THU0586 Impact of Solicitous and Punishing Spouse Responses on Pain and Negative Emotions in the Everyday Life of Women with Fibromyalgia
Authors: I. López-Chicheri, H. van Middendorp, M. A. Lumley, R. Geenen
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Theories suggest that the social environment, especially one's spouse or partner, affects one's pain as well as emotions, which is confirmed by both cross-sectional and experimental studies. For instance, the operant conditioning model postulates that spouses may serve as a discriminant cue and selective reinforcer for the behavioral expression and experience of pain [1]. This has been confirmed in studies showing a positive correlation between a solicitous spouse response style and more severe everyday pain in people with fibromyalgia [2]. Moreover, a punishing spouse response style will more easily trigger negative emotions than a solicitous response spouse style. This can be due to classical conditioning processes such as previous associations between punishment and negative affect [3]. Finally, the coupling of pain and emotions may have become stronger in patients having a spouse with a high solicitous or punishing response style. <h3>Objectives</h3> To examine whether solicitous or punishing spouse responses predict pain, negative emotions, emotion-induced pain, and pain-induced emotions in the everyday life of female patients with fibromyalgia. <h3>Methods</h3> A diary study was conducted. At the end of each of 28 consecutive days, 229 participants with a steady relationship (age 47.5±11.1) reported a significant emotional event during the day and rated their pain as well as sadness and anger. Patient perceptions of solicitous or punishing responses from their spouses were assessed prior to the daily assessment. Multilevel regression analyses were conducted. <h3>Results</h3> Solicitous spouse responses predicted greater daily pain (<i>p</i>&lt;.01), but not sadness or anger. Punishing responses predicted more sadness (<i>p</i>&lt; 01) and anger (<i>p</i>&lt;.01), but not pain. No evidence was found for spouse response styles predicting emotion-pain relations with one exception: in patients with a solicitous spouse response style, daily pain was especially high when sadness during the day was high (<i>p</i>=.04). <h3>Conclusions</h3> This study supports previous findings that a solicitous spouse may augment pain. In contrast, having a spouse characterized by a punishing response style is not predictive of daily pain, but negative emotions may be enhanced. The possibility of differing effects of spouse solicitous and punishing responses has implications for theoretical models of pain and emotion as well as for clinical interventions. <h3>References</h3> Fordyce WE (1976). <i>Behavioral methods for chronic pain and illness</i>. Saint Louis: The C.V. Mosby Company. Pence LB, Thorn BE, Jensen MP, Romano JM. Examination of perceived spouse responses to patient well and pain behavior in patients with headache. Clin J Pain 2008;24;654-61. Romano JM, Jensen MP, Schmaling KB, Hops H, Buchwald DS. Illness behaviors in patients with unexplained chronic fatigue are associated with significant other responses. J Behav Med 2009<i>;</i>32<i>;</i>558-69. <h3>Disclosure of Interest</h3> None Declared