The present study aims to expand our knowledge about the caregivers’ attentional bias to pain. Briefly, our results showed that caregivers demonstrate more attentional bias to painful faces than happy faces in comparison to control participants. Furthermore, we showed that attentional bias to pain was positively related to finding the behavioral pain cues. Finally, in contrast to our hypothesis, higher attentional bias to pain cues among caregivers did not relate to patients and caregivers’ disagreement in reporting pain behaviors.
The results of this study replicate the earlier findings on the existence of attentional bias to pain among family caregivers of chronic pain patients (Mohammadi et al., 2012) and parents of children with pain (Liossi et al., 2012; Vervoort et al., 2011). In detection of attentional biases to pain information one of the substantial elements is the nature of the stimuli. It is assumed that applying more salient (Khatibi et al., 2009; Roelofs, Peters, Fassaert, & Vlaeyen, 2005) and ecologically valid stimuli such as painful faces (Lautenbacher et al., 2013) compared to pain verbal stimuli (i.e. pain words), may increase the likelihood of observing attentional bias. Indeed, the previous studies on attentional bias among caregivers and parents (Liossi et al., 2012; Mohammadi et al., 2012; Vervoort et al., 2011) as well as the present study have used facial pain expressions which are more salient compared to pain related words. The results of these studies were also in line with the findings of the chronic pain patients’ studies that have used facial expressions of pain and confirm the existence of attentional bias to pain information among chronic pain patients (Khatibi et al., 2009; Mohammadi et al., 2012). Another important element in attentional bias to pain is the relevancy level of the stimuli for the observers (Dear, Sharpe, Nicholas, & Refshauge, 2011). It is possible that caregivers who are taking care of patients’ with back pain show higher attentional bias to back related pictures compared to neck related ones. However, in the current study pictures with facial expression of pain have been used for all the participants without counting the location of pain in the patients. Future studies need to focus on applying both salient and idiosyncratic stimuli (i.e. pictures that are related to the main concern of an individual) to enhance our understanding of the existence of attentional bias among caregivers.
Besides supporting the existence of attentional bias to pain information among caregivers, the results point to an important relationship between attentional bias and detection of pain behaviors, which was not previously explored. It seems that attentional bias is associated with caregivers’ higher detection of pain behaviors. This finding is important because caregivers rely on the detected pain behaviors such as facial expressions and body gestures to infer pain and illness (LeResche & Dworkin,...