Objective: Chronic pain is conceptualized as a biopsychosocial phenomenon that involves both physical and emotional processes. The vast majority of research regarding these facets of chronic pain characterizes differences between individuals. In this review, we describe problems with assuming that differences between persons accurately characterize within-person processes. We also provide a systematic review of studies that have examined within-person relationships between pain and affect among individuals with chronic pain.

Method: Articles published by December 2020 that pertained to within-person assessment of pain and emotion, affect, or mood were identified. Data regarding study design, adherence, and concurrent and prospective relationships among pain and affect variables were extracted and summarized.

Results: Of 611 abstracts, 55 studies met inclusion criteria. Results suggest that individuals with chronic pain tend to experience increased negative affect and decreased positive affect when experiencing more severe pain (r_pooled = .18 and − .19, respectively). However, the size of these effects appeared smaller than between-person associations, and there was evidence of significant variability between individuals. Examination of predictive relationships between pain and affect largely suggested the tendency of symptoms to predict themselves, rather than pain predicting affect or vice versa.

Conclusions: Consistent with group-level relationships, experiencing more severe pain relative to an individual's average seems to be associated with more negative affect and less positive affect. However, individuals vary in the size and even direction of these effects. More research is necessary to understand the implications of such variability for the assessment and treatment of chronic pain.

目的：慢性疼痛被概念化为一种涉及身体和情绪过程的生物心理社会现象。绝大多数关于慢性疼痛这些方面的研究都描述了个体之间的差异。在这篇评论中，我们描述了假设人与人之间的差异准确地描述了人内过程的问题。我们还对研究进行了系统评价，这些研究检查了慢性疼痛患者之间疼痛和情感之间的人际关系。

方法：确定了截至 2020 年 12 月发表的与对疼痛和情绪、情感或情绪的个人评估相关的文章。提取和总结了有关研究设计、依从性以及疼痛和影响变量之间的并发和前瞻性关系的数据。

结果：在 611 篇摘要中，55 篇研究符合纳入标准。结果表明，患有慢性疼痛的个体在经历更严重的疼痛时往往会经历更多的负面影响和减少的积极影响（r _pooled  = .18 和 − .19，分别）。然而，这些影响的大小似乎小于人与人之间的关联，并且有证据表明个体之间存在显着差异。对疼痛和情感之间的预测关系的检查在很大程度上表明症状倾向于自我预测，而不是疼痛预测情感，反之亦然。

结论：与群体层面的关系一致，相对于个人平均水平而言，经历更严重的疼痛似乎与更多的负面情绪和更少的正面情绪有关。然而，个体在这些影响的大小甚至方向上各不相同。需要更多的研究来了解这种可变性对慢性疼痛评估和治疗的影响。