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Cognitive load and the effectiveness of distraction for acute pain in children
Author(s) -
Gaultney Wendy M.,
Dahlquist Lynnda M.,
Quiton Raimi L.
Publication year - 2021
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1770
Subject(s) - distraction , mindfulness , psychology , pain catastrophizing , cognition , working memory , attentional control , task (project management) , cognitive load , developmental psychology , clinical psychology , audiology , chronic pain , cognitive psychology , medicine , psychiatry , management , economics
Background Distraction tasks that place continuous, high demand on executive resources have been shown to reduce pain intensity and pain unpleasantness ratings in some healthy adult samples. We examined the effects of a high‐demand ‘working memory’ 1‐back task compared to a low‐demand ‘motor control’ task on pain intensity and unpleasantness ratings in healthy children. Additionally, dispositional mindfulness was examined to explore the mechanisms of distraction on the affective processing of pain. Methods Fifty‐seven children (9–13 years old) experienced three randomly presented heat levels (not painful, slightly painful, moderately painful) during two distraction conditions involving different levels of cognitive load (a high load ‘working memory’ task and a low load ‘motor’ control task) in counter‐balanced order. Children completed measures of dispositional mindfulness, and attentional control and emotional control. Results As predicted, children's pain intensity and pain unpleasantness ratings were lower in the high load condition compared to the low load condition. These differences were amplified in the moderately painful heat trials. In contrast with predictions, dispositional mindfulness did not significantly predict the effectiveness of distraction. Dispositional mindfulness was significantly related to measures of children's attentional and emotional control abilities; however, an exploratory serial mediation model did not produce significant indirect or overall effects to suggest a strong influence of mindfulness on the effectiveness of distraction. Conclusions Results demonstrate that distraction that places higher demand on executive resources is more effective for acute pain management for children. Further research is needed to explore cognitive and affective moderators of the effectiveness of distraction for children. Significance This study is one of the first to demonstrate that working‐memory engagement can attenuate pain intensity and pain unpleasantness in children aged 9–13. The findings suggest that distraction tasks used in clinical settings for moderately painful medical procedures may benefit more children if they are adequately demanding of cognitive resources.