Positive outlook on life eases chronic pain

A person’s outlook on life can minimize -- or aggravate -- a person’s chronic pain, reports a new Cornell study.

"While pain is a fact of life for many," says Anthony Ong, assistant professor of human development at Cornell, "how people relate to their pain can either help or hinder healthy coping."

Ong and colleagues report that a person’s habitual outlook on life and their ability to sustain positive emotions in the face of adversity or stress (what psychologists call psychological resilience) can make a dramatic difference in their experience of chronic pain, which afflicts millions of Americans, particularly the growing population of elderly.

The study, co-authored by M. Cary Reid, M.D., associate professor of medicine at Weill Cornell Medical College, and Alex Zautra, professor of health psychology at Arizona State University, is published in the September 2010 issue of Psychology and Aging (Vol. 25, No. 3).

The researchers studied 72 women and 23 men, ages 52 to 95, at Weill Cornell who were diagnosed with chronic pain -- the average duration of pain was about eight years. The patients completed daily diaries for two weeks containing information about their emotions and experience of pain each day.

The researchers found a link between the patients’ resilience, positive emotions and how much they then "catastrophized" about their pain. Some people with chronic pain tend have an exaggerated negative view of the actual or anticipated pain. This so-called "pain catastrophizing" makes the experience of pain worse and contributes to increased pain severity, disability and emotional distress, Ong said. It exacerbates anxiety and worry. Such negative emotions can potentially stimulate neural systems that produce increased sensitivity to pain. It can become a vicious cycle.

On the other hand, the researchers found that high-resilient individuals reported less day-to-day pain catastrophizing, compared with the low-resilient individuals. The findings also suggest that the day-to-day experience of positive emotions represent an active ingredient in what it means to be "resilient," Ong said.

Interestingly, the researchers also found that women with chronic pain tended to catastrophize more than men; there was also a stronger effect of positive emotion on pain catastrophizing in women.

"Daily experiences of positive emotions have the potential to counteract the sense of helplessness and focus on negativity that can make chronic pain so devastating," Ong said. "Based on the gender differences we found, interventions for women in particular may benefit from greater attention to sources of positive emotion."

Hartford Foundation and the National Institute on Aging.

Karene Booker is an extension support specialist in the Department of Human Development.

Higher levels of psychological resilience before the death of a spouse appears to buffer the potentially devastating negative impact of spousal loss, reports a new Cornell study.

Widows and widowers with higher levels of psychological resilience before their spouses died had little change in their positive emotion several years later, compared with those with lower levels of pre-loss psychological resilience, who experienced marked declines in positive emotion following spousal loss.

"Our analysis demonstrated that psychological resilience is a significant predictor of positive emotion in the face of major life challenges," said lead author Anthony Ong, assistant professor of human development, whose studied is published in Psychology and Aging (25:3). "And the maintenance of positive emotion has long-term consequences for well-being and health."

Ong and colleagues Thomas Fuller-Rowell, Ph.D. ’10, and clinical psychologist George Bonanno of Columbia University studied a subsample of adults in a survey that included information at two points in time, 10 years apart. During that time, 52 individuals had been widowed and had not remarried. This group was compared with 156 continuously married individuals selected to match the widowed adults in age, gender and education.

The survey included measures of positive emotions (e.g., how much time they felt cheerful), psychological resilience (e.g., the ability to see the positive side of a difficult situation), spousal strain and depressive symptoms.

The researchers also found that widowed participants who had had more conflict with their spouses had higher positive emotion scores than their low-strain counterparts. And vice versa, widowed adults who reported lower levels of prior spousal strain exhibited greater declines in positive emotion.

"It’s important to realize that the impact of spousal loss may vary widely based on personal characteristics and marital context," Ong said. "Contrary to historical beliefs, the experience of positive emotion during bereavement is not unusual, but relatively common and may be a signal of healthy adjustment."

The original study was supported by the John D. and Catherine T. MacArthur Foundation.

-- Karene Booker

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