Changes in basic emotion recognition in patients with chronic low back pain. A cross-sectional study analyzing emotion recognition and alexithymia

Persistent chronic pain leads to cortical changes in areas involved in the recognition of emotions. Wand et al. suggest a close correlation between the affective pain component and the extent to which these changes occur. As a consequence, the emotion profile may be influenced and difficulties in emotional communication may arise. A total of 49 patients with chronic low back pain (CLBP) were classified as grade 1 + 2 or 3 + 4 using the Graded Chronic Pain Scale (GCPS) questionnaire. In all patients, the ability to recognize basic emotions coded through facial expression was assessed using the Facially Expressed Emotion Labeling (FEEL) test. Furthermore, the Toronto Alexithymia Scale-26 (TAS-26) was used to assess if the patients showed signs of alexithymia. Data of the GCPS grade 3 + 4 (n = 35) group were analyzed. Findings of the FEEL test indicate that the GCPS grade 3 + 4 group recognized the basic emotion 'surprise' significantly more often (p = 0.001) and showed a higher level of currently perceived anger than unaffected subjects. The TAS-26 showed that 28.5 % of the patients with CLBP were alexithym. The results suggest changes in the recognition of emotions and that patients with CLBP show signs of alexithymia. Further studies with larger sample sizes are required to confirm the detected trends.