Attentional biases to pain and social threat in children with recurrent abdominal pain

Objectives To test whether children with recurrent abdominal pain ( RAP) exhibit subliminal ( nonconscious) and supraliminal ( conscious) attentional biases to pain-related words, and to determine correlates of these biases. Previous research indicates that individuals attend to disorder-relevant threat words, and in this study, attentional biases to disorder-relevant threat ( pain), alternative threat ( social threat), and neutral words were compared. Methods Participants were 59 children with RAP who completed a computer-based attentional bias task. Participants and their parents also completed questionnaires measuring pain, somatic complaints, anxiety/depression, and body vigilance. Results Children with RAP showed attentional biases toward subliminal pain-related words and attentional biases away from supraliminal pain-related words. Participants' attentional biases to social threat-related words were marginally significant and also reflected subliminal attention and supraliminal avoidance. Attentional biases were related to parent and child reports of pain, body vigilance, and anxiety/depression. Conclusions Children with RAP show nonconscious attention to and conscious avoidance of threat-related words. Their attentional biases relate to individual differences in symptom severity. Implications for models of pediatric pain and future studies are discussed.