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Comparison of Prospective and Retrospective Memory and Attention in Patients with Chronic Low Back Pain with Healthy People

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Comparison of Prospective and Retrospective Memory and Attention in Patients with Chronic Low Back Pain with Healthy People October 2015, Volume 3, Number 4 Comparison of Prospective and Retrospective Memory and Attention in Patients with Chronic Low Back Pain with Healthy People Mehdi Mehraban Eshtehardi 1, Hassan Shams Esfandabad 2*, Peyman Hassani Abharian 3 1. Department of General Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran. 2. Department of Psychology, Faculty of Social Sciences, Imam Khomeini International University, Qazvin, Iran. 3. Institute for Cognitive Science Studies, Tehran, Iran. Article info: A B S T R A C T Received: 18 Mar. 2015 Accepted: 29 Jul. 2015 Objective: The present study aimed to compare prospective and retrospective memory impairment and attention deficit in people suffering from chronic low back pain with those cognitive functions in healthy subjects. Furthermore, this study examines the relation between severity and duration of pain and prospective and retrospective memory impairment and attention deficit. Methods: The research was a causality-comparative study. Using convenience sampling method, 53 male patients and 53 healthy male individuals were selected. The participants were asked to fill out prospective and retrospective memory questionnaire and pain numeric rating scale (NRS). In addition, a continuous performance test was performed. The study hypotheses were tested using two independent group T-test and the Pearson correlation analysis by SPSS 22 with the significant level of 0.05. Results: The results showed that there was significant difference between the 2 groups of participants regarding prospective memory, but no significant difference regarding retrospective Keywords: memory. With respect to hypotheses, significant difference was found between the two groups Chronic pain, regarding attention. And finally results of the study did not show any relation between duration and intensity of pain with impairment in prospective and retrospective memory and attention. Prospective memory, Attention, Low back Conclusion: The prospective memory impairment and attention deficits are associated with pain chronic low back pain. In general, chronic pain is associated with cognitive impairment. 1. Introduction gious groups until the 13th century. However, there was a third group who believed that pain must be cured and here has been a great change in peo- gradually considered a serious issue in life and recog- ple’s beliefs about pain and its effects nized as a disease. over the past centuries in different cul- tures. Soldiers in the Middle ages con- Pain is the most common mental pressure known in med- T sidered pain as a scandal and a female icine. It is a personal experience, which is described as a trait. Religious people, however, considered pain as a symptom of agony. It was not until the last century that sign of bless or punishment from heaven. The pain the scientists found pain as a complicated and multi-aspect Christ sustained was the centerpiece of beliefs of reli- phenomenon. Today, pain is known as a phenomenon sub- * Corresponding Author: Hassan Shams Esfandabad, PhD Address: Department of Psychology, Faculty of Social Sciences, Imam Khomeini International University, Qazvin, Iran. Tel: +98 (28) 33780021 E-mail: [email protected] 283 October 2015, Volume 3, Number 4 ject to environmental, mental, and social factors. It influ- retrospective memory impairment (amnesia) and atten- ences quality of life, and thereby, exploring its effects on tion deficit on daily life of patients with chronic pains. mental and physical health has become part of national health and treatment systems. The Western countries rec- Memory is the way of storing previous experiences ommend adding pain as the fifth vital sign along with and information and using them for doing current activi- other vital signs that need to be measured and recorded. ties. Memory is the process that has to do with dynamic mechanisms of storing, keeping, and retrieving informa- The International Association for the Study of Pain tion and experiences (Strenberg, 2006). “Memory has (IASP) defines pain as “an unpleasant sensory and emo- prominence for all aspects of information processing tional experience associated with actual or potential tis- and that is the reason why it is invaluable to have a good sue damage, or described by the patient in terms of such memory during middle ages and late adulthood” (Ensafi, damage” (http://www.iasp-pain.org/Taxonomy). Rostami, Dolatshahi, Poursharifi, & Nouri, 2014). The IASP defines chronic pain as “pain which has per- With respect to storing the past subjects or future pur- sisted beyond normal tissue healing time” (http://www. poses, goals, or plans, memory is categorized into two iasp-pain.org/Taxonomy). types: Retrospective memory and prospective memory. Retrospective memory usually deals with what we have Chronic low back pain is a common pain that decreases already known, and might be featured with wide in- quality of life of millions all around the world. As docu- formation background. On the other hand, prospective ments show, human has suffered from low back pain memory focuses, for instance, on the place that some- throughout the history. Pain is a challenging problem in thing is going to carried out, and it is featured with small developed and developing countries and causes consid- background information. In addition, it has to do with erable economic costs. plans or goals that are formed to carry our daily activi- ties. Also, retrospective memory uses several external Several studies have shown that chronic pain is cor- signs (reminders), while prospective memory is based related with cognitive functions (Berryman et al., 2013; on mental goals and objectives (Eysenk & Keen, 2010). Oostermann, Derksen, Wijck, Kessles, & Veldhuijen, 2012; Karp et al., 2006). These studies have shown a cor- Attention is the ability to select specific information relation between operational functions and chronic pain. needed to make an in-depth survey and neglect the rest. It Operational functions refer to a set of mental activities is one of the higher mental activities. Attention is the pro- that are controlled by frontal lobe and are responsible for cess of focusing on specific aspects of the environment, abilities such as time and attention management, atten- thoughts, and activities. Focusing on specific aspects tion switch, setting plan and organizing, remembering helps us to neglect irrelevant aspects of information. details, limiting behaviors, and using previous experi- ences for current tasks. When these functions face with Attention is the center and core of many cognitive pro- problems, the individual loses parts of his or her ability cesses and influences our perception, memory, speak- to control his or her behavior. ing, and problem solving capabilities (Strenberg, 2006). There are some subdivisions for attention; in this study These studies have found evidence of cognitive and op- we perused sustained attention and shifting attention. erational functions impairment in people suffering from chronic pain. “The widely-used concept of cognition Sustained attention refers to the ability to maintain a consists of many cognitive processes such as perception, behavioral or cognitive set in the distracting or compet- memory, control, and attention. In particular, attention ing stimuli (Khalili, Dolatshahi, Farhodi, Pourshahbaz, is a set of mechanisms that help regulate and control & Niknam, 2013). Shifting attention is the same as the the search process inherent in perception and cogni- expression of mental flexibility in operational functions tion” (Mohammadkhani, Eskandari, Mehrabi, Bagheri, (Sohlberg & Mateer, 2001). 2015). Memory and attention deficits and problems in decision-making are some of issues that these patients Studies based on functional magnetic resonance imag- have to deal with (Berryman et al., 2013). Several stud- ing (fMRI) have shown that chronic pain causes mor- ies have focused on memory performance (functional phologic changes in the brain and different types of and operational) among patients with chronic pain. The pain create differences with specific patterns (Apkarian, present study investigates the status of prospective and Baliki, & Geha, 2009). There is some evidence that sub- stantiated chronic pain alters dynamics of the brain by 284 October 2015, Volume 3, Number 4 changing the format of DMN (default mode network) healthy people were selected as healthy group. Inclusion in the brain (Baliki, Geha, Apkarian, & Chialvo, 2008). criteria for both groups were as follows: 1) Being 40 to Furthermore, chronic pain is accompanied by rewarding 50 year’s old male; 2) Having a minimum of 5 years edu- system impairment in the brain (Baliki, Geha, Fields, cation to be able to read and understand the questions. & Apkarian, 2010). Therefore, brain morphological In addition, subjects in the patient group should have a changes happen during chronic pain. In this regard, some history of at least 6 months of low back pain. It must be changes in the density of gray matter was reported in a physical pain which was associated with actual or po- several studies (Apkarian et al., 2004; Wilcke, Leinisch, tential tissue damage, not a mental or psychological pain Gaunsbauer, Draganski, & Bogdahn, 2006; Kuchinad, according to the physiatrist’s diagnosis. Schweinhardt, Seminowicz, Wood, & Chizh, 2007). Exclusion criteria for the subjects in the patient group Most studies were focused on the effect of chronic pain were as follows: 1) Low back pain due to any other on one aspect of cognitive
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