Caregiving impact upon sufferers’ cognitive functioning

Abstract

Pain by its evolutionary nature demands attention, warrants interpretation, and often etches itself into our lifelong memories. These cognitive processes of attending, interpreting, and remembering are central components of the pain experience and guide our approach and avoidance of future pain-related experiences. In this chapter, we discuss how cognitive processes influence and are influenced by our experience of pain, and the role of caregivers in the development and malleability of pain-related cognition. We focus on the parent-child relationship, as this is where most research has been conducted. We present evidence suggesting that the experience of chronic pain, or maladaptive pain behaviors, is often associated with distortions in cognitive processes-known as cognitive biases. Biases in attention, interpretation, and memory may help maintain pain over time, and contribute to distress and disability. Evidence for the influence of parents in children’s pain memory development is growing. However, little research has investigated the role of parents and caregivers in attention and interpretation biases specifically. Here, we draw from research in anxiety disorders and depression indicating that caregivers may play a role in triggering, strengthening, and reducing threat-related cognitive biases. Indeed, threat-related cognitive biases appear to pass down through generations. Experimental studies in particular reveal that these biases can be influenced by parents’ verbal information, emotion, and behaviors, indicating potential mechanisms for this intergenerational transmission of cognitive bias. We suggest ways in which we can draw from these studies in anxiety and depression to design novel studies for understanding the role of caregivers in the experience of painrelated cognition. Targeting pain-related cognitive biases in caregivers and patients may provide novel therapeutic targets for individuals suffering from pain.