Although repressive style has been implicated in the maintenance and exacerbation of chronic pain, its true effects and how these are exerted remain obscure and largely anecdotal. This project will test a potential mechanism with a substantial empirical basis. Because repressors show high tolerance during acute pain, but report high levels of chronic pain and respond poorly to multidisciplinary pain treatment, it was hypothesized that repressor pain patients routinely suppress pain-related thoughts and emotions and thus suffer the ironic effects of such suppression (e.g., rebound). Two pain-induction studies with patients are proposed to test whether ironic effects of thought suppression represent a mechanism by which repressive style affects chronic pain. The first study examines whether repressors spontaneously show short-term pain tolerance but long-term pain sensitivity similar to that shown by high anxious patients instructed to suppress pain (i.e., analog repressors). Chronic pain patients will undergo a cold pressor, and then be followed through recovery, and another physical stimulus (massage device); half of patients will be instructed to suppress pain during cold pressor. The second study examines whether repressors reveal a bias toward pain-related information and sensitivity to acute pain when their efforts at thought suppression are undermined by competing cognitive demands. Chronic pain patients will identify pain-related and positive words imbedded in a letter grid, and undergo a cold pressor, recovery, and the massage device; half of patients will perform these tasks with a cognitive load. Repressors' tendency to suppress the distress of pain may confer beneficial immediate effects, but habitual suppression may hide an underlying paradoxical preoccupation with pain that incurs substantial long-term physiological and psychological costs. Support for the proposed model will provide empirical justification and an impetus for confronting repressive style among pain patients. Moreover, findings should provide theoretical principles on which to found new intervention strategies (e.g., """"""""regulating"""""""" suppression by engaging in cognitive exercises). ? ?
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