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Meta-Analysis
. 2021 Dec 15;22(1):1-13.
doi: 10.1515/sjpain-2021-0154. Print 2022 Jan 27.

Associations between anger and chronic primary pain: a systematic review and meta-analysis

Tomonori Adachi  1   2 , Keiko Yamada  3   4 , Haruo Fujino  5   6 , Kiyoka Enomoto  6   7 , Masahiko Shibata  8
Affiliations
Free article
Meta-Analysis

Associations between anger and chronic primary pain: a systematic review and meta-analysis

Tomonori Adachi et al. Scand J Pain. .
Free article

Abstract

Objectives: Anger is a negative emotion characterized by antagonism toward someone or something, is rooted in an appraisal or attribution of wrongdoing, and is accompanied by an action tendency to undo the wrongdoing. Anger is prevalent in individuals with chronic pain, especially those with chronic primary pain. The associations between anger and pain-related outcomes (e.g., pain intensity, disability) have been examined in previous studies. However, to our knowledge, no systematic review or meta-analysis has summarized the findings of anger-pain associations through a focus on chronic primary pain. Hence, we sought to summarize the findings on the associations of anger-related variables with pain and disability in individuals with chronic primary pain.

Methods: All studies reporting at least one association between anger-related variables and the two pain-related outcomes in individuals with chronic primary pain were eligible. We searched electronic databases using keywords relevant to anger and chronic primary pain. Multiple reviewers independently screened for study eligibility, data extraction, and methodological quality assessment.

Results: Thirty-eight studies were included in this systematic review, of which 20 provided data for meta-analyses (2,682 participants with chronic primary pain). Of the included studies, 68.4% had a medium methodological quality. Evidence showed mixed results in the qualitative synthesis. Most anger-related variables had significant positive pooled correlations with small to moderate effect sizes for pain and disability.

Conclusions: Through a comprehensive search, we identified several key anger-related variables associated with pain-related outcomes. In particular, associations with perceived injustice were substantial.

Keywords: anger; chronic primary pain; meta-analysis; perceived injustice; systematic review.

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References

    1. Fernandez, E, Turk, DC. The scope and significance of anger in the experience of chronic pain. Pain 1995;61:165–75. https://doi.org/10.1016/0304-3959(95)00192-u . - DOI
    1. Greenwood, KA, Thurston, R, Rumble, M, Waters, SJ, Keefe, FJ. Anger and persistent pain: current status and future directions. Pain 2003;103:1–5. https://doi.org/10.1016/s0304-3959(03)00132-5 . - DOI
    1. Trost, Z, Vangronsveld, K, Linton, SJ, Quartana, PJ, Sullivan, MJL. Cognitive dimensions of anger in chronic pain. Pain 2012;153:515–7. https://doi.org/10.1016/j.pain.2011.10.023 . - DOI
    1. Fernandez, E, Wasan, A. The anger of pain sufferers: attributions to agents and appraisals of wrongdoings. In: Potegal, M, Stemmler, G, Spielberger, C, editors. International handbook of anger: constituent and concomitant biological, psychological, and social processes . New York, NY: Springer New York; 2010:449–64 pp.
    1. Fernandez, E. The relationship between anger and pain. Curr Pain Headache Rep 2005;9:101–5. https://doi.org/10.1007/s11916-005-0046-z . - DOI

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