Determining the effectiveness of different forms of interpretation bias training on pain outcomes in healthy university students.

Brief interpretation bias training will be delivered in a laboratory setting. There will be 4 versions of this training. Undergraduate students will be taught to classify ambiguous facial expressions as either pain related or as benign; or will be taught to resolve ambiguous written scenarios as either pain related or benign. As such, participants will complete only one of the following 4 training procedures: 1) training towards pain faces, 2) training away from pain faces, 3) training towards pain interpretations of scenarios, or 4) training away from pain interpretations of scenarios. This intervention will be conducted in a single session and will last approximately 15 minutes. The scenario based training procedure is called the 'ambiguous situations paradigm' and has been previously developed and validated by Jones and Sharpe (2014). Participants will be presented with an ambiguous sentence or paragraph, which can be interpreted as pain related or benign until the last word. The last word will have letters missing, but can only be resolved by the participant in one way, to create a pain/threatening scenario (group trained towards pain interpretation) or a neutral scenario (group trained towards a benign interpretation). These scenarios are followed by a question that will consolidate the resolution of the paragraph. The face based training procedure is currently being developed but is based on the 'incidental learning task' as described by Khatibi, Schrooten, Vancleef, & Vlaeyen (2014). Participants will be presented with pictures of happy faces and pain faces, which will be followed by a target consistently on the left or the right hand side of the screen depending on the type of facial expression. Participants need to respond to this target with a mouse button press. Ambiguous faces will then be presented, and will be followed either by a target consistently on the pain face side (group trained towards pain interpretation) or happy face side (group trained towards a benign interpretation). All other questionnaires, computer tasks and the pain procedure will be used for assessment purposes only, and are detailed as follows: Participants will complete demographic questions as well as validated questionnaires including the Fear of Pain Questionniare (McNeil & Rainwater, 1998), Depression Anxiety Stress Scale (Lovibond & Lovibond, 1996), and the Pain Catastrophising Scale (Sullivan, Bishop, & Pivik, 1995). These will be completed on a computer. Participants will also 3 computer tasks to measure interpretation biases following the manipulation. These include the incidental learning task (Khatibi, Schrooten, Vancleef, & Vlaeyen, 2014) and the word recognition task as developed by Jones and Sharpe (2014). A third measurement task will be used that is currently being developed by the research group, which will be based on the stimuli presented in the incidental learning task. Participants will complete an experimental pain task. Two water tanks manufactured by Thermoline Scientific Australia are used to conduct the cold pressor task. Each tank is comprised of a 20L circulating water bath chamber (model TLWB-30), immersion cooler (TIC-400) and a heat circulator (TU-3). In order to ensure participants initial arm temperature is controlled for, they are firstly asked to submerge their arm up to the elbow for 30 seconds in the warm tank, with a maintained temperature of 37degrees C (plus or minus 0.5). Following this, they submerged the same arm up to the elbow into the tank of cold water, maintained at 5 degrees C(plus or minus 0.5). Research in the past indicates the cold pressor task produces the “Lewis Effect”, whereby pain is produced by vasodilation of the blood vessels due to warm water, quickly followed by vasoconstriction due to cold water. The whole experiment will take up to one hour to complete. The study will be administered by a qualified psychologist, as Jemma Todd is a qualified psychologist and Professor Louise Sharpe is a qualified Clinical Psychologist. A research script will be developed so that participation is as similar as possible across participants.