Predictive relationships between chronic pain and negative emotions: a 4-month daily process study using Therapeutic Interactive Voice Response (TIVR)

• Published in: Comprehensive psychiatry 2011-11, Vol.52 (6), p.731-736
• Main Authors: Naylor, Magdalena R, Krauthamer, G. Michael, Naud, Shelly, Keefe, Francis J, Helzer, John E
• Format: Article
• Language: English
• Subjects: Anger; Biological and medical sciences; Chronic pain; Chronic Pain - complications; Chronic Pain - physiopathology; Chronic Pain - prevention & control; Chronic Pain - psychology; Cognitive Therapy; Depression - etiology; Depression - psychology; Emotions; Emotions - physiology; Employment; Female; Humans; Male; Medical sciences; Middle Aged; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Rheumatoid arthritis; Secondary Prevention; Stress, Psychological - etiology; Stress, Psychological - psychology; Surveys and Questionnaires; Telephone; Temporomandibular joint disorders; Variables
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2010.11.008

Abstract This article examines temporal relationships between negative emotions and pain in a cohort of 33 patients with chronic musculoskeletal pain enrolled in a telephone-based relapse prevention program (Therapeutic Interactive Voice Response [TIVR]), after 11 weeks of group cognitive behavioral therapy (CBT). Patients were asked to make daily reports to the TIVR system for 4 months after CBT. Patients' daily reports were analyzed with path analysis to examine temporal relationships between 3 emotion variables (anger, sadness, and stress) and 2 pain variables (pain and pain control). As expected, same-day correlations were significant between emotion variables and both pain and pain control. The lagged associations revealed unidirectional relationships between pain and next-day emotions: increased pain predicted higher reports of sadness the following day ( P < .05). Conversely, increased pain control predicted decreased sadness and anger the following day ( P < .05). Unlike some previous studies, this study did not reveal that an increase of negative emotions predicted increased next-day pain. We speculate that CBT treatment followed by the relapse prevention program teaches patients how to modulate negative emotions such that they no longer have a negative impact on next-day pain perception. The clinical implications of our findings are discussed.