Reappraisal mitigates overestimation of remembered pain in anxious individuals

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Abstract

Anxiety sensitivity, a trait characterised by fear of anxiety-related body sensations, has been linked to heightened attention to pain, appraising body sensations as threatening, and remembering threat-related information. We assessed whether individuals with greater anxiety sensitivity overestimate in remembering pain. We also assessed whether emotion regulation strategies that direct attention away from pain (distraction), or alter appraisals of pain (reappraisal), alleviate memory bias. Participants (N = 137) were randomly assigned to one of two emotion regulation conditions or to a control condition before taking part in a cold pressor task. Greater anxiety sensitivity was associated with overestimation in remembering pain. Engaging in reappraisal mitigated this memory bias but engaging in distraction did not. This is the first study to examine the relations among anxiety sensitivity, emotion regulation and memory for pain. The findings suggest that health-care practitioners can encourage reappraisal to promote more positive memories of procedural pain, particularly in patients high in anxiety sensitivity.

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WHEN MORE PAIN IS PREFERRED TO LESS:. Adding a Better End

Daniel Kahneman, Barbara L. Fredrickson, Charles Schreiber … (1993)

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Patients' memories of painful medical treatments: real-time and retrospective evaluations of two minimally invasive procedures.

D Kahneman, Donald Redelmeier (1996)

Patients' memories of painful medical procedures may influence their decisions about future treatments, yet memories are imperfect and susceptible to bias. We recorded in real-time the intensity of pain experienced by patients undergoing colonoscopy (n = 154) and lithotripsy (n = 133). We subsequently examined patients' retrospective evaluations of the total pain of the procedure, and related these evaluations to the real-time recording obtained during the experience. We found that individuals varied substantially in the total amount of pain they remembered. Patients' judgments of total pain were strongly correlated with the peak intensity of pain (P < 0.005) and with the intensity of pain recorded during the last 3 min of the procedure (P < 0.005). Despite substantial variation in the duration of the experience, lengthy procedures were not remembered as particularly aversive. We suggest that patients' memories of painful medical procedures largely reflect the intensity of pain at the worst part and at the final part of the experience.