Effects of therapeutically induced affect arousal on depressive symptoms, pain and beta-endorphins among rheumatoid arthritis patients

Beutler, Larry E.; Daldrup, Roger J.; Engle, David; Oró-Beutler, M. Elena; Meredith, Keith; Boyer, John T.

doi:10.1016/0304-3959(87)90047-9

Cited by 18 publications

(12 citation statements)

References 26 publications

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“…More generally, several clinical trials have demonstrated that emotional awareness and expression interventions improve health outcomes for patients with various chronic pain disorders 25, 26 . Although early research suggested that it might be unhelpful or even iatrogenic to directly activate anger in patients with chronic pain 29, 30 , our results refute this. Not only did IBS symptoms and quality of life improve after an intervention that purposely activated and encouraged expression of anger in session, but EAET patients’ later hostility ratings decreased slightly, and were marginally lower than those of controls at post-treatment.…”

Section: Discussioncontrasting

confidence: 84%

Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial

Thakur

Holmes

Lockhart

et al. 2017

Neurogastroenterology Motil

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Background and Aims Current clinical guidelines identify several psychological treatments for irritable bowel syndrome (IBS). IBS patients, however, have elevated trauma, life stress, relationship conflicts, and emotional avoidance, which few therapies directly target. We tested the effects of emotional awareness and expression training (EAET) compared to an evidence-based comparison condition—relaxation training—and a waitlist control condition. Methods Adults with IBS (N = 106; 80% female, Mean age = 36 years) were randomized to EAET, relaxation training, or waitlist control. Both EAET and relaxation training were administered in three, weekly, 50-minute, individual sessions. All patients completed the IBS Symptom Severity Scale (primary outcome), IBS Quality of Life, and Brief Symptom Inventory (anxiety, depressive, and hostility symptoms) at pretreatment and at 2 weeks post-treatment and 10 weeks follow-up (primary endpoint). Results Compared to waitlist controls, EAET, but not relaxation training, significantly reduced IBS symptom severity at 10-week follow-up. Both EAET and relaxation training improved quality of life at follow-up. Finally, EAET did not reduce psychological symptoms, whereas relaxation training reduced depressive symptoms at follow-up (and anxiety symptoms at post-treatment). Conclusions Brief emotional awareness and expression training that targeted trauma and emotional conflicts reduced somatic symptoms and improved quality of life in patients with IBS. This emotion-focused approach may be considered an additional treatment option for IBS, although research should compare EAET to a full cognitive-behavioral protocol and determine which patients are best suited for each approach. Registered at clinicaltrials.gov (NCT01886027)

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Section: Discussioncontrasting

confidence: 84%

Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial

Thakur

Holmes

Lockhart

et al. 2017

Neurogastroenterology Motil

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“…This finding is consistent with a growing body of theory and research on the functional nature of emotion and the potential benefits that emotional awareness and expression can have for chronic pain disorders (60). These results also counter the generally negative conclusions of two earlier studies of the effects of anger expression for chronic pain (43, 44). Those studies, however, had substantial limitations or differences from ours; one was an uncontrolled trial that examined only six women with the autoimmune disease, rheumatoid arthritis (47), and the other, a controlled study, included only 9 patients per condition (48).…”

Section: Discussionsupporting

confidence: 56%

“…Yet, interventions that facilitate awareness, experiencing, and expression of negative emotions, particularly anger, need to be tested for chronic pain generally and for headaches specifically. Researchers and clinicians, however, may be hesitant to activate anger out of concern that doing so will not help, and may even exacerbate pain, as suggested by two older studies (43, 44). This concern needs to be addressed through additional research.…”

Section: Anger Suppression Expression and Painmentioning

confidence: 99%

Effects of Anger Awareness and Expression Training versus Relaxation Training on Headaches: A Randomized Trial

Slavin-Spenny¹,

Lumley²,

Thakur³

et al. 2013

ann. behav. med.

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Background and purpose Stress contributes to headaches, and effective interventions for headaches routinely include relaxation training (RT) to directly reduce negative emotions and arousal. Yet, suppressing negative emotions, particularly anger, appears to augment pain, and experimental studies suggest that expressing anger may reduce pain. Therefore, we developed and tested anger awareness and expression training (AAET) on people with headaches. Methods Young adults with headaches (N = 147) were randomized to AAET, RT, or a wait-list control. We assessed affect during sessions, and process and outcome variables at baseline and 4 weeks after treatment. Results On process measures, both interventions increased self-efficacy to manage headaches, but only AAET reduced alexithymia and increased emotional processing and assertiveness. Yet, both interventions were equally effective at improving headache outcomes relative to controls. Conclusions Enhancing anger awareness and expression may improve chronic headaches, although not more than RT. Researchers should study which patients are most likely to benefit from emotional expression versus emotional reduction approaches to chronic pain.

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“…At the one-year follow-up, the effect has been shown to remain stable. Another controlled treatment outcome study examined the benefits of expressive therapies on pain and psychological symptoms in chronic pain patients (Beutler, Daldrup, Engle, & Oro'-Beutler, 1987). Although symptoms of depression decreased during treatment, there was no improvement in pain levels.…”

Section: Treatment Considerationsmentioning

confidence: 99%

Somatoform disorders as disorders of affect regulation: A development perspective

Waller

Scheidt

2006

International Review of Psychiatry

217

136

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This paper considers the role of disturbances in affect regulation in the development and course of somatoform disorders. We first give an overview of contemporary theories in the field of psychosomatic medicine that links deficits in emotion regulation to the process of somatization, and then review recent empirical research that focuses on the association between affect regulation and somatoform disorders, with an emphasis on studies investigating the alexithymia construct. Overall, the findings suggest that somatoform disorders are linked to a diminished capacity to consciously experience and differentiate affects and express them in an adequate or healthy way. It must be noted, however, that this result has not been obtained exclusively for somatoform disorders. A promising approach to further our understanding of the developmental roots of impaired affect regulation in somatoform disorders is attachment research. The attachment research reviewed in this paper indicates that a dismissing status of attachment is linked to defensive forms of processing and expressing emotions. We present some new data that not only provide empirical support of a high proportion of dismissing attachment in somatoform disorders but also suggest that the degree to which somatoform disorder patients employ dismissing attachment strategies is strongly related to affect dysregulation. Finally, some implications for psychotherapeutic interventions in patients with somatoform disorders are considered.

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Effects of therapeutically induced affect arousal on depressive symptoms, pain and beta-endorphins among rheumatoid arthritis patients

Cited by 18 publications

References 26 publications

Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial

Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial

Effects of Anger Awareness and Expression Training versus Relaxation Training on Headaches: A Randomized Trial

Somatoform disorders as disorders of affect regulation: A development perspective

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