| Chronic pain constitutes a lifelong condition for numerous patients and presents a costly public health issue. The aim of this dissertation study was to examine the relation of self-report pain scales to neuropsychological test performance. Using exploratory factor analysis, two latent factor(s) of pain were identified: "pain distress" and "pain dysfunction." Using structural equation modeling, both factors were confirmed and examined in relation to an overall latent factor of cognition ("g"). Greater perceived pain distress and pain dysfunction significantly predicted worse cognition and accounted for 12% of the variance in g. History of sexual abuse moderated the path from pain distress to g, but not the path from pain dysfunction to g. After controlling for effort, the model was found to have slightly (not significantly), better fit. Word Memory Test (WMT) Delayed Recall and Consistency percent correct were found to significantly confound the relationship between pain distress and cognition. Greater perceived pain distress no longer significantly predicted worse cognition while greater perceived dysfunction still significantly predicted worse g. The model now accounted for nearly 50% of the variance seen in g. Multivariate analysis of variance was used to identify whether failure of a performance validity test resulted in reported symptoms of pain falling above established cutoffs. Results revealed a significant effect of type of WMT performance on the combined dependent variable of pain ratings. Separate examination of the dependent variables revealed that WMT performance groups significantly differed in their Pain Catastrophizing Scale scores, but not in other pain scales. Overall, this dissertation study found that latent factors of chronic pain, history of sexual abuse, and poor effort impact cognitive functioning. These findings have numerous implications for patients, the medical community, and resources allocated to provide support to individuals with chronic pain following surgical intervention. The more attempts made to understand exactly how these factors are affecting cognition and exactly who is being affected will only further help to bring the most appropriate aid and services to patients who are suffering from chronic pain. |
