Attention to pain words in irritable bowel syndrome: Increased orienting and speeded engagement

Objectives. Biopsychosocial models suggest altered attention to pain plays a role in the aetiology of irritable bowel syndrome (IBS). We investigated whether attention to pain words differed in IBS participants relative to healthy controls, and whether attentional indices predicted self-reported health and illness behaviour. Design. A between-subjects design was used to enable investigation of differences between an IBS participant group and a healthy participant group. Methods. Twenty IBS participants and 33 healthy controls completed a modified version of a task commonly used to investigate attentional processes, the exogenous cueing task. Attentional bias, engagement, and disengagement indices were calculated from reaction time data to assess attention to pain and social threat words. Questionnaires were used to investigate self-reported health and illness behaviour. Results. Relative to controls, IBS participants were more biased towards pain than neutral words, showing faster engagement with pain words than controls. Measures of attention to pain words were associated with increased reporting somatic symptoms and sick leave taking. Conclusions. These results support atypical attention to pain in IBS and suggest these attentional biases are associated with increased pain report and illness behaviour. A vicious circle maintenance model of IBS, in which attentional biases exacerbate symptom perception and illness behaviour, increasing focus on pain, is a potential explanation of these findings.