We present a new measure of adolescents' interpretations of ambiguous bodily threat.
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Adolescents with greater recent pain symptoms showed a negative interpretation bias.
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A negative bias mediated the association between catastrophizing and recent pain.
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Interpretation bias may be a cognitive mechanism associated with adolescent pain.
Abstract
Negative interpretation bias, the tendency to appraise ambiguous situations in a negative or threatening way, has been suggested to be important for the development of adult chronic pain. To our knowledge, this is the first study to examine the role of a negative interpretation bias in adolescent pain. We first developed and piloted a novel task that measures the tendency for adolescents to interpret ambiguous situations as indicative of pain and bodily threat. Using this task in a separate community sample of adolescents (N = 115), we then found that adolescents who catastrophize about pain, as well as those who reported more pain issues in the preceding 3 months, were more likely to endorse negative interpretations, and less likely to endorse benign interpretations, of ambiguous situations. This interpretation pattern was not, however, specific for situations regarding pain and bodily threat, but generalized across social situations as well. We also found that a negative interpretation bias, specifically in ambiguous situations that could indicate pain and bodily threat, mediated the association between pain catastrophizing and recent pain experiences. Findings may support one potential cognitive mechanism explaining why adolescents who catastrophize about pain often report more pain.
Perspective
This article presents a new adolescent measure of interpretation bias. We found that the tendency to interpret ambiguous situations as indicative of pain and bodily threat may be one potential cognitive mechanism explaining why adolescents who catastrophize about pain report more pain, thus indicating a potential novel intervention target.
Key words
Interpretation bias
adolescents
pain catastrophizing
cognitive bias
ambiguous situations
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Lauren Heathcote is a DPhil student at the University of Oxford, a Research Training Fellow for Action Medical Research for Children (Grant GN2122), a member of Pain in Child Health (a research training initiative of the Canadian Institutes of Health Research), and has received travel grants from Magdalen College, Oxford to present this research. Elaine Fox is supported by an ERC Advanced Investigator Award (324176). This study was funded in part by the Economic and Social Research Council (ES/I032959/1).
The authors have no conflicts of interest to declare.