• Patrick H Finan and Eric L Garland.
• *Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD †Hunstman Cancer Institute, University of Utah, Salt Lake City, UT.
• Clin J Pain. 2015 Feb 1; 31 (2): 177-87.

ObjectiveThis narrative review summarizes and integrates the available literature on positive affect (PA) and pain to: (1) provide a brief overview of PA and summarize the key findings that have emerged in the study of PA and pain; (2) provide a theoretical foundation from which to understand how PA operates in the context of chronic pain (CP); and (3) highlight how the prevailing psychosocial treatments for CP address PA in the therapeutic context, and offer suggestions for how future treatment development research can maximize the benefit of PA for patients with CP.ResultsIn experimental studies, the evidence suggests PA is analgesic. In clinical studies, the association of PA and pain is dynamic, time variant, and may be best considered in context of its interacting role with negative affect.DiscussionWe offer an "upward spiral" model of PA, resilience and pain self-management, which makes specific predictions that PA will buffer maladaptive cognitive and affective responses to pain, and promote active engagement in valued goals that enhance CP self-management.

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