Reappraisal mitigates overestimation of remembered pain in anxious individuals

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.

Keywords:

• Anxiety sensitivity
• Memory
• Pain
• Emotion regulation
• Reappraisal

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

¹ This study was part of a larger research project that assessed feelings of distress, spontaneous use of emotion regulation strategies, appraisals related to catastrophizing, and in a separate group of participants, responses to empathy. Questions about distress and spontaneous emotion regulation followed those about pain, and these variables did not interact with ratings or appraisals of pain, which were the focus of the present study.

² Online pain ratings were not related to anxiety sensitivity scores, did not differ by emotion regulation condition, and are not discussed further.

³ Because of the low number of males in the sample (n = 20), analyses on gender differences should be interpreted with caution.