Investigating behavioral brain system activity on pain intensity, with mediating role of cognitive flexibility in patients with chronic pain

Introduction: This study aimed to assess the activity of the behavioral brain system based on pain intensity with the mediating role of cognitive flexibility in patients with chronic pain. Materials and Methods: In order to conduct research, 200 patients with various types of chronic pain, who had referred to specialized clinics and offices of neurologists in Zahedan in 2020, were selected through the convenient method. Participants fulfilled the Jackson Questionnaire, the Dennis and Vanderwall Cognitive Flexibility Scale, and Van Korf et al. (1992) Pain Scale. Then, the data were analyzed using path analysis method, based on SPSS22 and AMOS-21 software. Results: The results show that the dimensions of the behavioral brain system are significantly associated with pain intensity. It had an inverse and significant relationship with the Behavioral Activation System (BAS) and had a positive and significant relationship with the Behavioral Inhibition System (BIS) (P<0.05). Cognitive paternal flexibility and pain intensity are also indirectly related to each other; therefore, it can be said that as patients' cognitive flexibility increases, their pain intensity score decreases. Also, this study showed that cognitive flexibility does not play a mediating role between the war components (FFFS) but between the FFS system with intensity pain. Conclusion: According to the results of the present study, there is a positive and significant relationship between behavioral inhibition system and cognitive flexibility and pain intensity. Also, cognitive flexibility is a mediating variable on the two components of inhibition and fear.