title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Utrecht University, The Netherlands. H.vanMiddendorp@uu.nl
authors.forename: Henriët
authors.initials: H
authors.lastname: van Middendorp
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lumley
authors.forename: Johannes W G
authors.initials: JW
authors.lastname: Jacobs
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
mesh_terms: D000328:Adult; D000368:Aged; D000786:Anger / Q000502:physiology; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D017288:Pain Threshold / Q000502:physiology / Q000523:psychology*; D055815:Young Adult