The effects of anger and sadness on clinical pain reports and experimentally-induced pain thresholds in women with and without fibromyalgia
Version of Record online: 21 APR 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 10, pages 1370–1376, October 2010
How to Cite
van Middendorp, H., Lumley, M. A., Jacobs, J. W. G., Bijlsma, J. W. J. and Geenen, R. (2010), The effects of anger and sadness on clinical pain reports and experimentally-induced pain thresholds in women with and without fibromyalgia. Arthritis Care Res, 62: 1370–1376. doi: 10.1002/acr.20230
- Issue online: 21 APR 2010
- Version of Record online: 21 APR 2010
- Accepted manuscript online: 21 APR 2010 12:00AM EST
- Manuscript Accepted: 12 APR 2010
- Manuscript Received: 3 FEB 2010
- Dutch Arthritis Association
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.
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.
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.
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.