Misremembering Pain: Memory Bias for Pain Words in Women Reporting Sexual Pain

Abstract

Introduction The debate over the classification of dyspareunia as a sexual dysfunction or as a pain disorder raises the question of the comparative cognitive salience of sex and/or pain in the experience of women who report pain with intercourse. Refinements in our understanding of cognitive factors in the experience of pain with intercourse may be important in the development of effective treatments. Aim This study aimed to compare the cognitive salience of sex and pain word stimuli in women reporting pain with intercourse and in a control group of women without sexual dysfunction. Methods Twenty women reporting pain during sexual intercourse and 20 women reporting no sexual dysfunction (controls) participated in a memory protocol designed to detect differences as a function of group membership and type of stimulus (sex, pain, and two other control stimuli). Main Outcome Measures Dependent measures were recall, recognition, intrusions, and false positives for sex words, pain words, and two other control word types. Results Regardless of group membership, women had best recall for sex-related words; however, women reporting sexual pain evidenced more false memories for pain words than did control women, and pain words elicited more false memories than any other type of word for women with sexual pain. Conclusion Results are interpreted to suggest that repeated activation through experience with persistent sexual pain may have contributed to the: (i) development of stronger semantic networks related to pain in comparison to no sexual dysfunction controls and; (ii) activation of pain networks more easily triggered by pain-related stimuli in women with sexual pain than in no sexual dysfunction controls. Sex, however, had not attained the cognitive salience of pain.

The Biopsychosocial Puzzle of Painful Sex

“…Anxiety and fear also orient women toward the pain. In lab studies, women with intercourse pain have displayed a memory bias for pain words (Thaler et al 2009) and a selective attentional bias toward pain stimuli (Payne et al 2005). Combined with pessimistic pain attributions, the anxiety leads to pain hypervigilance and hopelessness, which result in pain catastrophizing.…”