Rajcevich Schwer, A., McPherson-Isbell, G., Miller, S. A., Buscemi, J., Greenley, R. N., & Tran, S. T. (Under Review April 10-12, 2025). Perceived and biological stress in chronic pain and mood disorders. [Poster presentation]. Midwestern Psychological Association, Chicago, IL, United States. 

Stress has a significant effect on chronic pain, including initiation and maintenance of pain (Wyns et al., 2023). Additionally, stress system dysfunction is a typical characteristic of acute depression and other mood disorders (Holsboer & Ising, 2021). There is also a mutual relationship between chronic pain and depressive and manic mood states (Travaglini et al., 2020). Cortisol and alpha-amylase measure biological stress levels in the body. We sought to analyze perceived and biological stress in individuals with chronic pain and mood disorders. 

Our study consisted of 86 undergraduate students. Participants self-reported chronic pain and diagnosis of a current mood disorder. Participants were divided into 4 groups, current mood disorder, chronic pain, comorbid chronic pain and mood disorders, and neither. Salivary samples were collected over 3 days to measure cortisol and alpha-amylase. Participants also completed a daily hassles questionnaire.  

There was no significant difference in cortisol t(84)=1.417, p = 0.160 and in alpha-amylase t(84)=0.530, p = 0.598, between those with and without chronic pain; however there was a significant difference in hassles between individuals with chronic pain (M = 60.91 ,SD = 19.87) and those without (M = 49.36, SD = 15.10), t(83)=-2.268, p = 0.026. Individuals with chronic pain experienced more daily hassles, reporting higher rates of perceived stress.   

There were also no significant difference in cortisol t(82)=1.209, p = 0.230 and in alpha-amylase t(82)=-1.147, p = 0.255, between those with and without mood disorders; however, there was a  significant difference in hassles between those with mood disorders (M = 55.63, SD = 17.07) and without (M = 48.14, SD = 15.35), t(81)=-2.007, p = 0.048. Individuals with mood disorders experienced more daily hassles, reporting higher rates of perceived stress.  

One-Way ANOVAs yielded no significant differences in cortisol, alpha-amylase, or daily hassles between those with chronic pain, mood disorders, both, or neither. 

We found no significant differences in stress biomarkers across conditions. However, individuals with chronic pain and those with mood disorders reported experiencing significantly more daily hassles, indicating higher levels of perceived stress. While not indicated by biological stress, participants reported more stress, demonstrating the continued need for stress interventions for individuals with chronic pain and mood disorders. It is possible that consistent pain reduced hormone secretion, and/or stress management technique utilization lowered cortisol and alpha-amylase levels. It is necessary to further dissect this relationship between perceived and biological stress, considering the major implications stress has on biopsychosocial health.