Linking symptom-specific physiological reactivity to pain severity in chronic low back pain patients: A test of mediation and moderation models.

Burns, John W.; Wiegner, Sandra; Derleth, Martha; Kiselica, Kathleen; Pawl, Ronald P.

doi:10.1037//0278-6133.16.4.319

Cited by 12 publications

References 26 publications

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Anger Expression and Pain: An Overview of Findings and Possible Mechanisms

2006

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A tendency to manage anger via direct expression (anger-out) is increasingly recognized as influencing responses to pain. Elevated trait anger-out is associated with increased responsiveness to acute experimental and clinical pain stimuli, and is generally related to elevated chronic pain intensity in individuals with diverse pain conditions. Possible mechanisms for these links are explored, including negative affect, psychodynamics, central adipose tissue, symptom specific muscle reactivity, endogenous opioid dysfunction, and genetics. The opioid dysfunction hypothesis has some experimental support, and simultaneously can account for anger-out's effects on both acute and chronic pain. Factors which may moderate the anger-out/pain link are described, including narcotic use, gender, and genetic polymorphisms. Pain exacerbating effects of trait anger-out are contrasted with the apparent pain inhibitory effects of behavioral anger expression exhibited in anger-provoking contexts. Conceptual issues related to the state versus trait effects of expressive anger regulation are discussed.

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Anger Expression and Pain: An Overview of Findings and Possible Mechanisms

2006

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Attentional Strategy Moderates Effects of Pain Catastrophizing on Symptom-Specific Physiological Responses in Chronic Low Back Pain Patients

Quartana

Burns

Lofland³

2007

J Behav Med

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In the present study, we examined whether experimentally-manipulated attentional strategies moderated relations between pain catastrophizing and symptom-specific physiological responses to a cold-pressor task among sixty-eight chronic low back patients. Patients completed measures of pain catastrophizing and depression, and were randomly assigned to sensory focus, distraction or suppression conditions during a cold pressor. Lumbar paraspinal and trapezius EMG, and cardiovascular responses to the cold pressor were assessed. Attentional strategies moderated the relation between pain catastrophizing and lumbar paraspinal muscle, but not trapezius muscle or cardiovascular responses. Only for participants in the suppression condition was catastrophizing related significantly to lumbar paraspinal muscle responses. Depressed affect did not account for this relation. These findings indicate that 'symptom-specific' responses among pain catastrophizers with chronic low back depend on how they attend to pain-related information. Specifically, it appears that efforts to suppress awareness of pain exaggerate muscular responses near the site of injury.

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Anger Suppression, Ironic Processes and Pain

2007

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Whether anger suppression exerts a causal influence on pain experience, and the mechanisms of such an influence, are not well understood. We report two experimental studies that examine the hypothesis that anger suppression paradoxically increases cognitive accessibility of anger, in turn coloring perceptions of succeeding pain in an anger-congruent fashion. The results of two experimental studies largely confirmed these predictions. Study 1 revealed that participants instructed to suppress emotions during anger-provocation experienced greater cold-pressor pain than those in the control condition. This difference was confined to perception of anger-specific qualities of pain. Study 2 replicated key findings of Study 1, but also provided partial evidence for increased cognitive accessibility of anger tied to anger suppression through self-report and modified dot-probe methodologies. Implications and limitations of these findings are discussed.

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Linking symptom-specific physiological reactivity to pain severity in chronic low back pain patients: A test of mediation and moderation models.

Cited by 12 publications

References 26 publications

Anger Expression and Pain: An Overview of Findings and Possible Mechanisms

Anger Expression and Pain: An Overview of Findings and Possible Mechanisms

Attentional Strategy Moderates Effects of Pain Catastrophizing on Symptom-Specific Physiological Responses in Chronic Low Back Pain Patients

Anger Suppression, Ironic Processes and Pain

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