Depression and pain: independent and additive relationships to anger expression

Anger and anger expression (ANGX) are concerns in the U.S. military population and have been linked to stress dysregulation, heart disease, and poor coping behaviors.

We examined associations between depression, pain, and anger expression among military veterans.

Subjects (N = 474) completed a depression scale, a measure of pain across the last 4 weeks, and an ANGX scale. A multiple regression model assessed the independent and additive relationships of depression and pain to ANGX.

Almost 40% of subjects met the case definition for either major or minor depression. Subjects reported low-to-moderate levels of pain (mean = 6.3 of possible 20) and somewhat frequent episodes of ANGX. As expected, depression and pain were positively associated (r = 0.42, p < 0.001) and crossover effects of antidepressant and pain medication were shown. Specifically, frequency of antidepressant medication use was inversely associated with pain symptoms (r = -0.20, p < 0.001) and frequency of pain medication use was inversely linked to depressive symptoms (r = -0.21, p < 0.001). In a multiple regression model, depression (β = 0.58, p < 0.001) and pain (β = 0.21, p < 0.05) showed independent and additive relationships to ANGX (F = 41.5, p < 0.001, R(2)adj = 0.31).

This study offers empirical support for depression-pain comorbidity and elucidates independent and additive contributions of depression and pain to ANGX.