Effects of mood on pain responses and pain tolerance: An experimental study in chronic back pain patients

Abstract

Although chronic pain and depression commonly co-occur, causal relationships have yet to be established. A reciprocal relationship, with depression increasing pain and vice versa, is most frequently suggested, but experimental evidence is needed to validate such a view. The most straightforward approach would be a demonstration that increasing or decreasing depressed mood predictably modifies pain responses. The current experiment tested whether experimentally induced depressed and happy mood have differential effects on pain ratings and tolerance in 55 patients suffering from chronic back pain. Participants were randomly assigned to depressed, neutral (control) or elated mood induction conditions. They completed a physically passive baseline task prior to receiving mood induction, then a clinically relevant physically active task (holding a heavy bag) to elicit pain responses and tolerance. Measures were taken immediately after the baseline task and immediately after the mood induction to assess the changes in mood, pain ratings and tolerance before and after the experimental manipulation. Results indicate that the induction of depressed mood resulted in significantly higher pain ratings at rest and lower pain tolerance, whilst induced happy mood resulted in significantly lower pain ratings at rest and greater pain tolerance. Correlations between changes in mood on the one hand and changes in pain response and pain tolerance on the other hand were consistent with these findings. It is concluded that, in chronic back pain patients, experimentally induced negative mood increases self-reported pain and decreases tolerance for a pain-relevant task, with positive mood having the opposite effect.

Passing the time when in pain: Investigating the role of musical valence.

“…happy music; Tang et al, 2008;van Laarhoven et al, 2012). Since participants liked all music in this study, it is possible that some emotional transference existed between relaxing and happy music, with the relaxing music inducing positive emotions in addition to unique feelings of relaxation (Tang et al, 2008). However, it could be argued that the different findings between happy and relaxing music could be a results of a time perception mechanism: participants perceived time passing differently when listening to happy and relaxing music.…”

“…Tang et al (2008) found that a negative mood state increased self-reported pain intensity and decreased pain tolerance, while a positive mood reduced self-reported pain intensity and increased pain tolerance.…”

Emotional distress and pain tolerance in obsessive-compulsive disorder

“…Some data suggest that depression may lower physical pain tolerance (Chiu et al, 2005;Tang et al, 2008). Indeed, associations between depression and pain have been identified in people who suffer from chronic pain disorders, such as fibromyalgia or neuropathic pain (Maletic & Raison, 2009).…”

Cross-validation of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) for Clinical Use

“…In this sense, to understand better how chronic pain can be reduced and better tolerated, is of relevance. 9 Regarding validity of DAPOS, the results can be generalized to other patients in clinical settings.…”

“…7,8 In contrast, the hypothesis that happy mood, that is positive affect, can significantly reduce pain perception and increases pain tolerance has been demonstrated and it may certainly contribute in the management of chronic musculoskeletal pain. 9,10 Researchers and clinicians evaluating mood have a variety of options. 11 Most of the questionnaires used to assess depression and anxiety have been shortened to make them more user friendly but still, showing reliability and validity consistent with the original versions.…”