Psychosomatic Medicine
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Published online before print August 25, 2008
Psychosom Med 2008, doi:10.1097/PSY.0b013e3181835cb7
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© 2008 by American Psychosomatic Society

Research Article


Received January 8, 2008
Returned for revision April 1, 2008

Trait Anger Management Style Moderates Effects of Actual ("State") Anger Regulation on Symptom-Specific Reactivity and Recovery Among Chronic Low Back Pain Patients

John W. Burns , PhD, Amanda Holly , PhD, Phillip Quartana , MS, Brandy Wolff , MS, Erika Gray , MS, Stephen Bruehl , PhD


Address correspondence and reprint requests to: John W. Burns, PhD, E-mail: john.burns{at}rosalindfranklin.edu.


  Abstract

Objectives: We examined whether "state" anger regulation—inhibition or expression—among chronic low back pain (CLBP) patients would affect lower paraspinal (LP) muscle tension following anger-induction, and whether these effects were moderated by trait anger management style. Method: Eighty-four CLBP patients underwent harassment, then they regulated anger under one of two conditions: half expressed anger by telling stories about people depicted in pictures, whereas half inhibited anger by only describing objects appearing in the same pictures. They completed the anger-out and anger-in subscales (AOS; AIS) of the anger expression inventory. Results: General Linear Model procedures were used to test anger regulation condition by AOS/AIS by period interactions for physiological indexes. Significant three-way interactions were found such that: a) high trait anger-out patients in the inhibition condition appeared to show the greatest LP reactivity during the inhibition period followed by the slowest recovery; b) high trait anger-out patients in the expression condition appeared to show the greatest systolic blood pressure (SBP) reactivity during the expression period followed by rapid recovery. Conclusions: Results implicate LP muscle tension as a potential physiological mechanism that links the actual inhibition of anger following provocation to chronic pain severity among CLBP patients. Results also highlight the importance of mismatch situations for patients who typically regulate anger by expressing it. These CLBP patients may be at particular risk for elevated pain severity if circumstances at work or home regularly dictate that they should inhibit anger expression.

Key Words: anger regulation, trait anger-out, trait anger-in, symptom-specific reactivity, chronic pain




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J. W. Burns, P. J. Quartana, and S. Bruehl
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
Psychosom Med, May 1, 2009; 71(4): 454 - 462.
[Abstract] [Full Text] [PDF]


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Copyright © 2008 by the American Psychosomatic Society