title: Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity.
abstract: BACKGROUND
  Because of its high global burden, determining biopsychosocial influences of chronic low back pain (CLBP) is a research priority. Psychological factors such as pain catastrophizing are well established. However, cognitive factors such as working memory warrant further investigation to be clinically useful.
  
  
  OBJECTIVE
  The purpose of this study was to determine how working memory and pain catastrophizing are associated with CLBP measures of daily pain intensity and movement-evoked pain intensity.
  
  
  METHODS
  This study was a cross-sectional analysis of individuals with ≥3 months of CLBP (n=60) compared with pain-free controls (n=30).
  
  
  METHODS
  Participants completed measures of working memory, pain catastrophizing, and daily pain intensity. Movement-evoked pain intensity was assessed using the Back Performance Scale. Outcome measures were compared between individuals with CLBP and those who were pain-free using nonparametric testing. Associations were determined using multivariate regression analyses.
  
  
  RESULTS
  Participants with CLBP (mean age=47.7 years, 68% female) had lower working memory performance (P=.008) and higher pain catastrophizing (P<.001) compared with pain-free controls (mean age=47.6 years, 63% female). For individuals with CLBP, only working memory remained associated with daily pain intensity (R(2)=.07, standardized beta=-.308, P=.041) and movement-evoked pain intensity (R(2)=.14, standardized beta=-.502, P=.001) after accounting for age, sex, education, and interactions between pain catastrophizing and working memory.
  
  
  CONCLUSIONS
  The cross-sectional design prevented prospective analysis. Findings also are not indicative of overall working memory (eg, spatial) or cognitive performance.
  
  
  CONCLUSIONS
  Working memory demonstrated the strongest association with daily pain and movement-evoked pain intensity compared with (and after accounting for) established CLBP factors. Future research will elucidate the prognostic value of working memory on prevention and recovery of CLBP.
authors.affiliation: C.B. Simon, DPT, PhD, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida; Pain Research and Intervention Center of Excellence, University of Florida, 2004 Mowry Rd, PO Box 100242, Gainesville, FL 32610 (USA); and Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida. csimon@dental.ufl.edu.
authors.forename: Corey B
authors.initials: CB
authors.lastname: Simon
authors.affiliation: T.A. Lentz, PT, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida, and Pain Research and Intervention Center of Excellence, University of Florida.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Lentz
authors.affiliation: M.D. Bishop, PT, PhD, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida, and Pain Research and Intervention Center of Excellence, University of Florida.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Bishop
authors.affiliation: J.L. Riley III, PhD, Pain Research and Intervention Center of Excellence, University of Florida, and Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Riley
authors.affiliation: R.B. Fillingim, PhD, Pain Research and Intervention Center of Excellence, University of Florida, and Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.affiliation: S.Z. George, PT, PhD, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida, and Pain Research and Intervention Center of Excellence, University of Florida.
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D058443:Catastrophization / Q000523:psychology*; D059350:Chronic Pain / Q000209:etiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000523:psychology*; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009068:Movement; D010147:Pain Measurement