Anger and anger management style (the tendency to suppress or express anger) are important emotional factors which contribute to the aggravation of chronic pain. Few mechanisms, however, have be examined which explain how anger variables affect chronic pain. A """"""""symptom-specificity model"""""""" is advanced in which chronic low back pain (CLBP) patients can be distinguished from patients with chronic nonback pain and from normals on the basis of anger-induced tension in the musculature at the site of pain (lower paraspinals). The investigator proposes that exaggerated lower paraspinal (LP) reactivity during anger constitutes a physiological mechanism by which anger and anger management style affect CLBP.
Three aims will be pursued. First, it will be determined whether anger provocation has unique effects on LP reactivity among CLBP patients. Study 1 will examine whether CLBP patients show: greater overall LP reactivity than nonback pain patients and normals; greater LP reactivity during anger-induction versus anxiety-induction; trapezius, bicep and cardiovascular reactivity equivalent to the other groups. Second, it will be determined whether anger expression or suppression have effects on LP reactivity. Study 2 will examine whether self-reported anger management style predicts the degree to which anger is expressed during provocation, which in turn predicts LP reactivity, but not trapezius nor bicep reactivity, only among CLBP patients. Third, it will be determined whether anger arousal can influence variables reflecting CLBP aggravation via LP reactivity. Study 3 will test whether anger-induced LP reactivity, but not trapezius nor bicep reactivity, is related to pain report and pain behavior among CLBP patients during a subsequent pain-induction task. Findings will show whether LP reactivity constitutes a unique pathway by which anger, distinct from other emotions, exacerbates CLBP. Documenting a link between anger and LP reactivity will give empirical justification for targeting problematic anger among CLPB patients, and will provide principles on which to found new intervention strategies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29NS037164-04
Application #
6393894
Study Section
Behavioral Medicine Study Section (BEM)
Program Officer
Kitt, Cheryl A
Project Start
1998-09-01
Project End
2003-06-30
Budget Start
2001-07-01
Budget End
2002-06-30
Support Year
4
Fiscal Year
2001
Total Cost
$108,865
Indirect Cost
Name
Rosalind Franklin University
Department
Psychology
Type
Schools of Medicine
DUNS #
069501252
City
North Chicago
State
IL
Country
United States
Zip Code
60064
Burns, John W; Quartana, Phillip; Bruehl, Stephen (2011) Anger suppression and subsequent pain behaviors among chronic low back pain patients: moderating effects of anger regulation style. Ann Behav Med 42:42-54
Burns, John W; Quartana, Phillip J; Elfant, Erin et al. (2010) Shifts in attention biases in response to acute pain induction: examination of a model of ""conversion"" among repressors. Emotion 10:755-66
Burns, John W; Quartana, Phillip J; Bruehl, Stephen (2009) 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 71:454-62
Burns, John W; Quartana, Phillip; Gilliam, Wesley et al. (2008) Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: evaluation of an ironic process model. Health Psychol 27:645-52
Burns, John W; Holly, Amanda; Quartana, Phillip et al. (2008) Trait anger management style moderates effects of actual (""state"") anger regulation on symptom-specific reactivity and recovery among chronic low back pain patients. Psychosom Med 70:898-905
Wolff, Brandy; Burns, John W; Quartana, Phillip J et al. (2008) Pain catastrophizing, physiological indexes, and chronic pain severity: tests of mediation and moderation models. J Behav Med 31:105-14
Burns, John W; Quartana, Phillip J; Bruehl, Stephen (2007) Anger management style moderates effects of emotion suppression during initial stress on pain and cardiovascular responses during subsequent pain-induction. Ann Behav Med 34:154-65
Quartana, Phillip J; Yoon, K Lira; Burns, John W (2007) Anger suppression, ironic processes and pain. J Behav Med 30:455-69
Quartana, Phillip J; Burns, John W; Lofland, Kenneth R (2007) Attentional strategy moderates effects of pain catastrophizing on symptom-specific physiological responses in chronic low back pain patients. J Behav Med 30:221-31
Quartana, Phillip J; Burns, John W (2007) Painful consequences of anger suppression. Emotion 7:400-14

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