Abstract
Adults with chronic pain interpret ambiguous information in a pain and illness related fashion. However, limitations have been highlighted with traditional experimental paradigms used to measure interpretation biases. Whilst ambiguous scenarios have been developed to measure interpretation biases in adolescents with pain, no scenario sets exist for use with adults. Therefore, the present study: (i) sought to validate a range of ambiguous scenarios suitable for measuring interpretation biases in adults, whilst also allowing for two response formats (forced-choice and free response); and (ii) investigate paradigm efficacy, by assessing the effects of recent pain experiences on task responding. A novel ambiguous scenarios task was administered to adults (N = 241). Participants were presented with 62 ambiguous scenarios comprising 42 that could be interpreted in a pain/pain-illness or non-pain/non-pain illness manner: and 20 control scenarios. Participants generated their own solutions to each scenario (Word Generation Task), then rated how likely they would be to use two researcher-generated solutions to complete each scenario (Likelihood Ratings Task). Participants also rated their subjective experiences of pain in the last 3 months. Tests of reliability, including inter-rater agreement and internal consistency, produced two ambiguous scenario stimulus sets containing 18 and 20 scenarios, respectively. Further analyses revealed adults who reported more recent pain experiences were more likely to endorse the pain/pain-illness solutions in the Likelihood Ratings Task. This study provides two new stimulus sets for use with adults (including control items) in pain research and/or interventions. Results also provide evidence for a negative endorsement bias in adults.
Highlights
19% of Adult Europeans experience moderate to severe Chronic Pain (Breivik et al, 2006)
The word-stem completion task involves the presentation of a word stem (e.g., Ten_ _ _) that can be interpreted in a pain/illnessrelated (Tender) or non-pain/non-pain illness related manner (Tennis)
The aim of the present study was to validate a series of ambiguous scenarios that can be interpreted in a pain/pain-illness and/or non-pain/non-pain illness related fashion
Summary
19% of Adult Europeans experience moderate to severe Chronic Pain (Breivik et al, 2006). IB paradigms can be organized into three main categories; single ambiguous words; including the Homographic Response Task (McKellar et al, 2003), Homophone Task (e.g., Pincus et al, 1996), Sentence Generation Task (Taghavi et al, 2000; e.g., Schoth et al, 2018, 2019) and Word-stem Completion Task (e.g., Edwards and Pearce, 1994; Griffith et al, 1996); ambiguous images; including the Incidental Learning Task (Khatibi et al, 2014, 2015); and ambiguous scenarios; including the Ambiguous Scenarios Test (e.g., Heathcote et al, 2016, 2017; Lau et al, 2019). Participants are instructed to note the first word that enters their mind relating to each homograph Independent judges categorize these responses as pain-related, disability-related or neutral. While these paradigms are all easy to administer and offer relatively straightforward response classifications, in many instances the stimuli used restrict response selection choice
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