Cognitive impairment in individuals with chronic pain is frequently observed and clinically significant (McCracken, & Iverson, 2001). It has... Show moreCognitive impairment in individuals with chronic pain is frequently observed and clinically significant (McCracken, & Iverson, 2001). It has long been recognized that emotional factors contribute to both patient perception of impaired cognition and verifiable cognitive impairment on testing (Burt, Zembar, & Niederehe, 1995). However, scientific consensus is lacking regarding how specific emotions, such as depression, anxiety, and pain catastrophizing impact cognition in chronic pain patients. Research seeking to clarify such relationships has been hampered by methodological shortcomings, which include limited sample sizes, non-objective measures, and failure to examine multiple emotional dimensions in unique samples (McCracken and Vowels, 2014; Moriarty, McGuire, & Finn, 2011). The present study examined factors that might contribute to cognitive impairment in this population using a sample of 78 chronic pain patients evaluated for surgical candidacy for spinal cord stimulator (SCS) implantation at the University of Illinois at Chicago. Use of such a sample ensured patients were wellmotivated to perform to the best of their ability, so as to increase their chance of being cleared for such a highly desirable procedure. Additionally, the vast majority of participants passed well-validated objective measures of effort. Hypothesized associations between attentional function as measured objectively by the RBANS attention index and a number of predictor variables: depression and anxiety, subjective pain experience, pain catastrophizing, somatization, and engagement in pain behaviors were not found, and subsequent analyses of proposed mediating relationships could not be performed. However, fully a third (35.9 percent) of our well-motivated sample did not show clinically significant impairment (below 85, or 1 SD below the mean), as was expected. Thus, it is possible that a well-motivated sample may have been less likely than samples used in previous investigations to show cognitive impairment overall. Strengths and limitations of the study are discussed, as well as clinical and research implications. Ph.D. in Psychology, December 2016 Show less
