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Memory of pain induced by physical exercise

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The aim of this study was to assess the memory of pain induced by running a marathon and the factors that influence it. Sixty-two marathon runners participated in the study, which comprised two phases. Immediately after a participant had reached the finishing line of the marathon, they were asked to rate the intensity and the unpleasantness of their pain and the emotions they felt at that time. Either three or six months later they were asked again to rate the intensity and the unpleasantness of the same pain experience. Regardless of the length of recall delay, participants underestimated both recalled pain intensity and unpleasantness. The pain and negative affect reported at the time of the pain experience accounted for 24% of the total variance in predicting recalled pain intensity and 22% of the total variance in predicting recalled pain unpleasantness. Positive affect at the time of pain experience was not a significant predictor of both the recalled pain intensity and pain unpleasantness. It is concluded that pain induced by physical exercise is not remembered accurately and the pain and negative affect experienced influence recall. Further research is needed on the influence of positive affect on the memory of pain.
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Memory of pain induced by physical exercise
Przemysław Bąbel
a
a
Institute of Psychology, Jagiellonian University, Kraków, Poland
Published online: 25 Mar 2015.
To cite this article: Przemysław Bąbel (2015): Memory of pain induced by physical exercise, Memory, DOI:
10.1080/09658211.2015.1023809
To link to this article: http://dx.doi.org/10.1080/09658211.2015.1023809
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Memory of pain induced by physical exercise
Przemysław Bąbel
Institute of Psychology, Jagiellonian University, Kraków, Poland
(Received 23 September 2014; accepted 23 February 2015)
The aim of this study was to assess the memory of pain induced by running a marathon and the factors
that influence it. Sixty-two marathon runners participated in the study, which comprised two phases.
Immediately after a participant had reached the finishing line of the marathon, they were asked to rate
the intensity and the unpleasantness of their pain and the emotions they felt at that time. Either three or
six months later they were asked again to rate the intensity and the unpleasantness of the same pain
experience. Regardless of the length of recall delay, participants underestimated both recalled pain
intensity and unpleasantness. The pain and negative affect reported at the time of the pain experience
accounted for 24% of the total variance in predicting recalled pain intensity and 22% of the total
variance in predicting recalled pain unpleasantness. Positive affect at the time of pain experience was not
a significant predictor of both the recalled pain intensity and pain unpleasantness. It is concluded that
pain induced by physical exercise is not remembered accurately and the pain and negative affect
experienced influence recall. Further research is needed on the influence of positive affect on the
memory of pain.
Keywords: Athletes; Marathon; Negative affect; Pain intensity; Pain unpleasantness.
The accuracy of the memory of pain is an
important problem in clinical practice and research
on pain. Diagnoses and decisions about treatment
are often made on the basis of how a patient
describes pain, both present and past. Moreover,
memory of pain is often implied in the pain
measures used in both pain diagnosis and research.
Assessments of the effectiveness of treatments for
pain are based on patient reports of relief from
pain, assuming that relief represents the difference
between present (post-treatment) and past (pre-
treatment) pain. Previous research has found that
when pain was recalled with a greater intensity in
comparison to the actual pain experience, patients
reported greater pain relief after both active and
placebo treatments (De Pascalis, Chiaradia, &
Carotenuto, 2002; Feine, Lavigne, Thuan Dao,
Morin, & Lund, 1998; Price et al., 1999), but those
who reported complete pain relief during the pain
experience were unable to recollect this pain relief
at the six-month follow-up check (Everts et al.,
1999). There is also evidence that the memory of
past pain influences subsequent pain experience
(Chen, Zeltzer, Craske, & Katz, 2000; Gedney &
Logan, 2006; Noel, Chambers, McGrath, Klein, &
Stewart, 2012a) and may play a role in the
development of chronic pain (Tasmuth, Kataja,
Blomqvist, von Smitten, & Kalso, 1997; Tasmuth,
von Smitten, Hietanen, Kataja, & Kalso, 1995).
Moreover, memories of painful medical proce-
dures may influence the willingness of patients
to undergo future painful medical procedures
(Redelmeier, Katz, & Kahneman, 2003), and
memories of painful experimental procedures
may influence the later decisions of experimental
subjects in relation to pain stimuli (Kahneman,
Fredrickson, Schreiber, & Redelmeier, 1993).
Address correspondence to: Przemysław Bąbel, Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060 Kraków,
Poland. E-mail: przemyslaw.babel@uj.edu.pl
© 2015 Taylor & Francis
Memory, 2015
http://dx.doi.org/10.1080/09658211.2015.1023809
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There is growing evidence that people may not
remember pain accurately, i.e., there are significant
differences between the ratings of the experienced
and recalled pain. Some studies have shown
that recalled chronic (Broderick et al., 2008;De
Wit et al., 1999; Stone, Schwartz, Broderick, &
Shiffman, 2005), acute (Eli, Schwartz-Arad, Baht,
& Ben-Tuvim, 2003; Everts et al., 1999; McNeil
et al., 2011) and experimental (De Pascalis et al.,
2002; Gedney & Logan, 2006; Price et al., 1999)
pain is exaggerated. However, a few studies have
demonstrated that recalled acute (Bruck, Ceci,
Francoeur, & Barr, 1995; Eli, Baht, Kozlovsky, &
Simon, 2000; Norvell, Gaston-Johansson, & Fridh,
1987) and experimental (De Pascalis, Cacace, &
Massicolle, 2008; Fors & testam, 1996;Rode,
Salkovskis, & Jack, 2001) pain may be under-
estimated. Additional data show that past chronic
(Bolton, 1999; Lefebvre & Keefe, 2002), acute
(Bąbel, 2014a, 2014b; Terry, Niven, Brodie, Jones,
& Prowse, 2007) and experimental (Jantsch et al.,
2009; Terry, Brodie, & Niven, 2007) pain may be
remembered accurately.
Many factors may influence the memory of pain,
including the experienced pain (Bąbel, 2014a;
Bąbel, Pieniążek, & Zarotyński, 2015; Jantsch et al.,
2009; Noel, Chambers, McGrath, Klein, & Stewart,
2012b), the peak and the end of pain (Redelmeier
& Kahneman, 1996; Redelmeier et al., 2003;Stone,
Broderick, Kaell, DelesPaul, & Porter, 2000), the
length of delay between the pain experience and its
recall (Broderick et al., 2008; Feine et al., 1998;
Gedney, Logan, & Baron, 2003), and current pain
during pain recall (Bryant, 1993; Feine et al., 1998
;
Holroyd, France, Nash, & Hursey, 1993). Psycho-
logical factors that may be related to the memory
of pain include pain expectations (De Pascalis et al.,
2002; Gedney et al., 2003; Price et al., 1999),
negative affect (Gedney & Logan, 2004, 2006),
state anxiety (Bąbel, 2014a, 2014b;Bąbel et al.,
2015; Eli et al., 2000; Gedney et al., 2003; Noel
et al., 2012b) and distress (Everts et al., 1999;
Jamison, Sbrocco, & Parris, 1989). All the above-
mentioned factors are positively related to the
recalled pain. The only exception is positive affect
which is negatively related to the recalled pain
(Bąbel, 2014a, 2014b). However, recent findings
suggest that memory of pain is influenced by the
type of pain, i.e., the meaning and affective value
of the pain experience, where negative affect may
be negatively related to the recalled pain, and
positive affect may be positively related to the
recalled pain (Bąbel et al., 2015).
Physical exercise often results in pain, and
athletes are regula rly exposed to painful training.
Moreover, physical exercise has an effect on pain
perception: analgesia occurs during and following
exercise (see Koltyn, 2000, and OConnor &
Cook, 1999, for review), and athletes possess
higher pain tolerance than normally active con-
trol subjects (see Tesarz, Schuster, Hartmann,
Gerhardt, & Eich, 2012, for review). This is
particularly true for regular runners whose pain
threshold was found to be significantly higher
than that of normally active controls (Janal,
Glusman, Kuhl, & Clark, 1994). As previous
experience with pain has a desensitising effect
on pain tolerance, the athletes are more willing to
compete while injured and in pain (Raudenbus h
et al., 2012). This may be the result of the coping
strategies related to pain, e.g., it was found that
ignoring pain significantly attenuated the negative
effect of pain intensity on athletes inclination to
play through pain (Der oche, Woodman, Stephan,
Brewer, & Le Sc anff, 2011). Moreover, it was
found that ultra-marathon runners differ from
controls without marathon experience not only in
pain tolerance but also in personality traits (e.g.,
runners are less cooperative and reward depend-
ent) which correlates with pain tolerance (Freund
et al., 2013).
Taking together the results of the above-men-
tioned studies, it seems clearly that athletes in
general and marathon runners in particular may
significantly differ from the population of pain
sufferers whose memories of the pain have been
studied so far. However, although memories of the
pain induced by physical exercise may influence
both subsequent pain experiences during sports
activities and future decisions about whether to
participate in sport and which sport activity to
choose, there have not yet been any studies on the
memory of pain induced by physical exercise.
The main aim of the present study was to
assess the memory of pain induced by running a
marathon. Based on the results of the previous
research on the memory of acute pain, it was
hypothesised that both the recalled pain intens-
ity and unpleasa ntness would be underestimated.
The second aim of the study was to investigate
several factors that may influence the memor y of
pain: the length of recall delay, experienced pain
and negative affect. Based on the resul ts of the
previous studies on the effects of the recall delay
on the memory of pain, it was hypothesised that
after six months from pain experience both the
recalled pain intensity and unpleasantness would
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be underestimated more than after three months
delay. Moreover, based on the results of the
previous research on the factors influencing the
memory of pain, it was hypothesised that experi-
enced pain and negative affect would have an
effect on the recalled pain, i.e., that more negat-
ive affect and more experienced pain would be
related to recall of more pain. Given that running
a marathon is generally a positive experience, the
impact of positive affect on the memory of pain
was also studied, and it was hypothesised that
positive affect would have an effect on the
memory of pain induced by physical experience,
i.e., that more positive affect would be related to
recall of less pain.
METHOD
Participants
A total of 62 marathon runners participated in
the study, 39 of whom were males (63%). The
mean age of the participants was 37.1 ± 14.2
years. All participants were of polish Caucasian
origin. Participants were recruited from the run-
ners of the 11th Cracovia Marathon, organised on
the 22 April 2012 in Kraków, Poland. None of the
participants has sustained any injuries during the
marathon. The runners were informed that they
would participate in a study on pain induced by
running a marathon and that the study would
comprise two phases: the first phase conducted
immediately after running the marathon, and the
second phase conducted either three or six
months after completion of the marathon. How-
ever, the participants were not informed that the
second phase of the study would investigate
memory of pain.
The runners gave their informed written con-
sent to participate in the study. They wer e
assigned randomly to two experimental groups
that differed in terms of the length of delay
between the marathon and the second phase of
the study. The first group consisted of 32 partici-
pants who completed the second phase of the
study about three months after the marathon; the
second group consisted of 30 participants who
completed the second phase of the study about
six months after the marathon (see Table 1).
There were no significant differences with respect
to age and sex between the groups. The study
protocol was approved by the Research Ethics
Committee at the Institute of Psychology of
Jagiellonian University.
Materials
Pain is a multidimensional experience (Melzack
& Casey, 1968). It contains both sensory (pain
intensity) and affective (pain unpleasantness)
dimensions, and the affective dimension is made
up of feelings of unpleasantness and emotions
associated with future implications, termed sec-
ondary affect (Price, 2000). It has been shown
that both dimens ions are separate (Rainville,
Carrier, Hofbauer, Bushnell, & Duncan, 1999;
Rainville, Feine, Bushnell, & Duncan, 1992), and
that separate measures of the sensory intensity
versus the affective dimension of pain should be
utilised (Price, Harkins, & Baker, 1987), espe-
cially in the research on the memory of pain
(Ornstein, Manning, & Pelphrey, 1999 ). More-
over, it has been shown that the affective dimen-
sion of different types of pain is differentially
influenced by psychological factors (Price et al.,
1987). That is why it was decided to measure both
dimensions of pain in the current study.
The participants rated pain intensity by means
of an 11-point Numeric Rating Scale (NRS),
ranging from 0 = no pain to 10 = the most
intense pain imaginable. Pain unpleasantn ess
was measured by means of a similar 11-point
NRS, ranging from 0 = not at all unpleasant
pain to 10 = the most unpleasant pain imagin-
able. The NRS has demonstrated good vali dity
and reliab ility, and psychometric analyses suggest
TABLE 1
Group means and standard deviations of all the study variables
Sex Pain intensity Pain unpleasantness Affect
Group N M F Age
Recall
delay (days) Experienced Recalled Experienced Recalled Positive Negative
1 32 19 13 38.56 ± 18.6 104.69 ± 9.7 5.31 ± 2.52 4.19 ± 2.67 4.75 ± 2.69 3.84 ± 2.3 33.91 ± 8.27 14.19 ± 4.35
2 30 20 10 35.52 ± 6.61 186.77 ± 5.12 5.43 ± 2.22 3.2 ± 1.92 5.13 ± 2.34 3.17 ± 2.2 32.48 ± 9.63 15.62 ± 6.14
M, male; F, female; NRS, Numeric Rating Scale; PANAS, the Positive and Negative Affect Schedule.
MEMORY OF PAIN INDUCED BY PHYSICAL EXERCISE 3
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that the NRS is the preferred pain ratin g scale
(Ferreira-Valente, Pais-Ribeiro, & Jensen, 2011;
Gagliese, Weizblit, Ellis, & Chan, 2005; Jensen,
Karoly, & Braver, 1986).
Positive and negative affect were measured by
the two 10-item mood scales that comprise the
Positive and Negative Affect Schedule (PANAS;
Watson, Clark, & Telleg en, 1988). Respondents
were asked to rate the extent to which they
experienced each particular emotion (e.g., alert,
distressed, excited, nervous) with reference
to a 5-point scale: 1 = very slightly or not at all,
2=a little,3=moderately,4=quite a bit
and 5 = very much. The scales have been shown
to be highly internally consistent (α = 0.840.90),
largely uncorrelated (r = 0.12 to 0.23) and
stable at appropriate levels over a two-month
time period (r = 0.390.71; Watson et al., 1988).
So far the PANAS scales have been used in
just a few studies on memory of pain in which
different types of pain have been recalled: dental
pain induced by tooth restoration (Bąbel, 2014b),
experimental pain induced by forehead cold
pressor task (Gedney & Logan, 2004, 2006),
migraine and non-migraine headaches (Bąbel,
2014a), post-operative pain, post-partum pain
induced by vaginal delive ry and post-partum
pain induced by caesarean section (Bąbel et al.,
2015). Experienced negative affect measured by
PANAS correlated positively with the recalled
intensity of experimental pain induced by fore-
head cold pressor task (Gedney & Logan, 2006),
and it was found to be a positive predictor of the
recalled intensity of experimental pain induced by
forehead cold pressor task (Gedney & Logan,
2004). Both the recalled and experienced negat-
ive affect measured by PANAS were found to be
positive predictors of both the recalled intensity
and unpleasantness of the post-partum pain
induced by vaginal delivery (Bąbel et al., 2015).
Recalled negative affect measured by PANAS
was also found to be a positive predictor of the
recalled intensity of dental pain induced by tooth
restoration (Bąbel, 2014b). Experienced positive
affect measured by PANAS was found to be a
positive predictor of both the recalled intensity
and unpleasantness of the post-partum pain
induced by caesarean section (Bąbel et al., 2015)
and a negative predictor of both the recalled
intensity and unpleasantness of dental pain
induced by tooth restoration (Bąbel, 2014b).
Recalled positive affect measured by PANAS
was found to be a negative predictor of both the
recalled intensity and unpleasantn ess of headache
(Bąbel, 2014a). Moreover, both the experienced
and recalled positive affect measured by PANAS
correlated negatively with both the recalled
intensity and unpleasantness of headache, and
both the experienced and recalled negative affect
measured by PANAS correlated positively with
both the recalled intensity and unpleasantness of
headache (Bąbel, 2014a ).
Procedure
The study consisted of two phases. The first was
conducted immediately after each participant had
reached the finishing line of the marathon. He or
she was asked to rate the intensity and the
unpleasantness of pain they felt at that moment,
using the two NRS, and to rate the emotions they
felt at that moment, using the PANAS. Three or
six months after completion of the marathon
(depending on the experimental group), the
second phase of the study was conducted. The
participants were emailed a link to an online
survey in which they were asked to rate the
intensity and the unpleasantness of pain they
had felt immediately after they reached the
finishing line of the marathon, using two NRS. It
was emphasised that they were being asked to
recall and describe how they remembered the pain
they felt during the first phase of the study, rather
than to recall how they had rated the pain on the
same scales in the first phase of the study.
Statistical analysis
Statistical comparisons were performed using a
repeated measures, analysis of variance
(ANOVA) design, with length of recall delay
(three and six months) as a between-subjects
factor and type of pain rating (experienced and
recalled) as a within-subjects factor. Separate
ANOVAs were conducted for pain intensity and
pain unpleasantness.
To test whether the experienced pain ratings
and the positive and negative affect influenced
the memory of pain, two forward stepwise mul-
tiple regression analyses were performed with
experienced pain intensity or pain unpleasantness
and positive and negative affect as independent
variables and recalled pain intensity or unplea-
santness as the dependent variables. The order of
entering the variables into the equation was not
predefined a priori. Rather, it was determined by
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the amount of variance explained by a new
variable, while controlling for other variables
already in the equation. All the analyses were
carried out using the STATISTICA data analysis
software system versi on 10 (StatSoft Inc., Tulsa,
OK, USA), with the exception of the compromise
power analyses which were performed using
G*Power 3.1.9.2 (Faul, Erdfelder, Buchner, &
Lang, 2009; Faul, Erdfelder, Lang, & Buchner,
2007). The level of significance was set at p < .05
for rejecting the null hypothesis in all the statist-
ical analyses.
RESULTS
ANOVA revealed a statistically significant main
effect of type of pain rating on pain intensity
(F
(1, 60)
= 25.14, p < .001, η
2
= 0.30, power = 0.99),
indicating that the participants later recalled less
intense pain than they reported immediately after
completion of the marathon (see Figure 1). No
significant main effect of recall delay (F
(1, 60)
=
0.76, p > .05, η
2
= 0.01, power = 0.71) and no
significant interaction between pain rating and
recall delay (F
(1, 60)
= 2.74, p > .05, η
2
= 0.04,
power = 0.91) were found.
ANOVA further revealed a statistically signi-
ficant main effect of type of pain rating on pain
unpleasantness (F
(1, 60)
= 18.63, p < .001, η
2
=
0.24, power = 0.99), indicating that the partici-
pants later recalled less unpleasant pain than they
reported immediate ly after completion of the
marathon (see Figure 2). No significant main
effect of recal l delay (F
(1, 60)
= 0.08, p > .05, η
2
=
0.001, power = 0.53) and no significant interaction
between pain rating and recall delay (F
(1, 60)
=
2.54, p > .05, η
2
= 0.04, power = 0.90) were found.
By analysing individual results, it was found
that 2 participants recalled both the pain intensity
and unpleasantness accurat ely (i.e., in the exactly
same way), 11 participants overestimated both
the pain intensity and unpleasantness and 35
participants underestimated both pain intens ity
and unpleasantness. The results of the rest of the
participants (14) were inconsistent (e.g., they
underestimated pain intensity but overestimated
pain unpleasantness), so it was impossible to
identify their memory style. As comparing three
Figure 1. NRS ratings of the experienced and recalled pain intensity in two study groups, recalling pain three or six months after
the marathon. Regardless of the length of recall delay, the subjects recalled less intense pain than they reported immediately after
completion of the marathon.
MEMORY OF PAIN INDUCED BY PHYSICAL EXERCISE 5
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groups of participants that differ so much in their
number is unjustified, it was decided not to do it.
Given that both ANOVAs revealed no statist-
ically significant main effects of recall delay,
stepwise multiple regression analyses were per-
formed on the entire sample studied. The first
stepwise regression was performed with experi-
enced pain intensity and positive and negative
affect as independent variables and recalled pain
intensity as a dependent variable. Negative affect
entered as a significant predictor (β = 0.40, p <
.01) in step 1, accounting for a significant portion
of the variance in recalled pain intensity (COR
R
2
= 0.14, p < .01, power = 0.80). The step 2
variables (negative affect a nd experienced pain
intensity) accounted for 24% of the total vari-
ance in recalled pain intensity (COR R
2
= 0.24,
p < .001, power = 0.94). Both negative affect (β =
0.35, p < .01) and experienced pain intensity (β =
0.33, p < .01) were significant predictors of
recalled pain intensity. The step 3 variables
(negative affect, experienced pain intensity and
positive affect) accounted for 27% of the total
variance (COR R
2
= 0.27, p < .001, power = 0.96).
Both negative affect (β = 0.36, p < .01) and
experienced pa in intensity (β = 0.4, p < .001) were
significant predictors of recalled pain intensity,
but positive affect was not a significant predictor
(β = 0.22, p < .07; see Table 2 ).
The second stepwise regression was perform ed
with experienced pain unpleasantness and posit-
ive and negative affect as independent variables
and recalled pain unpleasantness as a dependent
variable. Experienced pain unpleasantness was a
significant predictor of recalled pain unpleasant-
ness in step 1 (β = 0.41, p < .001), accounting for a
significant portion of the variance in recalled pain
unpleasantness (COR R
2
= 0.15, p < .001, power
= 0.81). The step 2 variables (experienced pain
unpleasantness and negative affect) accounted for
22% of the total variance in recalled pain
unpleasantness (COR R
2
= 0.22, p < .001, power
= 0.92). Both the experienced pain unpleasant-
ness (β = 0.39, p < .001) and negative affect (β =
0.29, p < .01) were significant predictors of the
recalled pain unpleasantness. The step 3 vari-
ables (experi enced pain unpleasantness, negative
affect and positive affect) accounted for 23% of
the total variance (COR R
2
= 0.23, p < .001,
power = 0.94). Although both the experienced
Figure 2. NRS ratings of the experienced and recalled pain unpleasantness in two study groups, recalling pain three or six months
after the marathon. Regardless of the length of recall delay, the subjects recalled less unpleasant pain than they reported
immediately after completion of the marathon.
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pain unpleasantness (β = 0.43, p < .001) and
negative affect (β = 0.31, p < .01) were significant
predictors of the recalled pain unpleasantness,
positive affect was not a significant predictor (β =
0.15, p > .05; see Table 3).
DISCUSSION
The major finding of the study is that pain
induced by running a marathon is not remem-
bered accurately. Both the recalled pain intensity
and the recalled unpleasantness are underesti-
mated. These findings are in line with the results
of studies that show that recalled acute (Bruck
et al., 1995; Eli et al., 2000; Norvell et al., 1987)
and experimental (De Pascalis et al., 2008 ; Fors &
Götestam, 1996; Rode et al., 2001), but not
chronic, pain may be underestimated. Indeed,
the pain induced by physical exercise is a type
of acute pain. It should be also noted that
memory of labour pain is often underestimated
(Bennett, 1985; Lowe & Roberts, 1988; Norvell
et al., 1987; Simkin, 1992; Waldenström, 2003).
Niven and Murphy-Black (2000), who reviewed
the studies on memory of labour pain, concluded
that labor pain intensity is remembered accur-
ately or decreases on recall. Labour pain and
pain induced by running a marathon share an
important feature, i.e., both types of acute pain
are harbingers of a happy event: having a child or
completing a marathon. In other words, both
childbirth and running a marathon are emotion-
ally positive experiences. In contrast, chronic pain
and most other types of acute pain (e.g., surgical
and dental) are related to negative events, i.e.,
illness or painful med ical procedures. One of the
reasons for underestimation of the memory of
labour pain and pain induced by physical exercise
may be the positive dimension of these types of
pain experience.
The length of recall delay had no effect on the
results of the current study. Although previous
studies have shown that the length of delay
between pain experience and its recall is an
important factor influencing the memory of pain
(Broderick et al., 2008; Feine et al., 1998; Gedney
et al., 2003), only a few of th ese studies have
involved a recall delay period of longer than a
month (Cog an, Perkowski, & Anderson, 1988;
TABLE 2
Results of the forward stepwise multiple regression analysis predicting the recalled pain intensity
Independent variables
β
t p COR R
2
Fp
Step 1
Negative affect 0.40 3.32 0.01 0.14 11.00 0.01
Step 2
Negative affect 0.35 3.05 0.01
Experienced pain intensity 0.33 2.89 0.01 0.24 10.35 0.001
Step 3
Negative affect 0.36 3.22 0.01
Experienced pain intensity 0.4 3.4 0.001
Positive affect 0.22 1.87 0.07 0.27 8.36 0.001
TABLE 3
Results of the forward stepwise multiple regression analysis predicting the recalled pain unpleasantness
Independent variables
β
t p COR R
2
Fp
Step 1
Experienced pain unpleasantness 0.41 3.42 0.001 0.15 11.71 0.001
Step 2
Experienced pain unpleasantness 0.39 3.45 0.001
Negative affect 0.29 2.56 0.01 0.22 9.69 0.001
Step 3
Experienced pain unpleasantness 0.43 3.67 0.001
Negative affect 0.31 2.69 0.01
Positive affect 0.15 1.31 0.2 0.23 7.11 0.001
MEMORY OF PAIN INDUCED BY PHYSICAL EXERCISE 7
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Gedney et al., 2003; Haas, Nyiendo, & Aickin,
2002; McGorry, Webster, Snook, & Hsiang, 1999;
Tasmuth, Estlanderb, & Kalso, 1996). Moreover,
three recent studies in which the same recall
delays of three and six months were used also
found no effect of the length of recall delay on
pain recall (Bąbel, 2014a, 2014b;Bąbel et al.,
2015). Interestingly, the only studies to use a
between-subjects design are these three recent
studies, the current study and Cogan and colla-
borators study (1988) which also found no effect
of recall delay on pain recall. It is possible that
the comparison of pain recall at longer recall
delays than used in the current study would
reveal the influence of the length of recall delay
on the memory of pain induced by physical
exercise, or that the results of the studies in which
a within-subjects design was applied are biased by
repeated pain recall. However, it cannot be
excluded that the length of recall delay has no
impact on the memory of the specific type of pain
induced by physical exercise.
According to the results of the current study,
two factors influence the memory of pain induced
by running a marathon: experienced pain and
negative affect. These factors accounted for 24%
of the total variance in predicting the recalled pain
intensity and 22% of the total variance in predict-
ing the recalled pain unpleasantness. The pain and
negative affect experienced were found to have a
similar impact on the prediction of the recalled
pain. Adding positive affect to the regression
equation did not significantly change the percent-
age of the predicted variance (the experienced pain
and negative and positive affect accounted for 27%
of the total variance in predicting the recalled pain
intensity and 23% of the total variance in predict-
ing the recalled pain unpleasantness). Moreover,
positive affect was not a significant predictor of
both the recalled pain intensity and the recalled
pain unpleasantness.
The impact of experienced pain on recalled
pain revealed in the current study is in line with
the results of previous studies (Bąbel, 2014a;
Bąbel et al., 2015; Jantsch et al., 2009; Noel et al.,
2012b). Similarly, the influence of negative affect
on recalled pain is in line with the previous
findings showing that negative affect (Bąbel et al.,
2015; Gedney & Logan, 2004, 2006), state anxiety
(Bąbel, 2014a, 2014b;Bąbel et al., 2015; Eli et al.,
2000; Gedney et al., 2003; Noel et al., 2012b) and
distress (Everts et al., 1999; Jamison et al., 1989)
are related to the memory of pain. Moreover, the
results of the current study support Gedney and
Logans(2004) model of acute pain memory
recall. According to their model, pain is accur-
ately recalled both immediately after a painful
experience and after a short delay. At intermedi-
ate periods of recall delay, variance in the
prediction of recall is shared between the experi-
enced pain and negative affect at the time of pain
experience. With greater periods of recall delay,
negative affect at the time of the pain experience
increasingly predicts the level of pain recall. In
the current study, the length of recall delay was
three or six months and may be treated as
intermediate in terms of Gedney and Logans
(2004) model. However, this model accounts only
for recalled pain intensity and exaggeration of the
recalled pain. The results of the current study
suggest that a similar model may explain recalled
pain unpleasantness and underestimation of the
recalled pain. Some support for this view also
comes from the results of previous studies which
showed that negative affect, i.e., pre-treatment
anxiety, predicts memory of pain (Bąbel, 2014a,
2014b;Bąbel et al., 2015; Gedney et al., 2003),
and that state anxiety at the moment of recall
predicts underest imation of pain recall (Eli et al.,
2000). In summary, the results of the current
study support and extend Gedney and Logans
(2004) model of acute pain memory recall by
showing that, three to six months after running a
marathon, the variance in the prediction of
underestimated pain recall, with respect to both
pain intensity and unpleasantness, is shared
between experienced pain and negative affect at
the time of the pain experience.
No definite conclusions can be draw n from the
findings concerning the influence on pain recall of
positive affect at the time of the pain experience.
Positive affect was not a significant predictor of
the recalled pain intensity (β = 0.22, p < .07);
adding it to the regression equation increased the
percentage of predicted variance of the recalled
pain intensity and unpleasantness by just 3% and
1%, respectively. However, the results of the
recent studies have shown that positive affect
has an effect on memory of pain (Bąbel, 2014a,
2014b;Bąbel et al., 2015).
The effect of affect on the memory of pain is
well documented, as well as the effect of affect on
memory in general. Affect increases not only the
likelihood of remem bering some information or
an event but also the vividness with which it is
remembered (see Kensinger & Schacter, 2008, for
review). Different explanations for the way that
affect influences memor y have been offered,
8BĄBEL
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including network (affective state is a node in the
memory network and is used as a retrieval cue),
attentional (high levels of affective arousal tend
to cause forgetting of the details of events,
resulting from the limited attentional capacity at
encoding), energy (affective arousal at the time of
encoding determines directly whether a particular
memory enters long-term memory for storage),
motivational (those who are in a positive frame of
mind take chances and expend efforts more
willingly, and this way their memory is impr oved)
and integrated trace explanations (cognitive-per-
ceptual and affective features are integrated into
a single memory trace, so one type of feature can
be a cue for the other; see Leichtman, Ceci, &
Ornstein (1992) for review). These explanations
can account for the effect of affect on the memory
of pain induced by physical exercise that has been
found in the current study.
The results of the current study may seem to
have no clinical relevance to the understanding of
pain in general. However, the recent study by
Bąbel and collaborators (2015)hasshownthatthe
memory of pain is influenced by the meaning and
affective value of the pain experience. The authors
compared three specific types of acute pain: post-
partum pain induced by vaginal delivery, post-
partum pain induced by caesarean section and
post-operative pain induced by gynaecological sur-
gery. Both vaginally induced and caesarean-
induced post-partum pain are associated with the
happy event of having a child, whereas post-
operative pain is associated with negative events
(i.e., illness or painful medical procedures).
Although post-operative pain induced by gynaeco-
logical surgery and post-partum pain induced by
caesarean section are induced by invasive medical
procedures, they have a very different meaning and
affective value. On the other hand, birth by
caesarean section has similar meaning and affective
value as birth by vaginal delivery, although they
are very different medical procedures. The three
groups of participants differed in terms of the
accuracy of memory of pain and affect as well as
in the terms of the predictors of recalled pain
intensity and unpleasantness, and the proportion of
variance predicted by the same independent
variables.
The results of the current study in some way
extend the results of Bąbel and collaborators
(2015) research. As mentioned above, running a
marathon shares an important feature with post-
partum pain, i.e., both types of acute pain are
harbingers of a happy event (having a child or
completing a marathon) and are emotionally
positive experiences. Taking together the results
of the current study and Bąbel and collaborators
(2015) study may help to understand the role of
positive affect in pain in general and specifically
in memory of pain. However, it would be prema-
ture to draw any conclusions as further evidence
is needed .
Some limitations of the current study sho uld be
acknowledged. First, acute pain induced by phys-
ical exercise was studied, and the results may not
be generalisable to clinical (either acute or
chronic) or experimental pain. Second, a specific
mode of physical exercise was studied, i.e., run-
ning a marathon, and the results may not be
generalisable to pain induced by other modes of
physical exercise. Third, recall delays different from
those examined in this study, i.e., different from
three and six months, may yield different results.
Fourth, although the same measures of pain (NRS)
were used in both phases of the study, in the first
phase a paper and pencil method of pain assess-
ment was applied, and in the second phase an
online survey was conducted.
This study appears to be the first to investigate
memory of pain induced byphysicalexerciseand
one of only four studies to attempt to determine the
effect of positive affect on the memory of pain
(Bąbel, 2014a, 2014b;Bąbel et al., 2015). Moreover,
the current study is also one of only a few
investigations on memory of pain in which both
pain intensity and unpleasantness were measured
(Bąbel, 2014a, 2014b;Bąbel et al., 2015;Bryant,
1993;DePascalisetal.,2002;Feineetal.,1998;
Gedney et al., 2003;Koyama,Koyama,Kroncke,&
Coghill, 2004;Priceetal.,1999;Smith,Gracely,&
Safer, 1998). It was found that both recalled pain
intensity and unpleasantness are underestimated,
and that experienced pain and negative affect
influence the memory of pain induced by physical
exercise. Although the results of the current study
cannot substantiate the hypothesis that positive
affect influences the memory of pain, they should
stimulate further research on this topic. An import-
ant area of the future research seems to be the
effect of affect that precedes the painful experiences
on both the experienced and recalled pain. For
example, Noel and collaborators (2012c)modelof
acute pain memory development in childhood
suggests that children with higher levels of both
general anxiety (e.g., state/trait anxiety and anxiety
sensitivity) and fear and anxiety that is specific to
pain itself (e.g., fear of pain, pain anxiety and pain
catastrophising) tend to develop pain memories
MEMORY OF PAIN INDUCED BY PHYSICAL EXERCISE 9
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that are characterised by amplified estimations of
sensory and affective threat over time. It would be
also interesting to find out whether the fulfilment of
the runners goals and expectations related to how
they would perform would have an effect on the
memory of pain. Moreover, further investigations
are needed into the effect of the length of recall
delay on the memory of pain induced by physical
exercise. The memory of pain induced by other
modes of physical exercise should also be studied to
allow comparisons between different forms of
exercise and with memories of other types of acute
pain.
ACKNOWLEDGMENTS
I would like to thank Patryk Mazurkiewicz and Niwad
Putteeraj for their assistance with the preparation of
the study materials and data collection.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the
author.
FUNDING
This work was supported by the National Science
Centre in Poland [grant number N N106 009940].
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... Previous studies showed that the pain induced by running a marathon was remembered as less intense and less unpleasant than it originally was. 6,7 These data were collected from well-trained athletes who had finished a full marathon. The current study aimed to examine trail half-marathon participants who varied in terms of seniority and number of marathon starts. ...
... Two factors significantly influence the memory of pain induced by running a marathon: affect experienced upon completing the run, 6 and pain felt during recall. 7 However, the influence of cognitive factors on memories of this type of pain has not yet been investigated. ...
... [17][18][19] The NRSs were used in numerous studies to measure the experienced, expected and recalled pain. 6,7,[20][21][22][23] Moreover, the participants were also asked about gender, age, THM finishing time, pain duration after the THM, years of running, years of running marathons, the number of running events since the THM, how long since the last running event, whether they had experienced pain induced by running since the THM and how long ago this occurred, whether they had experienced pain since the THM that was not induced by running and how long ago this occurred, and whether they had participated in the previous year's THM. ...
Article
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Purpose: It has been shown that the memory of pain induced by running might be underestimated. Our previous study showed the contribution of emotional factors to this process. This study aimed to investigate the cognitive factors that might influence the memory of this type of pain, ie expectancy of pain intensity, expectancy of pain unpleasantness, and desire for pain relief. Participants and methods: A total of 49 half-marathon runners rated the intensity and unpleasantness of pain immediately after completing a run and one month later. Participants rated the expected intensity and unpleasantness of the upcoming pain before starting the run, as well as the desire for pain relief after its completion. Those who also participated in the previous edition of the half marathon were asked to recall the pain experienced due to that run. Results: Participants underestimated remembered pain intensity and unpleasantness. The desire for pain relief mediated the memory of pain intensity (p < 0.05), while expectancy of pain intensity influenced memory of pain intensity (a × b) through its effect on the experienced pain (bootstrapped point estimate = 0.08; 95% CI: 0.02-0.32). The remembered intensity of pain experienced during the previous half marathon affected the current pain experience directly (p < 0.05) or indirectly (a × b) by generating pain-related expectancy (bootstrapped point estimate = 0.11; 95% CI: 0.01-0.46). The cognitive variables did not influence the memory of pain unpleasantness. Conclusion: The memory of pain induced by sports activity may change due to cognitive factors; however, further research is needed to investigate their role in shaping the memory of the sensory and affective dimensions of pain.
... Yet, relatively little research has been done on recalling this type of pain. [18][19][20][21] These previous findings have shown that pain experienced during sports activity was remembered as less intensive 18,20,21 or accurately. 19 These results are also in line with other studies' findings on the memory of pain induced by positively valued experiences like giving birth. ...
... Yet, relatively little research has been done on recalling this type of pain. [18][19][20][21] These previous findings have shown that pain experienced during sports activity was remembered as less intensive 18,20,21 or accurately. 19 These results are also in line with other studies' findings on the memory of pain induced by positively valued experiences like giving birth. ...
... Preceding studies have concluded that the emotional or affective states accompanying pain experiences are significant predictors of pain memory. 3,5,8,11,14,15,20,[23][24][25][26][27][28][29] These studies mostly emphasize the role of negative affect, 5,11,14,15,20,[23][24][25][26]28 whereas some recent studies suggest that positive affect may also be of importance, especially in terms of pain associated with positively valued experiences. 3,30 One previous study shows that negative affect experienced after reaching the marathon finish line enabled pain memory predictions. ...
Article
Full-text available
Background: Memory and in turn, memory of pain is a reconstructive process. This study considers the relationship between time, memory, affective states, and pain induced by running a marathon by investigating the influence of these factors on a participant's memory of pain experienced after a marathon. The following two hypotheses were formulated: 1) participants' recalled-pain of marathon experience is underestimated; and 2) the underestimation of recalled pain would be greater for participants experiencing higher positive affect. Methods: A longitudinal design was employed to check pain intensities of marathon participants a) at the finish line and b) 6 months following its completion. The sample size was based on a power analysis, and 108 marathonists rated their pain intensities and positive and negative affects at the finish line. From this sample, 58 participants recalled their pain experience of running the marathon 6 months later. Linear models, including computer-based data-mining algorithms, were used. Results: The experienced pain was higher than their recalled pain (t(55) = 3.412, p < 0.01, d = 0.45), supporting the first hypothesis. The memory of pain faded similarly in all participants, which did not directly support the second hypothesis. Further exploratory analysis suggested that negative and positive affective states were related to participants' pain memory; positive affective states appeared to be inversely related to the recall (β = -0.289, p = 0.039). Discussion: This study shows that time has a significant effect on memory recall and that emotions may also influence the memory of pain. This is the first study that preliminarily showcased the effect of positive affective states on the memory of pain induced by physical exercise.
... Although memory of pain has been investigated extensively for the few last decades (for reviews see [5,6]), the results of previous studies are highly variable. Several studies have shown that pain may be remembered accurately [7][8][9][10][11][12][13][14][15], but there is also evidence indicating that people tend to overestimate [16][17][18][19] or underestimate their recollections of pain [20][21][22][23][24]. Thus, a definitive answer to the question of whether pain is remembered accurately is still lacking. ...
... Generally, lower accuracy of recall in the case of longer reporting periods has been observed in a few previous studies [21,23,[31][32][33]. At the same time, other studies failed to find an effect of recall delay on memory of pain [7][8][9][10]20]. Again, a meta-analytic approach may help in comparing the results of previous studies in which different recall delays were applied to find out whether memory of pain depends on recall delay. ...
... Some questions have been modified to reflect methodological issues crucial for memory of pain studies (see Additional file 1: Table S1). Moreover, in order to create a unified power criterion for all the studies (question 27 in the original checklist), an a priori power calculation will be performed based on the results of two studies that used similar methodology to investigate memory of pain [20,21]. The results of this calculation will serve as a criterion by which to judge other studies (Downs and Black checklist [39], question 27). ...
Article
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Background: The way pain is remembered and reported can affect medical decisions taken by patients and health-care professionals. Memory of pain has been investigated extensively for the past few decades; however, the results of previous studies are highly variable, indicating that the recollection of pain can be accurate, overestimated or underestimated. It is therefore difficult to conclude how well pain is remembered. The aim of this systematic review and meta-analysis is to summarize research findings on memory of pain in healthy adults and patients suffering from acute and chronic pain. Methods: The systematic review will be performed by searching for articles indexed in the following databases: PubMed, MEDLINE, PsycINFO, Web of Science, ScienceDirect, PsycARTICLES, Scopus and Academic Search Complete. Studies will be included if (1) they investigated healthy adults or patients with any acute or chronic pain condition and if (2) they assessed experienced pain (pain intensity and/or pain unpleasantness) and its recollection. No restrictions related to the date of publication and recall delay will be applied. Studies will be screened for eligibility and risk of bias by two independent assessors. The risk of bias will be assessed by a modified Downs and Black checklist. A narrative synthesis will be performed in the first stage; in the second stage, the results of studies with comparable designs will be pooled in meta-analytical syntheses. Discussion: The question of whether pain is remembered accurately is crucial for valid pain diagnosis, effective treatment and prognosis. So far, a number of studies on memory of pain have been conducted; however, a definitive conclusion on whether memory of pain is accurate is still lacking. In this systematic review and meta-analysis, available data will be pooled together to further inform research and clinical practice. Systematic review registration: PROSPERO CRD42018093523.
... Another example of pain related to positively valued experience is the suffering induced by physical exercise. Although the nature of this type of pain has been examined previously (Janal et al., 1994;Tesarz et al., 2012;Geva and Defrin, 2013;Rhudy, 2013), there is only one study on the memory of pain induced by physical exercise (Bą bel, 2016). The results of that research suggest that the memory of pain induced by running a marathon is underestimated: both three and 6 months after the pain experience, participants reported pain intensity and unpleasantness as lower than after reaching the finishing line. ...
... The second aim of the study was to explore factors affecting the memory of pain during recall. While the previous study focused on factors accompanying pain experience (Bą bel, 2016), the current research has been designed to investigate whether the pain felt during recall influences the memory of past pain experience. The results of previous studies have shown that the higher the pain experienced during the pain recall, the higher the remembered pain (Feine et al., 1998;Smith et al., 1998;Haas et al., 2002;Lefebvre and Keefe, 2002). ...
... indicating that other possible mediators cannot be totally excluded. For example, previous studies have shown that positive and negative affect may influence the memory of pain (Bą bel, 2014(Bą bel, , 2015(Bą bel, , 2016(Bą bel, , 2017a. ...
Article
Background: A previous study has shown that memory of pain induced by running a marathon might be underestimated. However, little is known about the factors that might influence such a memory distortion during pain recall. The aim of the study was to investigate the memory of pain induced by running a marathon and the factors that might influence it: (1) present pain during recall and (2) recall delay. Methods: A total of 127 marathon runners participated in the study, which comprised of two phases. After completion of the marathon, participants were asked to rate the intensity and the unpleasantness of their pain. Either a week or a month later, they were asked again to rate the intensity and the unpleasantness of the remembered and present pain experience. Results: Participants underestimated remembered pain intensity and pain unpleasantness only if they did not experience pain during recall (p < 0.05). We observed a trend for underestimation after a week (p = 0.09) and significant effect after a month (p < 0.05) of recall delay. Furthermore, present pain intensity during recall significantly mediated the memory of pain intensity induced by running the marathon, but only after a month. Similarly, present pain unpleasantness during recall significantly mediated the memory of pain unpleasantness, but only after a month. Conclusions: It is concluded that memory of pain induced by running the marathon is underestimated after a month of recall delay and mediated by present pain during recall. Significance: This study explores factors acting during recall, influencing memory of naturally occurring pain induced by physical effort. The empirical findings provide the first robust evidence for a causal relationship between memory of pain and present pain during recall.
... In addition to the intrinsic difficulty in describing and quantifying pain, it has been repeatedly shown that memories for painful events are inaccurate -when asked to recall a past painful event, people tend to overestimate their pain, with the intensity usually reported more severe than actually experienced (Salovey and Smith, 1997). The magnitude and direction of the discrepancy between remembered pain and actual pain seem to depend upon many factors, including emotional context (Eich et al., 1985;Norvell et al., 1987;Lowe and Roberts, 1988;Smith and Safer, 1993;Algom and Lubel, 1994;Salovey and Smith, 1997;Babel, 2015), an individual's personality traits and mood (Kent, 1985;Rocha et al., 2009), and the participants' previous experience with pain (Linton and Melin, 1982;Salovey and Smith, 1997;Feine et al., 1998). The psychometric properties of acute experimental pain also account for a large proportion of the error in remembering pain. ...
... Multi-factor multiple regression analyses were used to examine whether the psychometric qualities (peak, end, total, and average) examined from the pain and mood daily ratings, current pain and mood parameters from the day of memory assessment (given (Eich et al., 1985;Norvell et al., 1987;Lowe and Roberts, 1988;Smith and Safer, 1993;Algom and Lubel, 1994;Salovey and Smith, 1997;Babel, 2015)), and A1 posterior hippocampal shape displacement could explain the pain memory values. We incrementally tested 4 separate multivariable models (Table 1); each regression built off the previous one to explain the memory of pain. ...
... Kent (1985) showed that individuals who were highly anxious regarding dental examinations later rated their remembered pain as higher than experienced compared to individuals with lower anxiety; similar findings have also been reported in children (Rocha et al., 2009). Likewise, labor pain is retrospectively rated as less severe than was previously rated (Norvell et al., 1987;Lowe and Roberts, 1988;Algom and Lubel, 1994;Salovey and Smith, 1997), as is the pain of running a marathon (Babel, 2015), both of which are likely due to the impact of positive emotions at the end of each event. Our results also match these previous findings, as pain was shown to be anti-correlated with mood, and the mood at the end Fig. 4. Longitudinal and follow-up analyses relate pain memory bias to loss aversion. ...
Article
Full-text available
Experiences and memories are often mismatched. While multiple studies have investigated psychological underpinnings of recall error with respect to emotional events, the neurobiological mechanisms underlying the divergence between experiences and memories remain relatively unexplored in the domain of chronic pain. Here we examined the discrepancy between experienced chronic low back pain (CBP) intensity (twice daily ratings) and remembered pain intensity (n = 48 subjects) relative to psychometric properties, hippocampus morphology, memory capabilities, and personality traits related to reward. 77% of CBP patients exaggerated remembered pain, which depended on their strongest experienced pain and their most recent mood rating. This bias persisted over nearly 1 year and was related to reward memory bias and loss aversion. Shape displacement of a specific region in the left posterior hippocampus mediated personality effects on pain memory bias, predicted pain memory bias in a validation CBP group (n = 21), and accounted for 55% of the variance of pain memory bias. In two independent groups (n = 20/group), morphology of this region was stable over time and unperturbed by the development of chronic pain. These results imply that a localized hippocampal circuit, and personality traits associated with reward processing, largely determine exaggeration of daily pain experiences in chronic pain patients.
... A percepção da dor foi medida pela Numeric Rating Scale (NRS), uma escala gradual simples, com 11 pontos que se relacionam à intensidade da dor (0, como "nenhuma dor", até 10, como "a dor mais intensa já sentida"). Este instrumento é de fácil compreensão e uso e é frequentemente utilizado na pesquisa da dor (Downie et al., 1978), já tendo sido aplicado em maratonistas e ultramaratonistas (Anunciação & Landeira-Fernandez, 2017;Bąbel, 2015Bąbel, , 2016. ...
... Outros autores, em um delineamento de pesquisa similar, detectaram que o tempo vai, aos poucos, diminuindo a recordação da intensidade da dor ocorrida durante o momento do parto (Waldenstrom, 2003). Especificamente em relação a corredores de longas distâncias, em 2016, Bąbel concluiu que a recordação da dor era menos intensa após 6 meses do que o primeiro valor relatado, o que também foi parcialmente alcançado por outros autores (Anunciação & Landeira-Fernandez, 2017;Bąbel, 2016). Apesar das diferentes conclusões na literatura, torna-se evidente perceber o caráter dinâmico e altamente plástico das memórias (Izquierdo et al., 2013). ...
Article
Full-text available
Resumo A memória é uma função psicológica plástica e dinâmica. Além disso, há uma estreita ligação entre eventos mnêmicos e estados afetivos. Esse trabalho objetivou estudar o efeito do tempo e dos afetos positivos e negativos na evocação de uma memória de dor ocasionada por uma corrida de longa distância e de confirmar a estrutura fatorial da Escala de Afetos Positivos e Negativos (PANAS). Em 2016, 138 corredores de 21,1 e 42,2 km foram avaliados com a Escala Numérica de Dor (NRS) e a PANAS em dois momentos: imediatamente após completarem a corrida e 6 meses depois. Não houve diferença entre o relato imediato após a corrida e a evocação da magnitude da dor (t(57) = ,136, p = ,446). Todos os participantes tiveram mais afetivos positivos do que negativos ao completar a corrida (t(135) = 32,19, p < ,001) e os afetos positivos contribuíram como preditores significativos e inversamente associados à recordação da dor (b =-,118, p = ,02). A PANAS apresentou ajustes adequados na Análise Fatorial Confirmatória (χ2(169) = 306; p < ,001; TLI = ,921; CFI = .929; RMSEA = ,081), mostrando-se apropriada para o uso em situações como essa. Os resultados oferecem mais evidências sobre a distorção que a memória apresenta e valida o PANAS para uso em situações similares à desta pesquisa. Palavras-chave: memória; dor; afeto; corrida; psicologia; psicometria. Abstract Memory is a dynamic and plastic psychological function. In addition, there is a close connection between memory events and affective states. This study aimed to study the effect of time and positive and negative affects on the recall of pain memory caused by a long-distance run and to confirm the factorial structure of the Positive and Negative Affect Scale (PANAS). In 2016, 138 runners of 21.1 and 42.2 km were evaluated with the Numerical Pain Scale (NRS) and PANAS in two moments: immediately after completing the race and 6 months later. There
... A percepção da dor foi medida pela Numeric Rating Scale (NRS), uma escala gradual simples, com 11 pontos que se relacionam à intensidade da dor (0, como "nenhuma dor", até 10, como "a dor mais intensa já sentida"). Este instrumento é de fácil compreensão e uso e é frequentemente utilizado na pesquisa da dor (Downie et al., 1978), já tendo sido aplicado em maratonistas e ultramaratonistas (Anunciação & Landeira-Fernandez, 2017;Bąbel, 2015Bąbel, , 2016. ...
... Outros autores, em um delineamento de pesquisa similar, detectaram que o tempo vai, aos poucos, diminuindo a recordação da intensidade da dor ocorrida durante o momento do parto (Waldenstrom, 2003). Especificamente em relação a corredores de longas distâncias, em 2016, Bąbel concluiu que a recordação da dor era menos intensa após 6 meses do que o primeiro valor relatado, o que também foi parcialmente alcançado por outros autores (Anunciação & Landeira-Fernandez, 2017;Bąbel, 2016). Apesar das diferentes conclusões na literatura, torna-se evidente perceber o caráter dinâmico e altamente plástico das memórias (Izquierdo et al., 2013). ...
... Recollections of affective experiences are subject to recall biases (Levine, Lench, & Safer, 2009;Thomas & Diener, 1990), a robust negativity bias (Cacioppo & Berntson, 1999), individual differences (Safer, Levine, & Drapalski, 2002), and contextual influences (Levine, Prohaska, Burgess, Rice, & Laulhere, 2001). Accordingly, affective experiences during exercise are generally not recalled accurately (Bąbel, 2016) and, at least to some extent, tend to be "reconstructive" (Anderson & Brice, 2011). Nevertheless, remembered affective exercise experiences, despite being biased or inaccurate, are associated with subsequent affective responses to exercise (Karnaze, Levine, & Schneider, 2017), may be the basis of affective forecasting errors (Loehr & Baldwin, 2014;Ruby, Dunn, Perrino, Gillis, & Viel, 2011), and could be harnessed to motivate future exercise behavior (Biondolillo & Pillemer, 2015). ...
Article
Suggestions that affective experiences may influence exercise motivation have commonly appeared since the dawn of exercise psychology. However, a measure that captures the nature, the antecedents, and the motivational implications of such experiences has been lacking. We developed the Affective Exercise Experiences (AFFEXX) questionnaire to assess the constructs within a conceptual model, according to which core affective exercise experiences (pleasure-displeasure, energy-tiredness, calmness-tension) are influenced by six antecedent appraisals and, in turn, shape attraction or antipathy towards exercise. We report results from three studies (N = 1,799) evaluating internal consistency, test-retest reliability, and factorial, convergent, discriminant, construct, and criterion validity. We show that attraction-antipathy correlates with vigorous (.55) and moderate-to-vigorous (.48) self-reported physical activity, and accounts for 11-12% and 6-7% of additional variance, respectively, beyond variance explained by self-efficacy and behavioral intention. Affective exercise experiences warrant further study as possible contributors to motivation. The AFFEXX is available from this link: https://osf.io/ef76r/?view_only=7959ac258d4f4df992e2c4868d10f800
... Interestingly, most studies on chronic pain indicate that its memory is usually overestimated [2,11,30,31], whereas the memory of labor pain seems to be underestimated [9,[32][33][34]. Moreover, the results of our two recent studies on the memory of pain induced by running a marathon indicate that it is underestimated as well [35,36]. ...
Article
Pain can be overestimated, underestimated or reported accurately at recall. The way pain is remembered seems to depend on certain factors, including the type of pain or, in other words, its cause, the context, and the meaning it has for the person suffering from it. For instance, episodes of chronic pain, as well as pain related to surgery, are often overestimated at recall. Interestingly, research shows that pain induced by parturition or marathon running is often underestimated at recall despite the fact that both are not only physically grueling but also emotionally intense experiences. However, both processes can likewise be considered positive events, as opposed to most that involve pain. On the neurophysiological level, one of the similarities between giving birth and running a marathon is the particular involvement of the oxytocin system. Oxytocin is involved both in parturition and intense exercise, for various reasons. During labor, oxytocin mediates uterine contractions, while in the case of extensive running it might be involved in the maintenance of fluid balance. It also has well-documented analgesic properties and plays an important role in memory formation and recall. It has been suggested that oxytocin modulates the output of the central nucleus of the amygdala (CeA)during the fear recall. Moreover, it has been demonstrated that oxytocin can impair fear learning and influence the memory of both positive and negative emotionally salient stimuli. We propose that the reason for pain to be remembered in a more favorable light is the central action of oxytocin in the central nucleus of the amygdala, first and foremost during the encoding phase.
Article
Objectives: Previous research on pain memory provides inconsistent evidence about the accuracy of pain recall, and few studies have attempted to examine broad affective and contextual contributions to this phenomenon. The present research aimed to determine the accuracy of postoperative pain recall after a 3-months, with respect to the context of the surgery and the congruence of affective states concurrent with the initial experience and its recall. The study also aimed to identify predictors of remembered pain by analysing a range of sensory, cognitive and affective factors. Methods: Older adults, undergoing planned (N=40) and unplanned hip surgery (N=31), were enrolled in this prospective study to investigate their pre-, post-surgery, and delayed ratings of expected, experienced, and recalled pain intensity and unpleasantness, state anxiety and positive and negative affect. Results: Memory of postoperative pain was found to be accurate, regardless of the context of the surgery. Affective states in the postoperative period were congruent with those during pain recall. The study also revealed that in planned surgery context, remembered pain was predicted by experienced postoperative pain, cognitive functions, positive and negative affect; whereas in unplanned surgery context its significant predictors included age, anxiety, negative and positive affect. Discussion: This study suggests that older orthopaedic patients remember postoperative pain correctly after 3 months and that mood dependence effect may contribute to memory of pain. Pain recall after planned surgery appears to depend mainly on the actual experience, while following unplanned surgery it depends on affective factors. Present findings contribute to scarce knowledge about pain memory in older adults and have implications for patients' recovery and best practice in perioperative hospital care.
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The main aims of this study were to assess memory of pain and pain-related affect in headache sufferers and to compare the pain memories of individuals who suffer from migraines and those who experience non-migraine headaches. A total of 313 women participated in the study, 86 of whom had a diagnosis of migraine headache. The women rated their state anxiety about having a headache, the intensity and unpleasantness of headache pain, and their emotions while actually experiencing a headache. Either three or six months later, the participants were asked to recall their state anxiety, the intensity and unpleasantness of pain, and the emotions they had felt. Regardless of the length of recall delay or migraine diagnosis, participants accurately remembered both pain intensity and unpleasantness. Together, recalled anxiety, experienced pain and recalled positive affect were the most important predictors of memories for headache, accounting for 41% and 37% of the total variance in recalled pain intensity and unpleasantness, respectively. However, participants overestimated recalled positive and negative affect. The effect of recalled affect on memory of headache, together with the overestimation of recalled affect, suggests that although memory of headache is accurate, it is influenced by distorted memories of affect.
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SUMMARY Over the past several decades, the field of pediatric pain has made impressive advances in our understanding of the pain experience of the developing child, as well as the devastating impact of inadequately managed pain early in life. It is now well recognized that, from infancy, children are capable of developing implicit memories of pain that can influence their subsequent reactions to pain. The present review provides a synthesis of selected studies that made a significant impact on this field of inquiry, with particular emphasis on recent clinical and laboratory-based experimental research examining children's explicit autobiographical memories for acute pain. Research has begun to move towards improving the precision with which children at risk for developing negatively estimated pain memories can be identified, given the adverse influence these memories can have on subsequent pain experiences. As such, several fear- and anxiety-related child and parent variables implicated in this process are discussed, and avenues for future research and clinical intervention are identified throughout. Finally, a preliminary empirically and theoretically derived model of acute pain memory development in childhood is presented to parsimoniously summarize the evidence accumulated to date and guide future investigation in this area.
Article
Purpose: The aim of this study was to analyse the risk factors that predispose women to chronic symptoms related to the treatment of breast cancer. Patients and methods: A questionnaire was sent to 569 women who had undergone modified radical mastectomies with axillary evacuation (MRM) or breast resection with axillary evacuation (BCT). Results: Pain, paraesthesias and strange sensations were reported by half of the patients. The chronic pain slightly affected the daily lives of about 50% of the patients and moderately or more the daily lives of about 25% of the patients. Pain was reported significantly more often after BCT than after MRM both in the breast scar (BS) and in the ipsilateral arm (IA). The patients with chronic pain were significantly younger and had larger primary tumours. Postoperative complications increased the incidence of chronic pain in the IA. The highest incidence of pain in the IA was reported by patients who had had both radio- and chemotherapy. The fact that the incidence of pain (IA) had a significant correlation with the incidence of paraesthesias, oedema, strange sensations and muscle weakness may be an indication of nerve injury. Conclusions: Chronic pain was more common after breast-conserving surgery than after radical surgery. Surgical complications and postoperative radiotherapy and chemotherapy increased the risk of chronic pain and other symptoms. Modifications in the treatment protocol and preclusion of postoperative complications may be necessary in order to minimize chronic treatment-related symptoms.
Article
Research has shown that previous experience with pain has a desensitizing effect on pain threshold and tolerance. In Phase I, athletes underwent a cold pressor pain test. Athletes participating in contact sports rated their pain as less severe and had a greater pain tolerance time than non-contact sports athletes. An analysis of co-variance using aggressiveness as the covariate did not alter the outcomes of the pain threshold and tolerance measures. In Phase II, a significant difference existed between the amount of pain required to stop practicing and the amount of pain required to stop playing. Athletes were more willing to compete while injured and in pain, thus potentially compounding and worsening their injuries. Taken together, these results provide support for the role of physical contact on desensitizing athletes to pain, and indicate a need for additional intervention and education concerning adequate injury healing time.
Article
Background Memory of chronic, acute and experimental pain may be inaccurate, but the research findings are inconsistent. The main aim of the study was to compare the memory of three types of pain and their associated affect.MethodsA total of 140 women, who gave birth by vaginal delivery or Caesarean section, or underwent gynaecological surgery, participated in the study. Before childbirth or surgery, the women rated their anxiety about the pain they would experience. Between 24 and 48 h after childbirth or surgery, they rated the intensity and unpleasantness of the pain, and their positive and negative affect. Either 3 or 6 months later, the participants recalled the pain and affect they had felt.ResultsThe study found that the type of pain had an effect on memory of pain and affect. Surgery led to an overestimation of all but one of the recalled variables. Participants who gave birth by Caesarean section were the most accurate at recalling pain and affect. Memories of pain and affect were most variable in participants who gave birth by vaginal delivery. The three groups of participants differed in terms of the predictors of recalled pain intensity and unpleasantness, and the proportion of variance predicted by the same independent variables.Conclusions The results of the current study suggest that memory of pain and affect is influenced by the meaning and affective value of the pain experience. This may help us to understand why the previous research on the memory of pain were so diverse.
Article
Physiological and psychological stressors, disease state, and psychosocial factors may influence recall accuracy in low back pain (LBP) reporting. The literature indicates that duration or frequency of the painful episode(s) may exert a greater influence on recall accuracy than pain intensity. The focus of this study is the recall accuracy in self-report of pain by a chronic, nonspecific LBP population. This retrospective study examined recall accuracy of LBP at 1-week, 1-month, and 6-month intervals as compared to self-report using daily pain diaries. Significant differences in recall accuracy were found at the 6-month recall period, but not at the 1-week or 1-month periods. Significant differences in accuracy were found between men and women at the 6-month recall period. Subjects with recurrent LBP were more accurate than subjects with more chronic pain. Pain level or intensity was not shown to effect recall.
Article
Objective Memories of dental pain may influence both subsequent pain experiences during dental treatment and future decisions about whether to go to a dentist. The main aims of this study were to assess memory of pain and pain-related affect induced by tooth restoration.MethodsA total of 39 women who underwent tooth restoration rated their state anxiety before dental treatment, and the intensity and unpleasantness of pain and the emotions they felt immediately after dental treatment. Either 3 months or 6 months later, the participants were asked to recall their state anxiety, the intensity and unpleasantness of pain and the emotions they had felt.ResultsRegardless of the length of recall delay, participants accurately remembered both pain intensity and unpleasantness. Although the state anxiety felt before the pain experience was found to be remembered accurately, the positive affect that accompanied pain was underestimated and the negative affect that accompanied pain was overestimated. Positive affect experienced, state anxiety experienced and recalled state anxiety accounted for 32% and 30%, respectively, of the total variance in recalled intensity and unpleasantness of pain.Conclusion It is concluded that although dental pain is remembered accurately, affective variables, rather than experienced pain, have an effect on memory of pain.
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