Mild Depression in Low Back Pain: the Interaction of Thought Suppression and Stress Plays a Role, Especially in Female Patients

Abstract

Our findings support the hypothesis that TS heightens depressive mood under conditions of high cognitive load especially in female patients with SLBP indicating a special vulnerability for depressive mood in women with SLBP.

Depression and suicidal ideation in high‐performance athletes suffering from low back pain: The role of stress and pain‐related thought suppression

“…Sex differences in depression are commonly reported in the general population (Piccinelli & Wilkinson, ). Previous research (Konietzny et al, ) also indicated sex to have an influence, on the interaction of PTS and stress on depression but was not supported by the present data. Since sport is assumed to have a protective influence, it may reduce presumed risk factors in sex differences (Piccinelli & Wilkinson, ), by providing a social network, social integration and support (Sabo, Miller, Melnick, Farrell, & Barnes, ).…”

“…The present study did not show a significant main effect of PTS on depression or suicidal ideation. This is consistent with recent research in non‐athletic patients with pain (Konietzny et al, ). Although habitual thought suppression was shown to be associated with depressive disorders in the general population (Aldao, Nolen‐Hoeksema, & Schweizer, ; Purdon, ) and patients with low back pain (Hülsebusch et al, ; Klasen et al, ), the effects were only of low effect size (Hülsebusch et al, ; Klasen et al, ).…”

“…We expect self‐reported PTS to be more frequent than other pain cognitions. Given the previous findings on thought suppression and stress (Beevers & Meyer, ; Konietzny et al, ; Wenzlaff & Luxton, ), we hypothesize highest depressive symptoms and suicidal ideation in the subgroup of athletes showing both high stress and high levels of PTS.…”

“…Especially under high cognitive load, for example under high stress, the search for distractors should get disorganized, while the non-effortful process of monitoring is ongoing, signalling success or failure. Several prospective and cross-sectional studies in nonathletes supported this interaction hypothesis with respect to depressive mood in patients with low back pain (Konietzny et al, 2018) and healthy people (Beevers & Meyer, 2004;Wenzlaff & Luxton, 2003).…”

Brain structural alterations associated with dysfunctional cognitive control of pain in patients with low back pain

“…Compared with pain monitoring strategies, experimental induction of TS as a response to cold pressor pain in healthy people has been shown to paradoxically cause higher pain ratings during (Sullivan et al, 1997) and after pain stimulation (Cioffi and Holloway, 1993), as well as higher levels of distress (Masedo and Esteve, 2007). Clinical studies revealed positive associations between habitual pain-related TS and several outcomes, such as pain, disability and depression in patients with low back pain (LBP) in primary care (Klasen et al, 2006;Hasenbring et al, 2009;H€ ulsebusch et al, 2016;Konietzny et al, 2017) or before and after lumbar disc surgery (Hasenbring, 1993;Grebner et al, 1999). Hence, there is a need to understand the mechanisms responsible for the paradoxical effects of this type of pain response.…”