The negative impact on Cara Therapeutics' stock price is directly related to the company's worse-than-expected Q4 financial results. Typically, when a company reports financial results that do not meet analysts' expectations, it can lead to a decrease in investor confidence and a subsequent drop in the stock price. Given that the news specifically mentions the company's disappointing financial performance, it is highly relevant and important for investors holding or considering CARA stock. The high confidence in the analysis stems from the clear cause-and-effect relationship between earnings reports and stock price movements.