Attention and the stages of pain processing.

OBJECTIVE Explore the relationships between the four stages of pain processing and attention in chronic pain sufferers. DESIGN A cross-sectional, retrospective study of 736 subjects participating in an outpatient university-based tertiary care pain treatment program. METHODS Self-report measures of pain, pain-related unpleasantness, and suffering (Pain Experience Visual Analog Scales) in conjunction with a structured interview assessing illness behavior (adaptation of the Psychosocial Pain Inventory) and attention (Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised) were employed. OUTCOME MEASURES Separate step-wise multiple regression analyses were conducted using variables that measure each of the four stages of pain processing as predictors, with Digit Span being the criterion variable. RESULTS Multiple regression analyses showed that, of the four pain stages, only suffering and pain behavior were related to attentional performance. Specifically, an individual's perception of lifestyle interference due to pain, level of depression, and the degree of solicitous responses from others each uniquely contributed to Digit Span performance. CONCLUSIONS Treatment interventions specifically targeting suffering and pain behavior may prove efficacious in addressing the attentional problems in chronic pain.