Choosing Well: A Scoping Review on Chronic Pain and Decision-making

Chronic pain is one of the most prevalent and costly health conditions in the developed world. Previous work has demonstrated that chronic pain impacts cognition and behavior. However, the impact of chronic pain on daily decisions is less well-known. This scoping review identifies and synthesizes current literature on the impact of chronic pain on decision-making via changes in cognition and behavior. Broadly speaking, the effects of chronic pain on decision-making are evidenced by reduced overall performance compared to healthy controls in decision-making tasks, increased risk-taking and delay discounting, altered outcome sensitivity, and reduced cognitive flexibility and learning. Chronic pain effects on decision-making also vary by individual factors such as age, sex/gender, and affective and social factors. Guided by these findings, current limitations and future directions in the field are also discussed.