Anger and Sadness Increase Pain Response in Women

A study involving women with and without fibromyalgia reveals that anger and sadness amplifies pain equally in both groups.

Researchers from Utrecht University performed the study, which will be published in the journal of the American College of Rheumatology, Arthritis Care & Research. The title of the study is “The Effects of Anger and Sadness on Clinical Pain Reports and Experimentally-Induced Pain Thresholds in Women With and Without Fibromyalgia.”

The goal of the study was to examine the effect of negative emotions on pain perception. Fibromyalgia is thought to involve heightened pain sensitivity to a variety of psychophysical and emotional stimuli. Negative emotions are believed to be experienced more strongly in FM patients than in the general population.

The research team sought to evaluate whether specific negative emotions such as sadness and anger would also increase pain more in women with FM than in healthy women.

The study examined the effects of experimentally-induced anger and sadness on self-reported clinical and experimentally-induced pain in women with and without FM. There were 62 female participants with FM and 59 without FM. Both groups were asked to recall 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 was analyzed with a repeated-measures analysis of variance.

The researchers found that experimentally-induced pain assessments always yielded self-reported clinical pain. These reports consisted of reporting current pain levels (“now, at this moment”) on a scale ranging from “no pain at all’ to “intolerable pain.”

Electrical pain induction was used to assess experimentally-induced pain. Participants pressed a button when they felt the current (sensory threshold) and when it became painful (pain threshold) and intolerable (pain tolerance). Four pain assessments were conducted per condition, and very high internal consistencies were obtained.

More pain was indicated by both the clinical pain reports in women with FM and pain threshold and tolerance 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.

Both groups manifested increased pain in response to the induction of both anger and sadness, and greater emotional reactivity was associated with a greater pain response.

“We found no convincing evidence for a larger pain response to anger or sadness in either study group (women with, or without FM),” said study leader Henriët van Middendorp, PhD, in a press release. “In women with FM, sensitivity was roughly the same for anger and sadness.”

“Emotional sensitization of pain may be especially detrimental in people who already have high pain levels,” Middendorp said. “Research should test techniques to facilitate better emotion regulation, emotional awareness, experiencing, and processing.”