Cognitive Bias Modification for interpretation and Expectancy in Patients with Chronic Pain

Cognitive Bias Modification for Interpretation (CBM-I); 4 x 20 minute CBM-I sessions over 2 weeks. Participants will be randomly presented with 30 individual scenarios as a paragraph of text online. Participants will be able to access a link to the intervention from their home computer. The program is automated. Each scenario will be ambiguous, such that it could be interpreted to be pain or illness related, or neutral in its meaning until resolution of a final word fragment. Participants will be instructed to imagine they are the person being described, and must use their understanding of the paragraph to guide solution of the word fragment. There is only one solution that fits the possible interpretation of the preceding paragraph, and given the nature of the intervention, the scenarios will be solved to reveal a neutral (non-pain related) meaning. Once the word fragment is solved, a comprehension question will follow, which can only be correctly answered by having the appropriate interpretation of the previous paragraph. Expectancy intervention: If participants are randomized to the psychoeducation condition, they will learn about the rationale for CBM-I on two occasions. The first occasion will occur prior to receiving CBM-I intervention. Participants will see the following information: The intervention you will receive over the course of this study is called Cognitive Bias Modification (CBM). Cognitive Bias Modification (CBM) has had promising results in previous research, reducing symptoms of depression and anxiety in both healthy and clinical populations. It has also been helpful in reducing fears about dying from cancer, therefore reducing anxiety in people with cancer. In a study from our laboratory, CBM significantly reduced the amount of time university students spent avoiding a painful task. However, CBM has not been trialed with people experiencing chronic pain. Due to the success of CBM in other populations, we believe CBM will be helpful for you. It is a novel, promising intervention, and you are the first ones to have the opportunity to try it. Then, they will view a short animated video with a voice over, explaining the basic mechanisms and theory behind the development of chronic pain, and the central role of interpretation biases. Prior to commencing the second training session, participants in the psychoeducation condition will be asked if they recall watching a video in the previous session. If they say no, they will be directed to re-watch the original video. If they say yes, they will be asked a multiple choice question "What does interpretation bias mean?" If participants correctly identify the definition, they will be directed to watch an abridged re-cap version of the animated video. If they are incorrect, they will be directed to watch the original video. Participants allocated to proceed with the intervention as usual will not view any of the psychoeducation. Instead, they will be only be presented with instructions for completing the training. .