Remembering the pain: Psychosocial factors related to endometriotic pain and its recall

Endometriosis is a chronic and debilitating disease, affecting women of childbearing years in a variety of ways, including infertility, dyspareunia, dysmenorrhea, and chronic pelvic pain. Diagnosis and treatment planning are guided primarily by retrospective pain recall, regardless of the fact that (1) there is only a tenuous relationship between pain reports and physical pathology and (2) the accuracy of pain recall has never been assessed in this population. The current study investigated the accuracy of endometriotic pain recall over a 30-day period, as well as potential psychological mediators to pain recall accuracy, including general psychological wellbeing, distress specific to infertility, passive and active coping, and pain present at time of recall. Contrary to expectations, findings indicated that women were relatively accurate in their recall of pain. Only passive coping and pain present at recall were predictive of accuracy, with greater passive coping and lower pain at recall predictive of higher recalled than recorded pain. Study implications are discussed, including: (1) report of pain over a 30-day duration appears credible for the majority of endometriotic patients and (2) women exhibiting greater passive coping may benefit from psychological treatment in addition to medical intervention.