Highlights
- •The ischemic pain (vs. control) group reported greater state pain catastrophizing.
- •State pain catastrophizing mediated the effect of group on working memory.
- •This mediated effect was moderated by trait pain catastrophizing.
- •Treatments for pain catastrophizing may ameliorate pain-related cognitive deficits.
Abstract
The bidirectional relationship between pain and working memory (WM) deficits is well-documented
but poorly understood. Pain catastrophizing—exaggerated, negative cognitive and emotional
responses toward pain—may contribute to WM deficits by occupying finite, shared cognitive
resources. The present study assessed the role of pain catastrophizing as both a state-level
process and trait-level disposition in the link between acute pain and WM. Healthy,
young adults were randomized to an experimentally-induced ischemic pain or control
task, during which they completed verbal and non-verbal WM tests. Participants also
completed measures of state- and trait-level pain catastrophizing. Simple mediation
analyses indicated that participants in the pain group (vs. control) engaged in more
state-level catastrophizing about pain, which led to worse verbal and non-verbal WM.
Moderated mediation analyses indicated that the indirect (mediation) effect of state-level
pain catastrophizing was moderated by trait-level pain catastrophizing for both verbal
and non-verbal WM. Participants in the pain group who reported a greater trait-level
tendency to catastrophize about pain experienced greater state-level catastrophizing
about pain during the ischemic task, which led to worse verbal and non-verbal WM performance.
These results provide evidence for pain catastrophizing as an important mechanism
and moderating factor of WM deficits in acute pain. Future research should replicate
these results in chronic pain samples, investigate other potential mechanisms (e.g.,
sleep disturbances), and determine if interventions that target pain catastrophizing
directly can ameliorate cognitive deficits in people with pain.
Perspective
This article presents a laboratory study examining the relationships among pain, pain
catastrophizing, and working memory in healthy participants. The results shed new
light on these relationships and raise the possibility that interventions that reduce
catastrophizing may lead to improved cognitive function among people with pain.
Key words
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Article info
Publication history
Published online: March 12, 2021
Accepted:
March 1,
2021
Received in revised form:
February 17,
2021
Received:
August 11,
2020
Footnotes
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of Interest: The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2021 by United States Association for the Study of Pain, Inc.
