Attentional bias toward negative information in patients with fibromyalgia syndrome

Pain Med. 2014 Apr;15(4):603-12. doi: 10.1111/pme.12360. Epub 2014 Jan 21.


Objective: In addition to central nervous sensitization, affect dysregulation constitutes an important factor in the pathogenesis of fibromyalgia syndrome (FMS). The present study is concerned with emotional influences on information processing in FMS. The hypothesis of attentional bias, i.e., selective processing of negatively connoted stimuli, was tested.

Methods: Twenty-seven female FMS patients and 34 healthy women undertook an emotional modification of the Stroop task. Subjects had to decide whether the colors of positive, negative, and neutral adjectives accorded with color words presented in black. Attentional bias was defined as delay in color naming of emotional words relative to neutral words. Affective and anxiety disorders, pain severity, as well as medication were considered as possible factors mediating the expected interference.

Results: Patients showed marked attentional bias, manifested in a greater response delay due to negative words compared with the control group. Among the clinical features, pain severity was most closely associated with the extent of the interference. While depression played only a subordinate role, anxiety and medication were without effect.

Conclusions: The study provides evidence of emotionally driven selective attention in FMS. Attentional bias to negative information may play an important role in the vicious circle between negative affective state and pain augmentation. In the management of FMS pain, strategies aiming at conscious direction of attention may be helpful, e.g., imagery techniques or mindfulness training.

Keywords: Chronic Pain; Emotion; Emotional Stroop Test; Fibromyalgia; Selective Attention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders / psychology*
  • Attention*
  • Case-Control Studies
  • Depressive Disorder / psychology*
  • Emotions*
  • Female
  • Fibromyalgia / psychology*
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Reaction Time
  • Severity of Illness Index
  • Stroop Test