Anger management style moderates effects of attention strategy during acute pain induction on physiological responses to subsequent mental stress and recovery: a comparison of chronic pain patients and healthy nonpatients

• Published in: Psychosomatic medicine 2009-05, Vol.71 (4), p.454-462
• Main Authors: Burns, John W, Quartana, Phillip J, Bruehl, Stephen
• Format: Article
• Language: English
• Subjects: Acute Disease; Adaptation, Psychological; Adult; Anger; Attention; Chronic Disease; Chronic low back pain; Chronic pain; Cold Temperature - adverse effects; Effects; Female; Hemodynamics; Humans; Induction; Inhibition (Psychology); Low Back Pain - physiopathology; Low Back Pain - psychology; Male; Mathematics; Middle Aged; Muscle Contraction; Pain; Pain - etiology; Pain - physiopathology; Pain - psychology; Personality Inventory; Psychosomatic medicine; Recovery; Stress; Stress, Psychological - physiopathology; Suppression
• ISSN: 0033-3174; 1534-7796
• DOI: 10.1097/PSY.0b013e318199d97f

To examine whether high trait anger-out chronic low back (CLBP) patients would show exceptionally large symptom-specific lower paraspinal (LP) responses, compared with healthy nonpatients, during pain induction, a subsequent mental stressor, and recovery when they were urged to suppress awareness of pain and suffering. CLBP patients (n = 93) and nonpatients (n = 105) were assigned randomly to one of four attention strategy conditions for use during pain induction: sensory-focus, distraction, suppression, or control. All participants underwent a cold pressor, and then performed mental arithmetic. They completed the anger-out (AOS) and anger-in (AIS) subscales of the Anger Expression Inventory. General Linear Model procedures were used to test Attention Strategy Condition x Patient/Nonpatient Status x AOS (or AIS) x Period interactions for physiological indices. Significant interactions were found such that: a) high trait anger-out patients in the Suppression condition seemed to show the greatest LP reactivity during the mental arithmetic followed by the slowest recovery compared with other conditions; b) high trait anger-out patients and nonpatients in the Suppression condition seemed to show the slowest systolic blood pressure recoveries compared with other conditions. Results extend previous work by suggesting that an anger-out style moderates effects of how attention is allocated during pain on responses to and recovery from a subsequent mental stressor. Results provide further evidence that trait anger-out and trait anger-in among CLBP patients are associated with increased LP muscle tension during and after pain and mental stress.