Abstract
Anger and how anger is regulated appear to affect acute and chronic pain intensity. The inhibition of anger (anger-in), in particular, has received much attention, and it is widely believed that suppressing or inhibiting the verbal or physical expression of anger is related to increased pain severity. We examine theoretical accounts for expecting that anger inhibition should affect pain, and review evidence for this claim. We suggest that the evidence for a link between trait anger-in (the self-reported tendency to inhibit anger expression when angry) and acute and chronic pain severity is quite limited owing to a number of factors including a inadequate definition of trait anger-in embodied in the popular anger-in subscale of Spielberger’s Anger Expression Inventory, and a strong overlap between trait anger-in scores and measures of general negative affect (NA). We argue that in order to determine whether something unique to the process of anger inhibition exerts direct effects on subsequent pain intensity, new conceptualizations and approaches are needed that go beyond self-report assessments of trait anger-in. We present one model of anger inhibition and pain that adopts elements of Wegner’s ironic process theory of thought suppression. Findings from this emerging research paradigm indicate that state anger suppression (suppression manipulated in the laboratory) may indeed affect sensitivity to subsequent painful stimuli, and we outline potentially productive avenues of future inquiry that build on this model. We conclude that although studies employing correlational designs and self-reports of trait anger-in have not upheld the claim that anger inhibition affects pain severity, evidence from studies using new models suggests that actually inhibiting anger expression during a provocative event may increase perceived pain at a later time.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Much work has been devoted to describing the construct of anger, and to attempting to differentiate anger, hostility and aggression. A thorough treatment of these efforts is beyond the scope of this review. For our purposes, we employ Spielberger et al.’s (1985) notion that anger is an emotional state that varies in intensity from mild irritation to full-blown fury. Work has also been directed toward distinguishing anger from other broad negative affects. Again, a thorough account of this research is beyond the scope of this review, and we point readers to some recent attempts to come to grips with what factors make anger a unique emotion (e.g., Harmon-Jones 2007; Harmon-Jones and Harmon-Jones 2007).
References
Abramowitz, J. S., Tolin, D. F., & Street, G. P. (2001). Paradoxical effects of thought suppression: A meta-analysis of controlled studies. Clinical Psychology Review, 21, 683–703.
al’Absi, M., Buchanan, T., & Lovallo, W. R. (1996). Pain perception and cardiovascular responses in men with positive parental history for hypertension. Psychophysiology, 33, 655–661.
Alexander, F. G. (1948). Emotional factors in hypertension. In F. Alexander & T. M. French (Eds.), Studies in psychosomatic medicine: An approach to the cause and treatment of vegetative disturbances. New York: Ronald.
Amir, M., Neumann, L., & Bor, O. (2000). Coping styles, anger, social support, and suicide risk of women with fibromyalgia syndrome. Journal of Musculoskeletal Pain, 8, 7–20.
Anderson, J. R., Qin, Y., & Stenger, V. A. (2004). The relationship of three cortical regions to an information-processing model. Journal of Cognitive Neuroscience, 16, 637–653.
Andreassi, J. L. (1995). Psychophysiology: Human behavior & physiological response. Hillsdale, NJ: Lawrence Erlbaum Associates.
Arena, J. G., Bruno, G. M., & Rozantine, G. S. (1997). A comparison of tension headache sufferers and nonpain controls on the state-trait anger expression inventory: An exploratory study with implications for applied psychophysiologists. Applied Psychophysiology and Biofeedback, 22, 209–214.
Arena, J. G., Sherman, R. A., Bruno, G. M., & Young, T. R. (1991). Electromyographic recordings of low back pain subjects and non-pain control is six different positions: Effects of pain levels. Pain, 45, 23–28.
Aronson, K. R., Barrett, L. F., & Quigley, K. (2006). Emotional reactivity and the overreport of somatic symptoms: Somatic sensitivity or negative reporting style? Journal of Psychosomatic Research, 60, 521–530.
Asendorpf, J. B., & Scherer, K. R. (1983). The discrepant repressor: Differentiation between low anxiety, high anxiety, and repression of anxiety by autonomic-facial-verbal patterns of behavior. Journal of Personality and Social Psychology, 45, 1334–1346.
Banks, S. M., & Kerns, R. D. (1996). Explaining high rates of depression in chronic pain: A diathesis-stress framework. Psychological Bulletin, 119, 95–110.
Barrett, L. F., Ochsner, K. N., & Gross, J. J. (2007). On the automaticity of emotion. In J. A. Bargh (Ed.), Social psychology and the unconscious: The automaticity of higher mental processes (pp. 173–217). New York, NY: Psychology Press.
Berkowitz, L. (1990). On the formation and regulation of anger and aggression: A cognitive-neoassociationistic analysis. American Psychologist, 45, 494–503.
Berkowitz, L. (1993). Pain and aggression: Some findings and implications. Motivation & Emotion, 17, 277–293.
Boals, A., & Klein, K. (2005). Word use in emotional narratives about failed romantic relationships and subsequent mental health. Journal of Language and Social Psychology, 24, 252–268.
Breuer, J. & Freud, S. (1955; 1895). Studies on hysteria. In Standard edition of the complete psychological works of Sigmund Freud (Vol. II). London: Hogarth Press.
Broderick, J. E., Junghaenel, D. U., & Schwartz, J. E. (2005). Written emotional expression produces health benefits in fibromyalgia patients. Psychosomatic Medicine, 67, 326–334.
Brosschot, J. F. (2002). Cognitive-emotional sensitization and somatic health complaints. Scandinavian Journal of Psychology, 43, 113–121.
Brosschot, J. F., & Thayer, J. F. (1998). Anger inhibition, cardiovascular recovery, and vagal function: A model of the link between hostility and cardiovascular disease. Annals of Behavioral Medicine, 20, 326–332.
Bruehl, S., Burns, J., Chung, O. Y., Ward, P., & Johnson, P. (2002a). Anger and pain sensitivity in chronic low back pain patients and pain-free controls: The role of endogenous opioids. Pain, 99, 223–233.
Bruehl, S., Chung, O. Y., & Burns, J. W. (2003a). Differential effects of expressive anger regulation on chronic pain intensity in CRPS and non CRPS limb pain patients. Pain, 104, 647–654.
Bruehl, S., Chung, O. Y., Burns, J. W., & Biridepalli, S. (2003b). The association between anger expression and chronic pain intensity: Evidence for partial mediation by endogenous opioid dysfunction. Pain, 106, 317–324.
Bruehl, S., Chung, O. Y., Ward, P., Johnson, B., & McCubbin, J. A. (2002b). The relationship between resting blood pressure and acute pain sensitivity in healthy normotensives and chronic back pain sufferers: The effects of opioid blockade. Pain, 100, 191–201.
Burns, J. W. (1997). Anger management style and hostility: Predicting symptom-specific physiological reactivity among chronic low back pain patients. Journal of Behavioral Medicine, 20, 505–522.
Burns, J. W. (2006a). Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients. Emotion, 6, 309–319.
Burns, J. W. (2006b). The role of attentional strategies in moderating links between acute pain induction and subsequent emotional stress: Evidence for symptom specific reactivity among chronic pain patients versus healthy nonpatients. Emotion, 6, 180–192.
Burns, J. W., Bruehl, S., & Caceres, C. (2004). Anger management style, blood pressure reactivity and acute pain sensitivity: Evidence for a “trait × situation” model. Annals of Behavioral Medicine, 27, 195–204.
Burns, J. W., Bruehl, S., & Quartana, P. J. (2006). Anger management style and hostility among chronic pain patients: Effects on symptom-specific physiological reactivity during anger- and sadness-recall interviews. Psychosomatic Medicine, 68, 786–793.
Burns, J. W., Evon, D., & Strain-Saloum, C. (1999). Repressed anger and patterns of cardiovascular, self-report and behavioral responses: Effects of harassment. Journal of Psychosomatic Research, 47, 569–581.
Burns, J. W., Johnson, B. J., Mahoney, N., Devine, J., & Pawl, R. (1996). Anger management style, hostility and spouse responses: Gender differences in predictors of adjustment among chronic pain patients. Pain, 64, 445–453.
Burns, J. W., Kubilus, A., & Bruehl, S. (2003). Emotion induction moderates effects of anger management style on acute pain sensitivity. Pain, 106, 109–118.
Burns, J. W., Quartana, P. J., & Bruehl, S. (2007). Anger management style moderates effects of emotion suppression during stress on pain and cardiovascular responses during pain-induction. Annals of Behavioral Medicine, 34, 154–165.
Burns, J. W., Quartana, P. J., Gilliam, W., Gray, E., Matsuura, J., Nappi, C., Wolfe, B., & Lofland, K. (in press). Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: Evaluation of an ironic process model. Health Psychology.
Burns, J. W., Wiegner, S., Derleth, M., Kiselica, K., & Pawl, R. (1997). Linking symptom-specific physiological reactivity to pain severity in chronic low back pain patients: A test of mediation and moderation models. Health Psychology, 16, 319–326.
Caceres, C., & Burns, J. W. (1997). Cardiovascular reactivity to psychological stress may enhance subsequent pain sensitivity. Pain, 69, 237–244.
Cacioppo, J. T., Amaral, D. G., & Blanchard, J. J. (2007). Social neuroscience: Progress and implications for mental health. Perspectives on Psychological Science, 2, 99–123.
Cioffi, D., & Holloway, J. (1993). Delayed costs of suppressed pain. Journal of Personality and Social Psychology, 64, 274–282.
Conant, L. L. (1998). Psychological variables associated with pain perceptions among individuals with chronic spinal cord injury pain. Journal of Clinical Psychology in Medical Settings, 5, 71–90.
Dannahy, L., & Stopa, L. (2007). Post-event processing in social anxiety. Behaviour Research and Therapy, 45, 1207–1219.
DeSteno, D., Petty, R. E., Rucker, D. D., Wegnener, D. T., & Braverman, J. (2004). Discrete emotions and persuasion: The role of emotion-induced expectancies. Journal of Personality and Social Psychology, 86, 43–56.
Duckro, P. N., Chibnall, J. T., & Tomazic, T. J. (1995). Chronic daily headache as a sequela of minor head and/or neck trauma: A multiple case study. Headache Quarterly, 6, 297–302.
Edwards, L., Ring, C., McIntyre, D., Carroll, D., Clarke, R., Webb, O., & Martin, U. (2006). Increases in arousal are associated with reductions in the human nociceptive flexion reflex threshold and pain ratings: Evidence for dissociation between nociception and pain. Journal of Psychophysiology, 20, 259–266.
Elfant, E., Burns, J., & Zeichner, A. (in press). Repressive coping style and suppression of pain-related thoughts: Effects on responses to acute pain induction. Cognition & Emotion.
Engebretson, T. O., Matthews, K. A., & Scheier, M. F. (1989). Relations between anger expression and cardiovascular reactivity: Reconciling inconsistent findings through a matching hypothesis. Journal of Personality and Social Psychology, 57, 513–521.
Engel, G. (1959). “Psychogenic” pain and the pain prone patient. American Journal of Medicine, 26, 899–918.
Epstein, S. (1980). The stability of behavior: II. Implications for psychological research. American Psychologist, 35, 790–806.
Faber, S. D., & Burns, J. W. (1996). Anger management style, degree of expressed anger, and gender influence cardiovascular recovery from interpersonal harassment. Journal of Behavioral Medicine, 19, 31–53.
Fassbender, C., Murphy, K., Foxe, J. J., Wylie, G. R., Javin, D. C., Robertson, L. H., & Garavan, H. (2004). A topography of executive functions and their interactions revealed by functional magnetic resonance imaging. Cognitive Brain Research, 20, 132–143.
Fields, H. L. (1987). Pain. New York, NY: Raven.
Flor, H., Birbaumer, N., Schugens, M. M., & Lutzenberger, W. (1992). Symptom-specific psychophysiological responses in chronic pain patients. Psychophysiology, 29, 452–460.
Flor, H., Birbaumer, N., Schulte, W., & Roos, R. (1991). Stress-related electromyographic responses in patients with chronic temporomandibular pain. Pain, 46, 145–152.
Flor, H., Knost, B., & Birbaumer N. (2002). The role of operant conditioning in chronic pain: An experimental investigation. Pain, 95, 111–118.
Flor, H., Turk, D. C., & Birbaumer, N. (1985). Assessment of stress-related psychophysiological reactions in chronic back pain patients. Journal of Consulting and Clinical Psychology, 53, 354–364.
France, C. R., & Stewart, K. M. (1995). Parental history of hypertension and enhanced cardiovascular reactivity are associated with decreased pain ratings. Psychophysiology, 32, 571–578.
Freud, S. (1957; 1915). Repression. In J. Strachey (Ed. and Trans.), The standard editions of the complete psychological works of Sigmund Freud (Vol. 14). London: Hogarth Press.
Frisina, P. G., Borod, J. C., & Lepore, S. J. (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. Journal of Nervous and Mental Disease, 192, 629–634.
Funkenstein, D. H., King, S. H., & Drolette, M. E. (1954). The direction of anger during a laboratory stress-inducing situation. Psychosomatic Medicine, 16, 404–413.
Gaskin, M. E., Greene, A. F., Robinson, M. E., & Geisser, M. E. (1992). Negative affect and the experience of chronic pain. Journal of Psychosomatic Research, 36, 707–713.
Gelkopf, M. (1997). Laboratory pain and styles of coping with anger. Journal of Psychology: Interdisciplinary and Applied, 131, 121–123.
Gillis, M. E., Lumley, M. A., & Mosley-Williams, A. (2006). The health effects of at-home written emotional disclosure in fibromyalgia: A randomized trial. Annals of Behavioral Medicine, 32, 135–146.
Green, A. L., Wang, S., Owen, S. L., Xie, K., Bittar, R. G., Stein, J. F., Paterson, D. J., & Aziz, T. Z. (2006). Stimulating the human midbrain to reveal the link between pain and blood pressure. Pain, 124, 349–359.
Greenberg, L. S., & Safran, J. D. (1987). Emotion in psychotherapy. New York: Guilford.
Greenberg, M. A., & Stone, A. A. (1992). Emotional disclosure about traumas and its relation to health: Effects of previous trauma and trauma severity. Journal of Personality and Social Psychology, 63, 75–84.
Gross, J. J. (1999). Emotion regulation: Past, present, and future. Cognition and Emotion, 13, 551–573.
Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39, 281–291.
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362.
Gross, J. J., John, O. P., & Richards, J. M. (2000). The dissociation of emotional expression from emotional experience: A personality perspective. Personality and Social Psychology Bulletin, 26, 712–726.
Gross, J. J., & Levenson, R. W. (1993). Emotional suppression: Physiology, self-report, and expressive behavior. Journal of Personality of Social Psychology, 64, 970–986.
Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: The acute effects of inhibiting positive and negative emotions. Journal of Abnormal Psychology, 106, 95–103.
Grothgar, B., & Scholz, O. B. (1987). On specific behavior of migraine patients in an anger-provoking situation. Headache: The Journal of Head and Face Pain, 27, 206–210.
Ham, L. P., Andrasik, F., Packard, R. C., & Bundrick, C. M. (1994). Psychopathology in individuals with post-traumatic headaches and other pain types. Cephalalgia, 14, 118–126.
Harburg, E., Blakelock, E. H., & Roeper, P. J. (1979). Resentful and reflective coping with arbitrary authority and blood pressure: Detroit. Psychosomatic Medicine, 41, 189–202.
Harburg, E., Erfurt, J. C., Hauenstein, L. S., Chape, C., Schull, W. J., & Schork, M. A. (1973). Socio-ecological stress, suppressed hostility, skin color, and black-white male blood pressure in Detroit. Psychosomatic Medicine, 35, 276–296.
Harburg, E., Julius, M., & Kaciroti, N. (2003). Expressive/suppressive anger-coping responses, gender, and types of mortality: A 17-year follow-up (Tecumseh, Michigan, 1971–1988). Psychosomatic Medicine, 65, 588–597.
Harmon-Jones, E. (2007). Asymmetrical frontal cortical activity, affective valence, and motivational direction. In E. Harmon-Jones & P. Winkielman (Eds.), Social neuroscience: Integrating biological and psychological explanations of social behavior (pp. 137–156). New York, NY: Guilford Press.
Harmon-Jones, E. A., & Harmon-Jones, C. (2007). Anger: Causes and components. In T. A. Cavell & K. T. Malcolm (Eds.), Anger, aggression and interventions for interpersonal violence (pp. 99–117). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.
Hatch, J. P., Schoenfeld, L. S., Boutros, N. N., Seleshi, E., Moore, P. J., & Cyr-Provost, M. (1991). Anger and hostility in tension-type headache. Headache, 31, 302–304.
Herrington, J. D., Mohanty, A., Koven, N. S., Fisher, J. E., Stewart, J. L., Banich, M. T., Webb, A., Miller, G. A., & Heller, W. (2005). Emotion-modulated performance and activity in left dorsolateral prefrontal cortex. Emotion, 5, 200–207.
Hogan, B. E., & Linden, W. (2004). Anger response styles and blood pressure: At least don’t ruminate about it! Annals of Behavioral Medicine, 27, 38–49.
Hokanson, J. E., & Shetler, S. (1960). The effect of overt aggression on physiological arousal. Journal of Abnormal and Social Psychology, 60, 446–448.
Holmes, D. S. (1990). The evidence for repression: An examination of sixty years of research. In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp 85–102). Chicago: The University of Chicago Press.
Janssen, S. A. (2002). Negative affect and sensitization to pain. Scandinavian Journal of Psychology, 43, 131–137.
Keefe, F. J., & Block, A. R. (1982). Development of an observation method for assessing pain behavior in chronic low back pain patients. Behavior Therapy, 13, 363–375.
Keefe, F. J., Lumley, M., Anderson, T., Lynch, T., & Carson, K. L. (2001). Pain and emotion: New research directions. Journal of Clinical Psychology, 57, 587–607.
Keefe, F. J., Rumble, M. E., & Scipio, C. D. (2004). Psychological aspects of persistent pain: Current state of the science. Journal of Pain, 5, 195–211.
Kelley, J. E., Lumley, M. A., & Leisen, J. C. C. (1997). Health effects of emotional disclosure among rheumatoid arthritis patients. Health Psychology, 16, 331–340.
Kerns, R. D., Rosenberg, R., & Jacob, M. C. (1994). Anger expression and chronic pain. Journal of Behavioral Medicine, 7, 57–67.
Kocovski, N. L., Endler, N. S., Rector, N. A. (2005). Ruminative coping and post-event processing in social anxiety. Behaviour Research and Therapy, 43, 971–984.
Lai, J. Y., & Linden, W. (1992). Gender, anger expression style, and opportunity for anger release determine cardiovascular reaction to and recovery from anger provocation. Psychosomatic Medicine, 54, 297–310.
Liberman, N., & Forster, J. (2000). Expression after suppression: A motivational explanation of postsuppressional rebound. Journal of Personality and Social Psychology, 79, 190–203.
Linden, W., Hogan, B. E., & Rutledge, T. (2003). There is more to anger coping than ‘in’ or ‘out’. Emotion, 3, 12–29.
Lombardo, E. R., Tan, G., Jensen, M. P., & Anderson, K. A. (2005). Anger management style and associations with self-efficacy and pain in male veterans. The Journal of Pain, 6, 765–770.
Lorenz, J., Minoshima, S., & Casey, K. L. (2003). Keeping pain out of mind: The role of the dorsolateral prefrontal cortex in pain modulation. Brain, 126, 1079–1091.
Lundberg, U., Dohns, I. E., Melin, B., Sandsjo, L., Palmeund G., Kadefors, R., Ekstron, M., & Parr, D. (1999). Psychophysiological stress responses, muscle tension, and neck and shoulder pain among supermarket cashiers. Journal of Occupational Health Psychology, 4, 245–255.
Lundberg, U., Kadefors, R, Melin, B., Palmeund G., Hassmen, P., Engstrom, M., & Dohns, I. E. (1994). Psychophysiological stress and EMG activity of the trapezius muscle. International Journal of Behavioral Medicine, 1, 354–370.
Materazzo, F., Cathcart, S., & Pritchard, D. (2000). Anger, depression, and coping interactions in headache activity and adjustment: A controlled study. Journal of Psychosomatic Research, 9, 69–75.
McCubbin, J. A., & Bruehl, S. P. (1994). Do endogenous opioids mediate the relationship between blood pressure and pain sensitivity in normotensives? Pain, 57, 63–67.
Melzack, R. (1987). The short form of the McGill pain questionnaire. Pain, 30, 191–197.
Mense, S. (1993). Nociception from skeletal muscle in relation to clinical muscle pain. Pain, 54, 241–289.
Mitchell, J. P., Heatherton, T. F., Kelley, W. M., Wyland, C. L., Wegner, D. M., & McCrae, C. N. (2007). Separating sustained from transient aspects of cognitive control during thought suppression. Psychological Science, 18, 292–297.
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive Psychology, 41, 41–100.
Newcomb, T. M. (1950). Social psychology. New York: The Dryden Press.
Newman, L. S., Duff, K. J., & Baumeister, R. (1997). A new look at defensive projection: Thought suppression, accessibility, and biased person perception. Journal of Personality and Social Psychology, 72, 980–1001.
Newton, T. L., & Contrada, R. J. (1992). Repressive coping and verbal-autonomic response dissociation: The influence of social context. Journal of Personality and Social Psychology, 62, 159–167.
Nicholson, R. A., Gramling, S. E., Ong, J. C., & Buenevar, L. (2003). Differences in anger expression between individuals with and without headache after controlling for depression and anxiety. Headache, 43, 651–663.
Nilsen, K. B., Sand, T., Westgaard, R. H., Stovner, L. J., White, L. R., Leistad, R. B., Helde, G., & Ro, M. (2000). Autonomic activation and pain in response to low-grade mental stress in fibromyalgia and shoulder/neck pain patients. European Journal of Pain, 11, 743–755.
Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504–511.
Norman, S. A., Lumley, M. A., & Dooley, J. A. (2004). For whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain. Psychosomatic Medicine, 66, 74–183.
Ochsner, K. N. (2006). Characterizing the functional architecture of affect regulation: Emerging answers and outstanding questions. In J. T. Cacioppo, P. S. Visser, & C. L. Pickett (Eds.), Social neuroscience: People thinking about thinking people (pp. 245–268). Cambridge, MA: MIT Press.
Ochsner, K. N., & Gross, J. J. (2004). Thinking makes it so: A social cognitive neuroscience approach to emotion regulation. In R. F. Baumeister & K. D. Vohs (Eds.), Handbook of self-regulation: Research, theory, and applications (pp. 229–255). New York, NY: Guilford Press.
Pennebaker, J. W. (1989). Confession, inhibition and disease. Advances in Experimental Social Psychology, 22, 211–244.
Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274–281.
Pennebaker, J. W., Kiecolt-Glaser, J., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239–245.
Petras, M. L., & Schmidt, A. J. (1991). Psychophysiological responses to repeated acute pain stimulation in chronic low back pain patients. Journal of Psychosomatic Medicine, 35, 59–74.
Petrie, K. J., Booth, R. J., & Pennebaker, J. W. (1998). The immunological effects of thought suppression. Journal of Personality and Social Psychology, 75, 1264–1272.
Pilowsky, I., & Spence, N. D. (1976). Pain, anger, and illness behavior. Journal of Psychosomatic Research, 20, 411–416.
Quartana, P. J., & Burns, J. W. (2007). The painful consequences of anger suppression. Emotion, 7, 400–414.
Quartana, P. J., & Burns, J. W. (under review). Cardiovascular responses to discrete laboratory stressors: Immediate and delayed effects of experiential versus expressive emotion suppression.
Quartana, P. J., Yoon, K. L., & Burns, J. W. (2007). Anger suppression, ironic processes and pain. Journal of Behavioral Medicine, 30, 455–469.
Rainville, P. (2002). Brain mechanisms of pain affect and pain modulation. Current Opinion in Neurology, 12, 195–294.
Raphael, K. G., Marbach, J. J., & Gallagher, R. M. (2000). Somatosensory amplification and affective inhibition are elevated in myofascial face pain. Pain Medicine, 1, 247–253.
Rene, M., Wan, C. K. D., Wegner, J. P., & Elizabeth, L. (1999). Style of anger expression: Relation to expressivity, personality, and health. Personality and Social Psychology Bulletin, 25, 1196–1207.
Riley, W. T., & Treiber, F. A. (1989). The validity of multidimensional self-report anger and hostility measures. Journal of Clinical Psychology, 45, 397–404.
Rucker, D. D., & Petty, R. E. (2004). Emotion specificity and consumer behavior: Anger, sadness, and preference for activity. Motivation and Emotion, 28, 3–21.
Sayar, K., Gulec, H., & Topbas, M. (2004). Alexithymia and anger in patients with fibromyalgia. Clinical Rheumatology, 23, 441–448.
Schwarz, N., & Clore, G. L. (1996). Feeling and phenomenal experiences. In E. T. Higgins & A. W. Kruglanski (Eds.), Social psychology: Handbook of basic principles (pp. 433–465). New York: Guilford Press.
Sjegaard, G., Lundberg, U., & Kudefors, R. (2000). The role of muscle activity and mental load in the development of pain and degenerative processes of the muscle cell level during computer work. European Journal of Applied Physiology, 83, 99–105.
Smyth, J. M., Stone, A. A., & Hurewitz, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. JAMA: Journal of the American Medical Association, 281, 1304–1309.
Spielberger, C. D., Johnson, E. H., Russell, S. F., Crane, R. J., Jacobs, G. A., & Worden, T. J. (1985). The experience and expression of anger: Construction and validation of an anger expression scale. In M. A. Chesney & R. H. Rosenman (Eds.), Anger and hostility in cardiovascular and behavioral disorders (pp. 5–30). Washington, DC: Hemisphere Publishing Corp.
Sukhodolsky, D. G., Golub, A., & Cromwell, E. N. (2001). Development and validation of the anger rumination scale. Personality and Individual Differences, 31, 689–700.
Sullivan, M. J. L., & Neish, N. (1999). The effects of disclosure on pain during dental hygiene treatment: The moderating role of catastrophizing. Pain, 79, 155–163.
Szasz, T. S. (1957). Pain and pleasure: A study of bodily feelings. London: Tavistock.
Thomas, E., Moss-Morris, R., & Faquhar, C. (2006). Coping with emotions and abuse history in women with chronic pelvic pain. Journal of Psychosomatic Research, 60, 109–112.
Tolin, D. F., Abramowitz, J. S., & Hamlin, C. (2002). Attributions for thought suppression failure in obsessive-compulsive disorder. Cognitive Therapy and Research, 26, 505–517.
Tschannen, T. A., Duckro, P. N., Margolis, R. B., & Tomazic, T. J. (1992). The relationship of anger, depression, and perceived disability among headache patients. Headache: The Journal of Head and Face Pain, 32, 501–503.
Vassend, O., & Knardahl, S. (2004). Cardiovascular responsiveness to brief cognitive challenges and pain sensitivity in women. European Journal of Pain, 8, 315–324.
Venable, V. L., Carlson, C. R. & Wilson, J. (2001). The role of anger and depression in recurrent headache. Headache: The Journal of Head and Face Pain, 41, 21–30.
Wade, J. B., Price, D. D., Hamer, R. M., Schwartz, S. M., & Hart, R. P. (1990). An emotional component analysis of chronic pain. Pain, 40, 303–310.
Wager, T. (2005). The neural bases of placebo effects in pain. Current Directions in Psychological Science, 14, 175–179.
Warner, L. J., Lumley, M. A., Casey, R. J., et al. (2005). Health effects of written emotional disclosure in adolescents with asthma: A randomized, controlled trial. Journal of Pediatric Psychology, 31, 557–568.
Watson, D., & Pennebaker, J. W. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234–254.
Weber, H. (2004). Explorations in the social construction of anger. Motivation and Emotion, 28, 197–219.
Weber, H., Wiedig, M., & Freyer, J. (2004). Social anxiety and anger regulation. European Journal of Personality, 18, 573–590.
Wegner, D. M. (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.
Wegner, D. M., & Erber, R. (1992). The hyperaccessibilty of suppressed thoughts. Journal of Personality and Social Psychology, 63, 903–912.
Wegner, D. M., Erber, R., & Zanakos, S. (1993). Ironic processes in the mental control of mood and mood-related thought. Journal of Personality and Social Psychology, 65, 1093–1104.
Wegner, D. M., & Gold, D. B. (1995). Fanning old flames: Emotional and cognitive consequences of suppressing thoughts of a past flame. Journal of Personality and Social Psychology, 68, 782–792.
Wegner, D. M., Shortt, J. W., Blake, A. W., & Page, M. S. (1990). The suppression of exciting thoughts. Journal of Personality and Social Psychology, 58, 409–418.
Weinberger, D. A., Schwartz, G. E., & Davidson, R. J. (1979). Low-anxious, high-anxious, and repressive coping styles: Psychometric patterns and behavioral and physiological responses to stress. Journal of Abnormal Psychology, 88, 369–380.
Wenzlaff, R. M., & Wegner, D. M. (2000). Thought suppression. Annual Review of Psychology, 51, 59–91.
Whalen, P. J., Shin, L. M., & McInerney, S. C. (2001). A functional MRI study of human amygdala responses to facial expressions of fear versus anger. Emotion, 1, 70–83.
Whitmer, A. J., & Banich, M. T. (2007). Inhibition versus switching deficits in different forms of rumination. Psychological Science, 18, 546–553.
Acknowledgments
This research was supported in part by Grants MH071260 from the National Institute of Mental Health (John W. Burns, Ph.D. and Stephen Bruehl, Ph.D.), and NS046694 from the National Institute of Neurological Disorders and Stroke (Stephen Bruehl, Ph.D.).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Burns, J.W., Quartana, P.J. & Bruehl, S. Anger inhibition and pain: conceptualizations, evidence and new directions. J Behav Med 31, 259–279 (2008). https://doi.org/10.1007/s10865-008-9154-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-008-9154-7