Executive functions, self-regulation, and chronic pain: A review

Abstract

Background: Chronic pain conditions are complicated and challenging to live with. Capacity to adjust to such conditions may depend on the ability to self-regulate, that is, the ability to alter thoughts, feelings, and behaviors. Self-regulation appears to rely on executive cognitive functions, and the current review, therefore, sought to draw attention to the impact of self-regulatory capacity and executive functions on chronic pain. Discussion: Chronic pain conditions present with complex interactions of cognitive, emotional, behavioral, and physiological components for which self-regulatory ability is crucial. The ability to self-regulate varies, and self-regulatory strength appears to be a limited resource that can be fatigued. The many challenges of chronic pain conditions could, therefore, tax self-regulatory strength, leading to self-regulatory deficits. Conclusion: The current review proposes a relationship among pain, self-regulatory capacity, self-regulatory demands, executive functions, and self-regulatory fatigue, suggesting that executive functions and self-regulatory deficits are indeed part of the etiology and maintenance of chronic pain conditions. © 2009 The Society of Behavioral Medicine.