The effects of anger and sadness on clinical pain reports and experimentally-induced pain thresholds in women with and without fibromyalgia.
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.
van Middendorp
Henriët
H
Utrecht University, The Netherlands. H.vanMiddendorp@uu.nl
Lumley
Mark A
MA
Jacobs
Johannes W G
JW
Bijlsma
Johannes W J
JW
Geenen
Rinie
R
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