Memory biases for pain-related information may contribute to the development and maintenance of chronic pain; however, evidence for when (and for whom) these biases occur is mixed. Therefore, we examined neural, stress, and psychological factors that could influence memory bias, focusing on memories that motivate disabling behaviors: pain perception, conditioned responses to threat-and-safety cues, and responses to aversive nonnoxious stimuli. Two studies were conducted with adolescents with and without chronic pain. Data from 58 participants were included in study 1 (chronic pain n = 34, pain free n = 24, mean age = 16 years), and 39 participants were included in study 2 (chronic pain n = 26, pain free n = 13, mean age = 16 years). Both studies used a threat-safety learning paradigm with memory recall (≈1 month later). Participants completed structural and functional (resting-state) magnetic resonance imaging, salivary cortisol measurements, and self-report measures. Adolescents with pain and pain-free peers consistently recalled being more afraid of safety cues (CS-) and, during heightened stress at encoding (higher cortisol levels), also reported being more afraid of threat cues (CS+). However, no memory bias was present for the emotional response to an aversive stimulus (US; loud scream) or for the recall of pain intensity. Functional connectivity of the amygdala and hippocampus with memory circuits related to the degree of memory bias, but the specific connections varied between the studies, and we observed no relationship between memory bias and brain morphology. Our findings highlight the value of considering the interaction between implicit and explicit memory systems, contributing to a more comprehensive understanding of emotional memory biases in the context of chronic pain.

中文翻译：

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慢性疼痛青少年的情绪记忆偏差：检查与神经、压力和心理因素的关系。


对疼痛相关信息的记忆偏倚可能有助于慢性疼痛的发展和维持;然而，关于这些偏倚何时（以及针对谁）发生的证据喜忧参半。因此，我们研究了可能影响记忆偏差的神经、压力和心理因素，重点关注激发残疾行为的记忆：疼痛感知、对威胁和安全线索的条件反应以及对厌恶性非伤害性刺激的反应。两项研究对患有和不患有慢性疼痛的青少年进行。研究 1 中包括来自 58 名参与者的数据（慢性疼痛 n = 34，无痛 n = 24，平均年龄 = 16 岁），研究 2 中包括 39 名参与者（慢性疼痛 n = 26，无痛 n = 13，平均年龄 = 16 岁）。两项研究都使用了带有记忆回忆的威胁安全学习范式（≈1 个月后）。参与者完成了结构和功能（静息态）磁共振成像、唾液皮质醇测量和自我报告测量。有疼痛和无痛同龄人的青少年一直回忆起更害怕安全线索 （CS-），并且在编码压力增加（皮质醇水平较高）期间，也报告更害怕威胁线索 （CS+）。然而，对厌恶刺激 （US;大声尖叫） 的情绪反应或对疼痛强度的回忆不存在记忆偏倚。杏仁核和海马体与记忆回路的功能连接与记忆偏差的程度相关，但具体联系因研究而异，我们观察到记忆偏差与大脑形态之间没有关系。 我们的研究结果强调了考虑内隐和外显记忆系统之间相互作用的价值，有助于更全面地理解慢性疼痛背景下的情绪记忆偏差。