Roebuck GS, et al. - Researchers performed this pilot study to examine pain-related psychological processes in ultra-marathon runners (‘ultra-runners’). In addition, they determined if psychological factors mediate the elevated pain tolerance displayed by ultra-runners. The study participants comprised of 20 ultra-runners and 20 age- and gender-matched controls. Ultra-runners displayed reduced pain-related anxiety compared with non-running controls. Their higher cold pain tolerance than controls and their elevated pain tolerance is partly mediated by reduced avoidance of pain.