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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Naylor, MR; Krauthamer, GM; Naud, S; Keefe, FJ; Helzer, JE

Published Date

  • 2011

Published In

Volume / Issue

  • 52 / 6

Start / End Page

  • 731 - 736

PubMed ID

  • 21349510

Pubmed Central ID

  • PMC3136612

Electronic International Standard Serial Number (EISSN)

  • 1532-8384

Digital Object Identifier (DOI)

  • 10.1016/j.comppsych.2010.11.008


  • eng

Conference Location

  • United States