In a sample of 70 chronic pain patients, hierarchical multiple regression analyses were utilized to assess the additive and interactive contributions of pain severity and psychological distress variables to neurocognitive performance across attention and concentration, memory, and reasoning ability domains. Although the full model predicting attention and concentration was found to be significant, there was no significant contribution of pain severity, psychological distress, or the Pain Severity x Psychological Distress interaction to the prediction of attention and concentration scores after controlling for the effect of years of formal education. After controlling for the effect of years of formal education, pain severity and psychological distress did make separate and significant contributions to the prediction of memory scores; however, the Pain Severity x Psychological Distress interaction did not significantly affect memory scores. After controlling for the effect of years of formal education, there was no significant contribution of pain severity, psychological distress, or the Pain Severity x Psychological Distress interaction to reasoning ability scores. Results suggest the importance of assessing memory function when managing psychologically distressed chronic pain patients.

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The following study examined the association between neurocognitive performance and emotional status in chronic pain patients. Seventy-three chronic pain patients recruited consecutively from services in a general medical hospital completed a battery of 10 neurocognitive measures and the Symptom Checklist-90-Revised (SCL-90-R; a gross measure of emotional distress). Cluster analytic procedures were used to identify a three-cluster group solution based on the SCL-90-R. Results indicate that subjects highest in emotional distress experienced more neurocognitive difficulties in intellectual functioning, immediate and delayed recall of verbal and nonverbal material, abstract thinking and problem solving, and cognitive efficiency than subjects lowest in emotional distress. The differences in neurocognitive functioning among the three cluster groups were not confounded by any differences on a number of background variables. These results suggest that level of emotional distress is associated with difficulties in a range of neurocognitive domains and have implications for the assessment and management of chronic pain patients.

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