Exploring pain sensitivity changes after acceptance and attention bias modification trainings: preliminary evidence on fear of pain and attention bias

Cognitive trainings for pain are suggested as promising interventions targeting core mechanisms related to pain. However, their efficacy varies greatly, and the factors that moderate training efficacy are poorly understood. Thus, this study investigated how individual characteristics influence the effectiveness of two commonly used cognitive trainings, attention bias modification (ABM) and acceptance training, in modulating experimental pain. Eighty healthy females attended two sessions of either pain acceptance training or pain ABM training. Each participant underwent one active training session and one control session in a randomized order. Pre- and post-training assessments included emotional questionnaires, attention bias tasks, and quantitative sensory testing (QST). At the group level, both active trainings reduced sensitivity to the heat temperature participants were trained on, but were not more effective than the control conditions, and no other group-level improvements emerged in other pain sub-modalities. Nevertheless, greater attentional interference from pain-related images and higher fear of pain at baseline predicted greater reductions in heat pain sensitivity following the acceptance training. These preliminary findings emphasize the importance of baseline cognitive and emotional traits in shaping the efficacy of acceptance-based interventions. Tailoring interventions to individual profiles may enhance treatment outcomes, warranting further research into personalized approaches for pain management.