title: Recall Bias in Patients with Chronic Low Back Pain: Individual Pain Response Patterns Are More Important Than Pain Itself!
abstract: BACKGROUND
  Patients' cognitive processing of pain-related information as well as their cognitive, affective and behavioral response pattern when experiencing pain in daily life has been shown to be associated with poorer prognosis in low back pain. However, the relationship between specific cognitive processes such as recall of pain-related material and individual pain responses remains unknown.
  
  
  OBJECTIVE
  The present study sought to investigate recall bias in patients with chronic low back pain (CLBP) compared to healthy controls. Furthermore, it was aimed to investigate the impact of patients' individual pain-related responses on recall bias, comparing fear-avoidance response (FAR), endurance response (ER) and adaptive response (AR) patterns.
  
  
  METHODS
  Thirty-one CLBP patients and 31 controls were tested on a free recall task with three word lists comprising pain words and neutral words. Further, the CLBP group was classified into patients with a FAR, ER and AR pattern, using a short screening including the Avoidance-Endurance Questionnaire (AEQ). Group differences with pain status (CLBP vs. healthy) and AEQ responses (FAR, ER, AR) as between-group factors, word type (pain vs. neutral) as within-group factor and free recall as dependent variable were analysed by means of repeated-measures analysis of (co-) variance.
  
  
  RESULTS
  Results revealed different pain processing of pain words between FAR and ER patterns, whereas CLBP patients as a whole did not differ from the healthy controls. FAR patients displayed significantly less recall than ER patients.
  
  
  CONCLUSIONS
  Recall biases in CLBP patients are not only a result of experiencing pain but also effected by patients' pain response pattern with respect to fear-avoidance versus endurance.
authors.affiliation: Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstraße 150, 44780, Bochum, Germany. zohra.karimi@rub.de.
authors.forename: Zohra
authors.initials: Z
authors.lastname: Karimi
authors.affiliation: Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstraße 150, 44780, Bochum, Germany.
authors.forename: Alisha
authors.initials: A
authors.lastname: Pilenko
authors.affiliation: Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstraße 150, 44780, Bochum, Germany.
authors.forename: Sabine Melanie
authors.initials: SM
authors.lastname: Held
authors.affiliation: Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstraße 150, 44780, Bochum, Germany.
authors.forename: Monika Ilona
authors.initials: MI
authors.lastname: Hasenbring
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001362:Avoidance Learning; D059350:Chronic Pain; D005239:Fear / Q000523:psychology; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D058748:Pain Perception / Q000502:physiology*; D011379:Prognosis; D011795:Surveys and Questionnaires
keywords: Avoidance; Chronic low back pain; Endurance; Free recall; Memory bias