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Reappraisal Mitigates Overestimation of Remembered Pain in Anxious Individuals

Abstract

Anxiety sensitivity, a trait characterized 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 appraisals of pain (reappraisal) would alleviate memory bias. Participants (N = 125) completed a measure of anxiety sensitivity. They were randomly assigned to one of two emotion regulation conditions (distraction, reappraisal) or to a control condition prior to taking part in a cold pressor task. They rated the intensity of pain during and immediately after the task. Memory for pain was assessed 3 to 7 days later. Greater anxiety sensitivity was associated with an increase in threat-related appraisals over time and with remembering pain as having been more intense than originally reported. Engaging in reappraisal mitigated this memory bias but engaging in distraction did not. These findings suggest that health-care practitioners can encourage reappraisal to promote more positive memories of procedural pain, particularly in highly anxious patients, who tend to misremember pain experiences as worse than experienced.

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