Cognitive/behavioral approaches: Effects of information type on expected, experienced, and remembered pain among endodontic patients

Abstract

Predictability about aversive events can decrease both fear and pain reporting. Information is an effective method of enhancing predictability about dental and medical procedures. Therefore, the effects of information type on expected, experienced, and remembered pain among endodontic patients was examined. There were 90 patients who viewed one of three types of information (i.e., Pain-relevant, Procedure, and Oral Hygiene) prior to treatment. Expected, experienced, and remembered pain were recorded prior to, during, and immediately following root canal treatment, respectively. Remembered pain also was recorded at 3-weeks post-treatment. Results indicate a significant main effect of time, F (3, 87)=22.86, p<.001; but no differential effect of information type on pain among groups, F (6, 84)=.07, p>.99. These data suggest that regardless of information type, patients over estimated the pain they actually experienced during a root canal procedure, and remembered pain (immediately following treatment) was significantly inflated compared to what was experienced. Furthermore, remembered pain at the 3-week follow-up continued to increase significantly compared to what patients recalled immediately following root canal therapy. Importantly, pain memory at 3-weeks was not meaningfully different than predicted pain at the outset of treatment. The current findings support previous research that has found memory for painful events to be worse than was experienced, contributing to the maintenance of inaccurate pain predictions. Possible reasons for this effect (e.g., fear) are discussed. Predictability about aversive events can decrease both fear and pain reporting. Information is an effective method of enhancing predictability about dental and medical procedures. Therefore, the effects of information type on expected, experienced, and remembered pain among endodontic patients was examined. There were 90 patients who viewed one of three types of information (i.e., Pain-relevant, Procedure, and Oral Hygiene) prior to treatment. Expected, experienced, and remembered pain were recorded prior to, during, and immediately following root canal treatment, respectively. Remembered pain also was recorded at 3-weeks post-treatment. Results indicate a significant main effect of time, F (3, 87)=22.86, p<.001; but no differential effect of information type on pain among groups, F (6, 84)=.07, p>.99. These data suggest that regardless of information type, patients over estimated the pain they actually experienced during a root canal procedure, and remembered pain (immediately following treatment) was significantly inflated compared to what was experienced. Furthermore, remembered pain at the 3-week follow-up continued to increase significantly compared to what patients recalled immediately following root canal therapy. Importantly, pain memory at 3-weeks was not meaningfully different than predicted pain at the outset of treatment. The current findings support previous research that has found memory for painful events to be worse than was experienced, contributing to the maintenance of inaccurate pain predictions. Possible reasons for this effect (e.g., fear) are discussed.