Distinct multidimensional anger profiles predict current and long-term chronic pain outcomes, 2026, Granjon et al.

Chandelier

Senior Member (Voting Rights)
Distinct multidimensional anger profiles predict current and long-term chronic pain outcomes

Granjon, Marine; Vest, Noel; Mackey, Sean C.; Gilam, Gadi

Highlights​

• Latent profile analysis identified four distinct anger profiles in individuals with chronic pain.
• Anger profiles associated with current and long-term outcomes, beyond anxiety and depression.
• Profiles with medium to high levels of perceived injustice associated with most severe outcomes.
• Anger-related profiling assesses and predicts high impact chronic pain to improve personalization.

Abstract​

Anger is prevalent in chronic pain (CP), often co-occurring with heightened distress and disability.
The complexity of the anger construct manifests in heterogeneity of how anger is experienced, expressed, and regulated.
Nevertheless, most work does not consider the inter-relationships between multiple dimensions of anger, limiting understanding of how anger might differentially contribute to pain outcomes.

Here, various anger metrics and latent profile analysis (LPA) were utilized to identify disparate anger profiles in people with CP.
Whether these profiles associated cross-sectionally and longitudinally with pain outcomes was subsequently examined.
Data was collected from 735 treatment-seeking adult patients with CP of varied etiologies, of which 242 also completed follow-up assessments about 5 months after baseline.
Anger measures included state and trait anger, anger expression (anger-in, anger-out), anger control (control-in, control-out), and perceived injustice. Pain outcomes included pain- intensity, distribution, interference, and behavior, and physical function.

LPA identified four distinct anger profiles characterized by the combination of varying levels (low, medium, high) of anger and of perceived injustice.
These profiles significantly associated with pain outcomes at both baseline and follow-up, above and beyond anxiety and depression.
Profiles with medium-to-high levels of both anger (state, trait, and expression) and perceived injustice predicted the worst pain outcomes, suggesting that injustice-based profiling should be prioritized for anger-related stratification of risk in CP.

The mechanistic and prognostic value of these anger profiles suggests that early assessment could enhance long-term treatment planning and advance personalized pain care, further emphasizing the need for tailored, anger-focused, patient-specific interventions.

Web | DOI | PMC | PDF | The Journal of Pain | Open Access
 
The paper suggests that latent profile analysis would help find out who the high anger-trait/perceived injustice persons are who will go on to have the worst pain outcomes (high pain levels) and doing interventions with them.

I worked with a doctor who was always angry, sniping at people, the most obnoxious person I had ever met. I'd hate to be his doctor at a pain clinic were he to develop a chronic pain condition. I imagine that he had a father who was very cruel and abusive to him.

My personal experience w/ FM pain at a level of 8/10 (e.g. yesterday afternoon) is I am too busy trying to think coherently enough to enact my pain treatment ladder (see below) to have any emotion.

FM pain demands that you do something about it. It's the "something is wrong here NOW, find out what and fix it" signal.

When the pain subsides down to a 6/10 pain level, I can take stock of what I deal with on a daily basis and think: oh shit, I have to deal with this tomorrow and every tomorrow for the rest of my life.

But that thought quickly dissipates.

My low level chronic irritation is the lack of awareness and compassion in other people toward me. They don't understand the severity of FM symptoms, or they think it's all in your head, and they haven't a clue how it impedes having a normal life or even a sense of self. The ones who understand this are special to me, essential.

OK, I'm a bit miffed at not being able to read books easily anymore. Or go for a walk without leg pain and massive thigh cramping.



*Pain treatment ladder (current version):

First, a hot bath (if energy exists) w/friction scrub of muscles
Capsaicin cream
Dark, quiet room, resting leaned back on heating pad, heat sac to trapezius (upper back/neck)
Tizanidine muscle relaxant,
If needed last option: clonazepam (a benzo).
 
Last edited:
Back
Top Bottom