The effect of executive function on the development of chronic pain: A prospective longitudinal study

Increasing evidence suggests a close association between chronic pain and executive function, a set of cognitive processes necessary for goal-directed behaviors. However, there is a dearth of longitudinal studies examining the predictive effect of executive function on the development of chronic pain. Drawing on the cyclical model of executive function and health, we sought to examine how executive function, measured at baseline, may predict chronic pain etiology approximately 9 years later. Using a large-scale dataset of midlife adults (N = 1553) from the MIDUS 2 and 3 (Midlife Development in the United States) studies, we employed multivariate logistic regression to examine the etiology of new chronic pain for individuals who did not have chronic pain at baseline. Further, we also tested whether executive function predicted the degree of pain interference, among individuals with chronic pain. Our results revealed that lower baseline executive function was associated with a significant likelihood of developing chronic pain 9 years later (OR = 0.812, p = .001), even after adjusting for demographics, health, and psychosocial confounds (OR = 0.827, p = .014). However, executive function failed to robustly predict the etiology and degree of chronic pain interference. Our findings underscore the critical role of executive function on the development of chronic pain.