The nature and adaptive implications of pain- affect dynamics

Because pain is in part an affective experience, investigators over the past several decades have sought to elaborate the nature of pain-affect connections. Our evolving understanding of the intersection of pain and affect is especially relevant to intervention efforts designed to enhance the quality of life and functional health of individuals managing chronic pain. This chapter describes how pain influences arousal of the vigilance/defensive and appetitive/approach motivational systems and thus the affective health of chronic pain patients. The focus then moves to the dynamic relations between changes in pain and other stressors and changes in positive and negative affect as observed in daily life and laboratory-based experiments. A consensus emerges that sustaining positive affect during pain and stress flares may limit their detrimental effects and promote better functional health. The authors consider the implications of increased understanding of the dynamic interplay between pain and affective experience for enhancing existing interventions.