problem for a substantial number of patients with musculoskeletal pain.

3,661 citations


"Cognitive biases in pain: an integr..." refers background in this paper

  • ...The second assumption proposes that cognitive biases are dynamic, fluctuating, and unfolding phenomena driven by motivational and contextual factors, rather than stable trait-like processes as often implicitly presumed.(8,67,68,94) This is supported by increasing evidence that cognitive biases are influenced by active goal pursuit and contextual factors....

    [...]

  • ...These models assume that cognitive biases are maladaptive, trait-like processes, and propose that individuals who selectively attend to pain-related information (attention bias), interpret ambiguous pain and/or health relevant information as threatening (interpretation bias), and/or recall pain-related information selectively or as more negative/threatening than initially experienced (memory bias), report higher levels of pain and disability and are at increased risk for developing chronic pain.(10,11,15,16,51,56,77,87,93,94) This intuitively appealing idea has resulted in an exponential increase in research addressing the presence, antecedents, and consequences of cognitive biases in people experiencing acute and chronic pain....

    [...]

Journal ArticleDOI
TL;DR: Acceptance and Commitment Therapy (ACT) as discussed by the authors is one of a number of new interventions from both behavioral and cognitive wings that seem to be moving the field in a different direction.

1,996 citations

Journal ArticleDOI
TL;DR: A model of the interruptive function of pain is developed that holds that pain is selected for action from within complex affective and motivational environments to urge escape.
Abstract: Pain interrupts and demands attention. The authors review evidence for how and why this interruption of attention is achieved. The interruptive function of pain depends on the relationship between pain-related characteristics (e.g., the threat value of pain) and the characteristics of the environmental demands (e.g., emotional arousal). A model of the interruptive function of pain is developed that holds that pain is selected for action from within complex affective and motivational environments to urge escape. The implications of this model for research and therapy are outlined with an emphasis on the redefinition of chronic pain as chronic interruption.

1,505 citations


"Cognitive biases in pain: an integr..." refers background in this paper

  • ...These models assume that cognitive biases are maladaptive, trait-like processes, and propose that individuals who selectively attend to pain-related information (attention bias), interpret ambiguous pain and/or health relevant information as threatening (interpretation bias), and/or recall pain-related information selectively or as more negative/threatening than initially experienced (memory bias), report higher levels of pain and disability and are at increased risk for developing chronic pain.(10,11,15,16,51,56,77,87,93,94) This intuitively appealing idea has resulted in an exponential increase in research addressing the presence, antecedents, and consequences of cognitive biases in people experiencing acute and chronic pain....

    [...]

Book
01 Jun 1992
TL;DR: Theories of Anxiety and Cognition and theoretical Framework: A Framework for Investigating Attentional Processes and Comprehension and Memory.
Abstract: Theorists are increasingly arguing that it is fruitful to approach anxiety from the cognitive perspective, and the empirical evidence supports that contention. The cognitive perspective is also adopted in this book, but the approach represents a development and extension of earlier ones. For example, most previous theories and research have been based on anxiety either in clinical or in normal groups. In contrast, one of the central themes of this book is that there are great advantages to be gained from a joint consideration of clinical and normal anxiety.Another theme of this book is that it is of major importance to establish whether or not there is a cognitive vulnerability factor which is associated with at least some forms of clinical anxiety. It is argued (with supporting evidence) that there is a latent cognitive vulnerability factor for generalized anxiety disorder which manifests itself under stressful conditions. This vulnerability factor is characterized by hypervigilance, and is found predominantly in normals high in the personality dimension of trait anxiety.The scope of the book extends to the effects of anxiety on performance and to the phenomenon of worry, which is regarded as the cognitive component of anxiety. In both cases, a new theoretical framework is presented.

1,163 citations


"Cognitive biases in pain: an integr..." refers background in this paper

  • ..., pain patients more often use pain-related words than healthy persons) can explain cognitive bias findings due to better recall of and altered attention to familiar information.(20,63) In similar vein, the link between various cognitive biases should be investigated in relation to similar relevant stimuli, as the presence and magnitude of biases may be determined by the particular type and relevance of pain-related stimuli....

    [...]

Frequently Asked Questions (5)
Q1. What are the contributions mentioned in the paper "Cognitive biases in pain: an integrated functional-contextual framework" ?

In this paper, the authors present a survey of the state of the art in Experimental Health Psychology and Clinical Psychological Science. 

80,86 Manipulating the features of active goals and the context (e.g., safe vs. dangerous; controllable vs. uncontrollable; stressful vs. relaxed) during the assessment of cognitive biases for pain will provide a better understanding of the dynamic nature of cognitive biases in daily life. 

The future research agenda for cognitive bias researchAdopting an integrated functional-contextual framework to explain the presence, direction, and dynamics of cognitive biases brings exciting new research avenues, as well as important methodologicalof pain. 

although examining single biases is valuable for understanding the exact phenomenon it provides only one piece of the larger puzzle to explain higher levels of pain and disability and increased risk for developing chronic pain. 

This heterogeneity may be partly due to task parameters, such as stimuli (e.g., sensory vs. affective pain words13,78) or instructions (selfreferent vs other-referent instructions58).