Interpretation bias

Data from studies of interpretative biases show consistently a bias for illness- and health-related material; both pain patients and persons with high levels of pain-related fear are inclined to interpret ambiguous and innocuous pain-related stimuli in a threatening or negative fashion (Edwards and Pearce 1994; Pincus et al. 1994; Pincus, et al. 1996a; Vancleef 2007; Vancleef et al. 2009). Recently, Keogh and colleagues (Keogh, Ellery et al. 2001; Keogh, Hamid, Hamid and Ellery 2004) have demonstrated that negative interpretative bias for ambiguous situations mediated the relation between individual levels of anxiety sensitivity and pain tolerance in a cold-pressor test. Nevertheless, it should be noted that studies on interpretive bias in the context of pain have relied on explicit measures predominantly, using homophones (words with the same pronunciation, but a different spelling: e.g. dye/die (McKellar et al. 2003; Pincus et al. 1994), homographs (words with the same spelling, but different meanings: e.g. needle (Pincus et al. 1996), word-stem completion tasks (word stem can be completed in different ways: e.g. ten—: tender/tennis (Edwards and Pearce 1994) or interpretation questionnaires (e.g. Keogh et al. 2001b; Keogh et al. 2004). Consequently, it remains unclear whether the negative bias results from elaborative, constructive, integrative processes at the moment of responding to ambiguity, or if negative interpretations occur actually at an automatic spontaneous level.

 
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