Oliver Dittmar, Corinna Baum, Raphaela Schneider, Stefan Lautenbacher

Hypervigilance to pain is the automatic prioritization of pain-related compared with other stimuli. The processing of threat information is influenced by negative contexts. Therefore, we intended to explore such context effects on hypervigilance to pain-cues, taking individual differences in self-reported vigilance to pain into consideration. In all, 110 healthy subjects viewed task-irrelevant emotional facial expressions (anger, happy, neutral, and pain) overlaid in half of the trials with a fine grid. The instructed task was to indicate the presence/absence of this grid. A threatening context was established by applying electrical stimuli slightly below pain-threshold. Using scores of Pain Vigilance and Awareness Questionnaire, the sample was divided into high vs low pain vigilant subjects. Reaction times and event-related brain potentials were recorded. No distinct attentional processing of pain faces (based on the event-related brain potentials) was observed as a function of high levels of self-reported vigilance to pain and contextual threat induction. High pain vigilant subjects showed generally enhanced processing of emotional and neutral faces as indicated by parameters of early (early posterior negativity) and late (late positive complex) processing stages. This enhancement was abolished when electro-stimuli were presented. Contextual threat does not enhance the attentional capture of pain-cues when they are presented concurrently with competing task demands. The study could, however, replicate a generally enhanced attentional processing of emotional cues in high pain vigilant subjects. This underpins that hypervigilance to pain is related to changes in emotional processing.