The effects of anger and sadness on clinical pain reports and experimentally‐induced pain thresholds in women with and without fibromyalgia

Abstract

Objective. Negative emotions are commonly experienced in fibromyalgia and may affect pain. This study examined the effects of anger and sadness on clinical pain reports and on pain threshold and tolerance in response to electrical stimulation in women with and without fibromyalgia. Methods. In an experimental study, 62 women with fibromyalgia and 59 women without fibromyalgia recalled a neutral situation, followed by recalling both an anger-inducing and a sadness-inducing situation, in counterbalanced order. The effect of these emotions on pain responses (non-induced clinical pain and experimentally-induced sensory threshold, pain threshold, and pain tolerance) was analyzed with a repeated-measures analysis of variance. Results. Clinical pain reports increased (P < 0.001) in women with fibromyalgia, and pain threshold (P < 0.001) and tolerance (P < 0.001) decreased in both groups in response to anger and sadness induction. Sadness reactivity predicted clinical pain responses. Anger reactivity predicted both clinical and electrically-stimulated pain responses. Conclusion. The experience of both anger and sadness amplifies pain in women with and without fibromyalgia. A stronger emotion-induced pain response was associated with more emotional reactivity. No convincing evidence was found for a larger sensitivity to anger and sadness in women with fibromyalgia than in women without fibromyalgia, or for a larger sensitivity to anger than to sadness in fibromyalgia. The occurrence of anger and sadness appears to be a general risk factor for pain amplification. Emotion regulation techniques may attenuate emotional pain sensitization in patients with fibromyalgia.

Rebt With Pharmacotherapy in the Management of Chronic Pain- A Quasiexperimental Study

“…15 When pain becomes chronic, sensory input plays a diminished role while affective and cognitive pathways play a more prominent role in the creation of painful perceptions. 16 Perception of depression, anxiety and stress also share the same pathophysiological pathways as pain which facilitate the central modulation of the pain response, in the periaqueductal grey, amygdala and hypothalamus. These brain areas play a role in depression and anxiety, and when deficits occur in these areas, modulation of signals from the body are disturbed, leading to a more severe experience of pain.…”

The match–mismatch model of emotion processing styles and emotion regulation strategies in fibromyalgia

“…Yet, the observation that emotions may amplify pain [2,3] suggests that emotion processing and regulation are also important. The aim of this study was to examine whether specific combinations of emotion processing styles and emotion regulation strategies are associated with better adjustment to fibromyalgia.…”

“…Negative emotions are commonly experienced in fibromyalgia and may amplify pain [2][3][4]. This implies that how people with fibromyalgia process and regulate their emotions may be relevant for their pain and adjustment.…”

Opioids: a two-faced Janus

“…Moreover, psychological factors can exacerbate chronic pain. Fear of pain (catastrophising) and avoidance of pain-inducing movement (kinaesiophobia) have been shown to exacerbate chronic back pain 29 , and negative affect, such as anger and sadness, may act as risk factors for pain amplification 30 . Therefore, in order to treat patients with long-term pain effectively, it is important to adopt a biopsychosocial model, targeting nociceptive, neuropathic and psychological mechanisms.…”