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Papers of the Week

Papers: 13 Apr 2019 - 19 Apr 2019


Human Studies

2019 Apr 06


Remembering the pain of surgery one year later: a longitudinal examination of anxiety in children’s pain memory development.


Noel M, Rosenbloom B, Pavlova M, Campbell F, Isaac L, Pagé GM, Stinson J, Katz J
Pain. 2019 Apr 06.
PMID: 30985626.


Children who develop greater negatively biased recall of pain (i.e., recalled pain is higher than the initial pain report) following surgery are at risk for developing chronic pain; therefore, identifying risk factors for the development of biased pain memories is important. Higher anxiety has been implicated in the development of greater negatively biased recall of pain; however, studies have not examined anxiety at multiple time points before and after a surgery and its relationship to children's post-surgical pain memories after one year. This prospective study examined a cohort of 237 children and adolescents undergoing major surgery. Anxiety sensitivity, pain catastrophizing, and pain anxiety were assessed at baseline, 48-72 hours post-surgery, and at 6- and 12-month follow-ups. Pain intensity at rest, movement-evoked pain intensity, and pain unpleasantness were assessed daily in hospital. Memories for pain were elicited via telephone one-year post surgery. Findings revealed that children who had higher levels of anxiety at baseline and 48-72 hours post-surgery developed greater negatively biased recall of pain intensity 12 months after surgery. Specifically, higher anxiety sensitivity at baseline and greater tendencies to catastrophize about pain at baseline and in the immediate acute recovery phase were most strongly linked to greater negatively biased recall of pain. Greater negatively biased recall of pain was related to higher pain intensity at 6- and 12-months post-surgery. Findings support conceptual models of anxiety and pain memory biases and can inform intervention efforts to reduce anxiety in the pre- and post-op periods to minimize negative biases in pain memories.