The association of depression and neuroticism with pain reports: a comparison of momentary and recalled pain assessment.

OBJECTIVE Pain assessment has been shown to be affected by depression, neuroticism, and recall bias. The purpose of this study was to determine whether momentary pain assessment, compared with recalled pain reports, would diminish the influence of neuroticism and depression on the measurement of pain. METHODS Patients with chronic pain (n=66) completed depression (Beck Depression Inventory II) and neuroticism (NEO Personality Inventory) questionnaires, made weekly recall pain ratings, judged their change in pain from 1 week to the next over a 4-week period, and collected momentary reports of pain intensity and pain unpleasantness over a 2-week period. RESULTS Analyses showed that neuroticism and depression correlated with pain intensity and pain unpleasantness at low levels for both momentary and recalled pain reports. Neuroticism and depression did not influence the accuracy of recalled pain (difference between momentary and recalled data). Both neuroticism and depression were systematically associated with ratings of judged change in pain even when actual changes in pain were controlled. Specifically, for increased levels of baseline depression and neuroticism, patients displayed a pattern of judging recent pain as more severe than pain in the previous week following several weeks of symptom monitoring. CONCLUSION There was little evidence for neuroticism and depression affecting either recall or momentary pain ratings or influencing the accuracy of recall ratings. However, neuroticism and depression did influence pain assessment when the task involved rating change in pain-a measure widely used in clinical research.