Depression and Pain: Independent and Additive Relationships to Anger Expression

UNLABELLED: 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. OBJECTIVE: We examined associations between depression, pain, and anger expression among military veterans. METHOD: 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. RESULTS: 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). CONCLUSIONS: This study offers empirical support for depression-pain comorbidity and elucidates independent and additive contributions of depression and pain to ANGX.