Choosing well: A narrative review on chronic pain and decision-making

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-08-08 DOI:10.1016/j.jpain.2025.105525

Marilyn Horta PhD , Kylie Wright , Nichole R. Lighthall PhD , Roger B. Fillingim PhD

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Abstract

Chronic pain is one of the most prevalent and costly health conditions in the United States. Previous work has demonstrated that chronic pain impacts cognition and behavior. However, the impact of chronic pain on daily decisions is less well-known. This narrative review identified and synthesized findings from a literature search that yielded 18 peer-reviewed, experimental, cross-sectional studies on the effects of chronic pain on different decision-making outcomes. According to the literature, the effects of chronic pain on decision-making are evidenced by 1) reduced decision performance, 2) increased risk-taking and delay discounting, 3) altered sensitivity to outcomes, and 4) reduced cognitive flexibility and learning. Chronic pain effects on decision-making also vary by individual factors such as sex/gender, age, and affective and social factors. Guided by these findings, current limitations and future directions in the field are discussed.

Perspective

This narrative review highlights current evidence and identifies critical knowledge gaps, emphasizing a need to better understand the relationship between chronic pain and decision-making. Findings can guide future theory and shape interventions aimed at improving decision-making in chronic pain.

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选择好：慢性疼痛和决策的叙事回顾。

慢性疼痛是美国最普遍和最昂贵的健康状况之一。先前的研究表明，慢性疼痛会影响认知和行为。然而，慢性疼痛对日常决策的影响却鲜为人知。这篇叙述性综述从文献检索中确定并综合了18项关于慢性疼痛对不同决策结果影响的同行评议的、实验性的、横断面研究。根据文献，慢性疼痛对决策的影响表现为：1)降低决策绩效；2)增加冒险和延迟折扣；3)改变对结果的敏感性；4)降低认知灵活性和学习能力。慢性疼痛对决策的影响也因个体因素而异，如性别/性别、年龄、情感和社会因素。在这些发现的指导下，讨论了该领域目前的局限性和未来的发展方向。观点：这篇叙述性综述强调了当前的证据，并确定了关键的知识差距，强调需要更好地理解慢性疼痛与决策之间的关系。研究结果可以指导未来的理论和制定干预措施，旨在改善慢性疼痛的决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.