''Attention'' to pain in persons with chronic pain: A behavioral approach

Preoccupation with or attention to pain may influence perceived pain severity and other pain responses. The purpose of this study was to investigate attention to pain in persons with chronic pain. Participants for this study were patients (N = 80, 58.8% female) with chronic low back pain referred to a university pain clinic. A measure of attention to pain, the Pain Vigilance and Awareness Questionnaire (PVAQ), was constructed for this study. It was intended to assess a number of related responses including awareness, vigilance, preoccupation, and observation of pain. The PVAQ showed adequate internal consistency and temporal stability over a short interval. PVAQ scores were positively correlated with private body consciousness and cognitive disability, and negatively correlated with a measure of ignoring pain, supporting their validity. The results of this study show that persons with chronic low back pain who report greater attention to pain also report higher pain intensity, emotional distress, psychosocial disability, and pain-related health care utilization. Regression analyses showed that level of attention to pain remained a significant predictor of distress, disability, and health care utilization independent of pain intensity and relevant demographic variables. These results provide preliminary support for a behavioral conceptualization of attention to pain.