Accuracy of children’s pain memories Lyonne N.L. Zonneveld a , Patrick J. McGrath b,c, *, Graham J. Reid d,e , Marjolijn J. Sorbi a a Department of Clinical and Health Psychology, Utrecht University, 3584 CS Utrecht, The Netherlands b Department of Psychology, Pediatrics, Psychiatry and Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, B3H 4J1, Canada c Departments of Psychology and Pain Service, IWK Grace Health Centre, Halifax, Nova Scotia, B3J 3G9, Canada d Department of Psychology, Dalhousie University, Halifax, Nova Scotia, B3H 4J1, Canada e Department of Psychology, IWK Grace Health Centre, Halifax, Nova Scotia, B3J 3G9, Canada Received 26 April 1996; revised version received 21 October 1996; accepted 19 February 1997 Abstract Despite its importance in clinical practice, little research has examined memory for pain in children. This prospective study tried to justify the use of children’s pain recall in clinical practice. The purpose of this study was to (a) investigate the accuracy of children’s recall of their worst and average pain intensity when controlling for the effects of repeated pain measurement and (b) examine the influence of children’s anxiety, age, general memory ability and pain coping strategies on this accuracy. The accuracy of children’s recalled pain intensities was studied in 55 inpatients aged 5–16 years by comparing the level of recorded pain intensity with the level of recalled pain intensity 1 day and 1 week after recording using Bieri’s Faces Pain Scale. The accuracy of children’s recalled pain intensities was high and showed little decrement over 1 week. Older children had more accurate recall of their worst pain intensity. Anxiety, general memory ability and pain coping strategies were not related to accuracy of recalled pain intensities.  1997 International Association for the Study of Pain. Published by Elsevier Science B.V. Keywords: Memory accuracy; Memory; Recall; Pain (intensity) 1. Introduction Clinicians typically rely on patients’ recall of pain to assess pain and its associated complaints. Treatment is eval- uated on the basis of pain recall. Is this reliance on pain memories in children justified? Over what time period are children’s pain memories reliable? What are the influences of the child’s anxiety, age, general memory ability and pain coping strategies on these memories? Memory for pain in children has been examined in only a few studies contrary to the numerous studies in adults (Ers- kine et al., 1990). Lehmann et al. (1990) studied the con- sistency of pain intensity rating of recalled painful events in children between 3 and 8 years of age. Twice within 1 week, children compared the relative difference in pain intensity of two recalled painful events on three different pain rating scales in response to the prompt ‘Which one shows me ‘pain’ as much as you had from (the recalled experience)’ (Lehmann et al., 1990). This difference in pain intensities was also rated in response to the simple question ‘Which of the two (experiences) hurt more?’. Children of 7 years of age and younger recalled the relative difference in pain intensities consistently 20–55%, across all four pain ratings. The consistency of the pain intensity rating was between 50–100% in children over 7 years of age. Lander et al. (1992) examined the relationships between expected, experienced and recalled pain and state anxiety in response to a venipuncture using a 100-mm vertical visual analogue scale (VAS). Children between 5 and 17 years of age had a 43% accurate recall of their pain intensity (within the range of ±9 mm on the 100-mm VAS). State anxiety was not related to recalled pain intensity, but was positively related to expected pain (Lander et al., 1992). A limitation of both studies was the neglect of the effects of repeated pain mea- surements in the design (Hunter et al., 1979; Erickson, 1990; von Baeyer, 1994). Recalling pain requires encoding the experienced pain, storing the encoded pain and retrieving the stored pain Pain 71 (1997) 297–302 0304-3959/97/$17.00  1997 International Association for the Study of Pain. Published by Elsevier Science B.V. PII S0304-3959(97)03379-4 * Corresponding author. Correspondence to the Dalhousie University address. Tel.: +1 902 4943581/1580; fax: +1 902 4946585; e-mail: patrick.mcgrath@dal.ca