The role of positive and negative emotion severity, anger symptoms, and depression level in the relationship between chronic pain and childhood traumas

The present study examined the roles of positive and negative emotions, anger symptoms, and depressive symptoms in the relationship between childhood traumas and pain burden. The research sample comprised 135 individuals aged 18-50 with chronic pain complaints and 139 individuals without chronic pain complaints. The development of the pain index was the first of several steps in this direction. This index was designed to assess chronic pain and consisted of the product of the variables of pain intensity, number of painful areas, and pain frequency. The pain index is indicative of the concept of 'Pain Burden', which is defined as the integrated effect of chronic pain on the individual. Participants were also required to complete various forms, including the Sociodemographic and Clinical Information Form, Beck Depression Inventory (BDI), Positive and Negative Emotion Scale (PANAS), Multidimensional Anger Scale (MAS), and Childhood Trauma Questionnaire-33 (CTQ-33). Chi-square analyses were performed to examine the relationships between all variables. The findings of the analysis demonstrate a positive correlation between the severity of emotional, sexual, and physical abuse, as well as negative emotions, anger symptoms, and depressive symptoms, and the level of pain burden experienced by the individual. Subsequently, serial mediation analyses were performed for negative emotions and anger symptoms, simple mediation analyses for depressive symptoms, and moderated mediation analyses for depressive symptoms and positive emotions in the relationship between childhood traumas and pain burden. The findings indicate that negative emotions and anger symptoms had a full serial mediating role in trauma subdimensions other than physical neglect and sexual abuse; while a partial mediating role was found in the sexual abuse subdimension, the model was not found to be significant as physical neglect did not predict the mediating and dependent variables. Furthermore, depressive symptoms were observed to have a full mediating role in all trauma subdimensions. Finally, positive emotions were found to moderate the full mediating role of depressive symptoms in trauma subdimensions other than sexual abuse and physical neglect. Based on the results of this study, it is recommended that parameters including trauma history and emotional experiences be considered in the prevention and treatment of chronic pain.