Research has shown clearly that reported level or intensity of pain sensation varies according to a number of affective elements. For example, depressed mood is associated with increased processing of negatively evaluated events. There is selective recall of unpleasant events and current circumstances are rated less positively than they are among non-depressed persons. A stimulus is more likely to be rated as painful and as more intensely painful by depressed compared to non-depressed people. The problem is amplified because persons in pain quickly become depressed and this compounds the intensification of the “painfulness” of the experience.

Anxiety also exacerbates the experience of pain. This seems to involve a different mechanism to that in depression. Anxiety is associated with the anticipation of harm and there is a tendency to tense or protect a painful body part from stimulation. This anxiety/fear leads to hyper-responsiveness to stimulation, which is experienced as an intensification of pain.. Even when there is no additional stimulation, pain is reported as being more intense among people reporting higher levels of anxiety than those reporting lower levels of anxiety.