Anger amplifies clinical pain in women with and without fibromyalgia

Sensitizing effect of anger and sadness not limited to fibromyalgia patients

2010-09-24

(Press-News.org) Researchers from Utrecht University who studied the effect of negative emotions on pain perception in women with and without fibromyalgia found that anger and sadness amplified pain equally in both groups. Full findings are now online and will publish in the October print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

Fibromyalgia (FM), a chronic pain condition, has among the largest impact of all rheumatic and chronic pain conditions. In addition to chronic, widespread pain, patients report accompanying symptoms such as fatigue, functional disability, and psychological distress. FM is thought to involve heightened pain sensitivity to a variety of psychophysical and emotional stimuli, with negative emotions believed to be experienced more strongly in FM patients than in the general population.

The Utrecht team theorized that specific negative emotions such as sadness and anger also would increase pain more in women with FM than in healthy women. Their study examined the effects of experimentally-induced anger and sadness on self-reported clinical and experimentally-induced pain in women with and without FM. Participants consisted of 62 women with FM and 59 women 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 (non-induced clinical pain and experimentally-induced sensory threshold, pain threshold, and pain tolerance) was analyzed with a repeated-measures analysis of variance.

Self-reported clinical pain always preceded the experimentally-induced pain assessments and consisted of reporting current pain levels ("now, at this moment") on a scale ranging from "no pain at all" to "intolerable pain." Clinical pain reports were analyzed in women with FM only. 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 women with and women without FM 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, Ph.D. "In women with FM, sensitivity was roughly the same for anger and sadness."

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

In a related study, a research team from Radboud University Nijmegen Medical Centre found that tailored cognitive-behavioral therapy (CBT) and exercise training tailored to pain-avoidance or pain-persistence patterns at a relatively early stage after diagnosis is likely to promote beneficial treatment outcomes for high-risk patients with FM.

The Nijmegen team evaluated the effects of this approach in a randomized controlled trial. The study compared a waiting list control condition (WLC) with patients in a treatment condition (TC) to demonstrate improvements in physical and psychological functioning and in the overall impact of FM.

High-risk patients were selected and classified into 2 groups (84 patients were assigned to a pain-avoidance group and 74 patients to the pain-persistence group) and subsequently randomized to either the TC or WLC. Treatment consisted of 16 sessions of CBT and exercise training, tailored to the patient's specific cognitive behavioral pattern, delivered within 10 weeks. Physical and psychological functioning and impact of FM were assessed at baseline, post-treatment, and 6-month follow-up.

The treatment effects were significant, showing notable positive differences in physical (pain, fatigue, and functional disability) and psychological (negative mood and anxiety) functioning, and impact of FM for the TC in comparison with the WLC. Clinically relevant improvement was found among patients in the TC group.

"Our results demonstrate that offering high-risk FM patients a treatment tailored to their cognitive behavioral patterns at an early stage after the diagnosis is effective in improving both short-and long-term physical and psychological outcomes," says junior investigator Saskia van Koulil. "Supporting evidence of the effectiveness of our tailored treatment was found with regard to the follow-up assessments and the low dropout rates. The effects were overall maintained at 6 months, suggesting that patients continued to benefit from the treatment."

###

These studies are published in Arthritis Care & Research. Media wishing to receive a PDF of these articles may contact healthnews@wiley.com.

Full Citation: "The Effects of Anger and Sadness on Clinical Pain Reports and Experimentally-Induced Pain Thresholds in Women With and Without Fibromyalgia." Henriët van Middendorp, Mark A. Lumley, Johannes W.G. Jacobs, Johannes W.J. Bijlsma, Rinie Greenen. Arthritis Care and Research; Published Online: April 21, 2010 (DOI: 10.1002/acr.20230); Print Issue Date: October 2010. http://onlinelibrary.wiley.com/doi/10.1002/acr.20230/abstract

"Tailored Cognitive-Behavioral Therapy and Exercise Training for High-Risk Patients With Fibromyalgia." Saskia van Koulil, Wim van Lankveld, Floris W. Kraaimaat, Toon van Helmond, Annemieke Vedder, Hanneke van Hoorn, Rogier Donders, Alphons J.L. De Jong, Joost F. Haverman, Kurt-Jan Korff, Piet L.C.M. van Riel, Hans A. Cats, Andrea W.M. Evers. Arthritis Care and Research; Published Online: June 2, 2010 (DOI: 10.1002/acr.20268); Print Issue Date: October 2010. http://onlinelibrary.wiley.com/doi/10.1002/acr.20268/abstract

Arthritis Care & Research is an official journal of the American College of Rheumatology, and the Association of Rheumatology Health Professionals, a division of the College. Arthritis Care & Research is a peer-reviewed research publication that publishes both original research and review articles that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with arthritis and related disorders, major topics are evidence-based practice studies, clinical problems, practice guidelines, health care economics, health care policy, educational, social, and public health issues, and future trends in rheumatology practice.

About Wiley-Blackwell

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

END

ELSE PRESS RELEASES FROM THIS DATE:

City living helped humans evolve immunity to TB

2010-09-24

New research has found that a genetic variant which reduces the chance of contracting diseases such as tuberculosis and leprosy is more prevalent in populations with long histories of urban living. The research, published in the journal Evolution, shows that in areas with a long history of urban settlements, today's inhabitants are more likely to possess the genetic variant which provides resistance to infection. In ancient cities, poor sanitation and high population densities would have provided an ideal breeding ground for the spread of disease. Natural selection ...

New map offers a global view of health-sapping air pollution

2010-09-24

In many developing countries, the absence of surface-based air pollution sensors makes it difficult, and in some cases impossible, to get even a rough estimate of the abundance of a subcategory of airborne particles that epidemiologists suspect contributes to millions of premature deaths each year. The problematic particles, called fine particulate matter (PM2.5), are 2.5 micrometers or less in diameter, about a tenth the fraction of human hair. These small particles can get past the body's normal defenses and penetrate deep into the lungs. To fill in these gaps in surface-based ...

Wheat researchers combine forces to battle major disease

2010-09-24

AMARILLO - Wheat streak mosaic virus is the most prevalent disease in the southwestern wheat producing region of the U.S., according to a Texas AgriLife Research scientist. Dr. Charlie Rush, AgriLife Research plant pathologist in Amarillo, is assembling several teams of scientists to work on the disease from every aspect: vector to diagnosis and mapping to control. "There are other diseases of concern, but wheat streak mosaic is always found somewhere in this wheat growing region, and every couple of years, we have an epidemic of it," Rush said. Several issues cause ...

Genetic switch underlies noisy cell division

2010-09-24

DURHAM, N.C. – While scientists have spent the past 40 years describing the intricate series of events that occur when one mammalian cell divides into two, they still haven't agreed on how the process begins. There are two seemingly contradictory theories, which now may be reconciled by a third theory being proposed by Duke University bioengineer Lingchong You. These findings could provide insights into the initiation of disease, such as cancer, which is marked by uncontrolled cell proliferation. During proliferation, the DNA within the nucleus of a cell makes a copy ...

Iowa State, Ames Lab researchers identify structure that allows bacteria to resist drugs

2010-09-24

AMES, Iowa – A research team led by Edward Yu of Iowa State University and the Ames Laboratory has discovered the crystal structures of pumps that remove heavy metal toxins from bacteria, making them resistant to antibiotics. The findings are published in the Sept. 23 issue of the journal Nature. Yu – an Iowa State associate professor of chemistry, of physics and astronomy, of biochemistry, biophysics and molecular biology and an associate of the U.S. Department of Energy's Ames Laboratory – said the finding gives researchers a better understanding of bacterial resistance ...

K-State research explains brand reputation's key role in a store-within-a-store

2010-09-24

MANHATTAN, KAN. -- With the concept of a store-within-a-store growing across the country, a Kansas State University researcher's work shows the increasing importance of brand reputation and its strong role in governing decisions. Richard McFarland, associate professor of marketing, and four colleagues recently completed "Understanding Governance Decisions in a Partially Integrated Channel: A Contingent Alignment Framework." Their research will be published in the elite Journal of Marketing Research next year. The research looks at separate companies who entered a store-within-a-store ...

Why are there no hyenas in Europe?

2010-09-24

A team from the National Museum of Natural Sciences (CSIC) has analysed the impact of climate change on spotted hyena survival in Europe over 10,000 years ago. These changes played an important role, but the scientists say studies are still needed to look at the influence of human expansion and changes in herbivorous fauna on the definitive extinction of this species across the continent. "Climate change in the past was not directly responsible for the extinction of the spotted hyena in southern Europe, but it was a factor in its disappearance", Sara Varela, lead author ...

Dust models paint alien's view of the solar system

2010-09-24

GREENBELT, Md. -- New supercomputer simulations tracking the interactions of thousands of dust grains show what the solar system might look like to alien astronomers searching for planets. The models also provide a glimpse of how this view might have changed as our planetary system matured. "The planets may be too dim to detect directly, but aliens studying the solar system could easily determine the presence of Neptune -- its gravity carves a little gap in the dust," said Marc Kuchner, an astrophysicist at NASA's Goddard Space Flight Center in Greenbelt, Md. who led ...

New species of multi-horned dinosaurs unearthed in Utah

2010-09-24

"A giant rhino with a ridiculously supersized head." "Fifteen long, pointed sideways oriented eye horns: one over the nose, one atop each eye, one at the tip of each cheek bone, and ten across the rear margin of the bony frill." "A horned face: large horn over the nose and short, blunt eye horns that project strongly to the side." Such phrases have been used to describe two newly discovered species of dinosaurs with looks only a mother could love. Still, they are drawing the attention and inspiring the imagination of scientists and lay people alike. Announced today ...

More predators doesn't equal more danger for urban bird nest

2010-09-24

COLUMBUS, Ohio – While birds living in urban areas face more predators than do those in rural areas, that doesn't mean urban birds face more danger from nest robbers. A six-year study conducted in 19 central Ohio forests from 2004 to 2009 found that, as expected, rural areas that had higher numbers of nest predators such as raccoons, domestic cats, and crows, also showed lower rates of nest survival. But there was no relation between the number of predators and nest survival in more urbanized areas. Researchers believe that's because nest predators in urban areas ...

Anger amplifies clinical pain in women with and without fibromyalgia

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: