Commentary: Harnessing the Fragility of Pain Memories to Help Children Forget: A New Avenue for Pediatric Psychology Interventions?

Children’s memories of pain play a powerful role in shaping their responses to future painful events (Noel, Chambers, McGrath, Klein, & Stewart, 2012). Pain memories are incredibly fragile. Children may remember pain accurately, or in a negatively or positively estimated way, with negatively estimated pain memories linked to greater distress at subsequent painful procedures (Chen, Zeltzer, Craske, & Katz, 2000). Pain memory development is dynamic across child development. Young children’s memories are particularly susceptible to distortion and parental influences (Noel, Palermo, Chambers, Taddio, & Hermann, 2015a). For pediatric psychologists, the malleability of children’s pain memories opens up exciting avenues for intervention. Given that pain cuts across nearly every pediatric population, pain memory-reframing interventions have broad appeal. Nevertheless, these interventions have been oft ignored and understudied, despite their potential for improving children’s health. In this issue, Marche, Briere, and von Baeyer (2015) introduce a novel and fascinating line of inquiry with great relevance to the field of pediatric psychology. Instead of examining children’s ability to remember pain, they investigated children’s ability to forget negative aspects of past painful events. Using a narrative elaboration technique to enhance recall, 86 children (7–15 years) recruited from the community were asked to recall two of their most physically painful experiences. One week later, children completed a retrieval-induced forgetting (RIF) task whereby they repeatedly practiced recalling positive details from their first pain memory. Children then completed an experimental pain task to examine the influence of forgetting on pain coping. Several child and parent factors thought to influence memory and forgetting were examined to determine whether they could account for individual differences in children’s ability to forget. By experimentally testing whether children’s pain memories could be modified, Marche and colleagues (2015) offer important data to our field. The clinical implications are particularly promising, given that our current psychological interventions for reducing children’s acute and chronic pain offer room for improvement. Findings showed that the RIF task was effective; children were able to engage in this task and subsequently forget the negative aspects of one of their most salient pain memories. Forgetting influenced pain coping. Children who were better able to forget negative aspects of a past pain experience were less anxious about the pain task. The RIF task is designed to induce explicit, unintentional forgetting because repeatedly retrieving positive details of a memory impedes the ability to subsequently recall other, nonrehearsed information from that memory (Anderson, Bjork, & Bjork, 1994). It is thought that the mechanism underlying this effect is inhibition (Anderson & Bell, 2001), which changes across development (Harnishfeger, 1995). Although age differences in forgetting were not found in this study, little is known about the developmental progression of children’s forgetting and memory of pain. Moreover, to date, only researchers have sought to modify children’s pain memories (Chen, Zeltzer, Craske, & Katz, 1999; Pickrell et al., 2007). It is unknown whether other individuals in the child’s life (e.g., parents, peers, teachers, physicians) are able to elicit the same effects.