Influence of attention focus and trait anxiety on tolerance of acute pain

Objectives. In light of inconsistencies in the reported effects of attention and anxiety on pain tolerance, this study examined the separate and combined effects of attention focus and trait anxiety on tolerance of acute experimental pain. Design. Participants with 'high' and 'low' trait anxiety were assigned to three attention-focus conditions: pain-focused attention, 'undirected' (no experimenter-induced attempts to influence attention focus) and distraction. Methods. Several indices of autonomic arousal (systolic and diastolic blood pressure, heart rate and EMG) were measured before and during, and several self-report inventories were completed before and after, each of two administrations of the cold pressor test. Results. In general, pain tolerance was greater when participants were distracted and in low- rather than high-anxiety participants. However, attention and anxiety interacted such that low-anxiety participants were most pain tolerant, and high-anxiety participants were least pain tolerant, in the undirected condition. Conclusion. The results are consistent with the notion that anxiety fosters attentiveness to possible environmental threats, and might have implications for the clinical management of acute pain.