Journal of Behavioral Medicine

, Volume 31, Issue 3, pp 259–279 | Cite as

Anger inhibition and pain: conceptualizations, evidence and new directions

  • John W. BurnsEmail author
  • Phillip J. Quartana
  • Stephen Bruehl


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.


Anger inhibition/suppression Acute and chronic pain 



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.).


  1. 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.PubMedCrossRefGoogle Scholar
  2. 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.PubMedCrossRefGoogle Scholar
  3. 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.Google Scholar
  4. 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.CrossRefGoogle Scholar
  5. 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.PubMedCrossRefGoogle Scholar
  6. Andreassi, J. L. (1995). Psychophysiology: Human behavior & physiological response. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
  7. 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.PubMedCrossRefGoogle Scholar
  8. 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.PubMedCrossRefGoogle Scholar
  9. 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.PubMedCrossRefGoogle Scholar
  10. 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.PubMedCrossRefGoogle Scholar
  11. Banks, S. M., & Kerns, R. D. (1996). Explaining high rates of depression in chronic pain: A diathesis-stress framework. Psychological Bulletin, 119, 95–110.CrossRefGoogle Scholar
  12. 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.Google Scholar
  13. Berkowitz, L. (1990). On the formation and regulation of anger and aggression: A cognitive-neoassociationistic analysis. American Psychologist, 45, 494–503.PubMedCrossRefGoogle Scholar
  14. Berkowitz, L. (1993). Pain and aggression: Some findings and implications. Motivation & Emotion, 17, 277–293.CrossRefGoogle Scholar
  15. 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.CrossRefGoogle Scholar
  16. 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.Google Scholar
  17. Broderick, J. E., Junghaenel, D. U., & Schwartz, J. E. (2005). Written emotional expression produces health benefits in fibromyalgia patients. Psychosomatic Medicine, 67, 326–334.PubMedCrossRefGoogle Scholar
  18. Brosschot, J. F. (2002). Cognitive-emotional sensitization and somatic health complaints. Scandinavian Journal of Psychology, 43, 113–121.PubMedCrossRefGoogle Scholar
  19. 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.PubMedCrossRefGoogle Scholar
  20. 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.PubMedCrossRefGoogle Scholar
  21. 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.PubMedCrossRefGoogle Scholar
  22. 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.PubMedCrossRefGoogle Scholar
  23. 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.PubMedCrossRefGoogle Scholar
  24. 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.PubMedCrossRefGoogle Scholar
  25. Burns, J. W. (2006a). Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients. Emotion, 6, 309–319.PubMedCrossRefGoogle Scholar
  26. 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.PubMedCrossRefGoogle Scholar
  27. 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.PubMedCrossRefGoogle Scholar
  28. 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.PubMedCrossRefGoogle Scholar
  29. 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.PubMedCrossRefGoogle Scholar
  30. 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.PubMedCrossRefGoogle Scholar
  31. Burns, J. W., Kubilus, A., & Bruehl, S. (2003). Emotion induction moderates effects of anger management style on acute pain sensitivity. Pain, 106, 109–118.PubMedCrossRefGoogle Scholar
  32. 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.PubMedCrossRefGoogle Scholar
  33. 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.Google Scholar
  34. 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.PubMedCrossRefGoogle Scholar
  35. Caceres, C., & Burns, J. W. (1997). Cardiovascular reactivity to psychological stress may enhance subsequent pain sensitivity. Pain, 69, 237–244.PubMedCrossRefGoogle Scholar
  36. 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.CrossRefGoogle Scholar
  37. Cioffi, D., & Holloway, J. (1993). Delayed costs of suppressed pain. Journal of Personality and Social Psychology, 64, 274–282.PubMedCrossRefGoogle Scholar
  38. 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.CrossRefGoogle Scholar
  39. Dannahy, L., & Stopa, L. (2007). Post-event processing in social anxiety. Behaviour Research and Therapy, 45, 1207–1219.PubMedCrossRefGoogle Scholar
  40. 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.PubMedCrossRefGoogle Scholar
  41. 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.Google Scholar
  42. 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.CrossRefGoogle Scholar
  43. 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.Google Scholar
  44. 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.PubMedCrossRefGoogle Scholar
  45. Engel, G. (1959). “Psychogenic” pain and the pain prone patient. American Journal of Medicine, 26, 899–918.PubMedCrossRefGoogle Scholar
  46. Epstein, S. (1980). The stability of behavior: II. Implications for psychological research. American Psychologist, 35, 790–806.CrossRefGoogle Scholar
  47. 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.PubMedCrossRefGoogle Scholar
  48. 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.PubMedCrossRefGoogle Scholar
  49. Fields, H. L. (1987). Pain. New York, NY: Raven.Google Scholar
  50. Flor, H., Birbaumer, N., Schugens, M. M., & Lutzenberger, W. (1992). Symptom-specific psychophysiological responses in chronic pain patients. Psychophysiology, 29, 452–460.PubMedCrossRefGoogle Scholar
  51. Flor, H., Birbaumer, N., Schulte, W., & Roos, R. (1991). Stress-related electromyographic responses in patients with chronic temporomandibular pain. Pain, 46, 145–152.PubMedCrossRefGoogle Scholar
  52. Flor, H., Knost, B., & Birbaumer N. (2002). The role of operant conditioning in chronic pain: An experimental investigation. Pain, 95, 111–118.PubMedCrossRefGoogle Scholar
  53. 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.PubMedCrossRefGoogle Scholar
  54. 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.PubMedCrossRefGoogle Scholar
  55. 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.Google Scholar
  56. 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.PubMedCrossRefGoogle Scholar
  57. 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.PubMedGoogle Scholar
  58. 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.PubMedCrossRefGoogle Scholar
  59. Gelkopf, M. (1997). Laboratory pain and styles of coping with anger. Journal of Psychology: Interdisciplinary and Applied, 131, 121–123.CrossRefGoogle Scholar
  60. 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.PubMedCrossRefGoogle Scholar
  61. 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.PubMedCrossRefGoogle Scholar
  62. Greenberg, L. S., & Safran, J. D. (1987). Emotion in psychotherapy. New York: Guilford.Google Scholar
  63. 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.PubMedCrossRefGoogle Scholar
  64. Gross, J. J. (1999). Emotion regulation: Past, present, and future. Cognition and Emotion, 13, 551–573.CrossRefGoogle Scholar
  65. Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39, 281–291.PubMedCrossRefGoogle Scholar
  66. 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.PubMedCrossRefGoogle Scholar
  67. 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.CrossRefGoogle Scholar
  68. Gross, J. J., & Levenson, R. W. (1993). Emotional suppression: Physiology, self-report, and expressive behavior. Journal of Personality of Social Psychology, 64, 970–986.CrossRefGoogle Scholar
  69. 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.PubMedCrossRefGoogle Scholar
  70. 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.CrossRefGoogle Scholar
  71. 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.PubMedCrossRefGoogle Scholar
  72. 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.PubMedGoogle Scholar
  73. 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.PubMedGoogle Scholar
  74. 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.PubMedCrossRefGoogle Scholar
  75. 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.Google Scholar
  76. 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.Google Scholar
  77. 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.PubMedCrossRefGoogle Scholar
  78. 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.PubMedCrossRefGoogle Scholar
  79. 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.PubMedCrossRefGoogle Scholar
  80. Hokanson, J. E., & Shetler, S. (1960). The effect of overt aggression on physiological arousal. Journal of Abnormal and Social Psychology, 60, 446–448.CrossRefGoogle Scholar
  81. 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.Google Scholar
  82. Janssen, S. A. (2002). Negative affect and sensitization to pain. Scandinavian Journal of Psychology, 43, 131–137.PubMedCrossRefGoogle Scholar
  83. 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.CrossRefGoogle Scholar
  84. 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.PubMedCrossRefGoogle Scholar
  85. 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.PubMedCrossRefGoogle Scholar
  86. 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.PubMedCrossRefGoogle Scholar
  87. Kerns, R. D., Rosenberg, R., & Jacob, M. C. (1994). Anger expression and chronic pain. Journal of Behavioral Medicine, 7, 57–67.CrossRefGoogle Scholar
  88. 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.PubMedCrossRefGoogle Scholar
  89. 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.PubMedGoogle Scholar
  90. Liberman, N., & Forster, J. (2000). Expression after suppression: A motivational explanation of postsuppressional rebound. Journal of Personality and Social Psychology, 79, 190–203.PubMedCrossRefGoogle Scholar
  91. Linden, W., Hogan, B. E., & Rutledge, T. (2003). There is more to anger coping than ‘in’ or ‘out’. Emotion, 3, 12–29.PubMedCrossRefGoogle Scholar
  92. 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.PubMedCrossRefGoogle Scholar
  93. 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.PubMedCrossRefGoogle Scholar
  94. 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.PubMedCrossRefGoogle Scholar
  95. 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.PubMedCrossRefGoogle Scholar
  96. 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.CrossRefGoogle Scholar
  97. 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.PubMedCrossRefGoogle Scholar
  98. Melzack, R. (1987). The short form of the McGill pain questionnaire. Pain, 30, 191–197.PubMedCrossRefGoogle Scholar
  99. Mense, S. (1993). Nociception from skeletal muscle in relation to clinical muscle pain. Pain, 54, 241–289.PubMedCrossRefGoogle Scholar
  100. 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.PubMedCrossRefGoogle Scholar
  101. 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.CrossRefGoogle Scholar
  102. Newcomb, T. M. (1950). Social psychology. New York: The Dryden Press.Google Scholar
  103. 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.PubMedCrossRefGoogle Scholar
  104. 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.PubMedCrossRefGoogle Scholar
  105. 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.PubMedCrossRefGoogle Scholar
  106. 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.CrossRefGoogle Scholar
  107. Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504–511.PubMedCrossRefGoogle Scholar
  108. 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.CrossRefGoogle Scholar
  109. 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.Google Scholar
  110. 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.Google Scholar
  111. Pennebaker, J. W. (1989). Confession, inhibition and disease. Advances in Experimental Social Psychology, 22, 211–244.CrossRefGoogle Scholar
  112. 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.PubMedCrossRefGoogle Scholar
  113. 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.PubMedCrossRefGoogle Scholar
  114. 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.CrossRefGoogle Scholar
  115. 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.PubMedCrossRefGoogle Scholar
  116. Pilowsky, I., & Spence, N. D. (1976). Pain, anger, and illness behavior. Journal of Psychosomatic Research, 20, 411–416.PubMedCrossRefGoogle Scholar
  117. Quartana, P. J., & Burns, J. W. (2007). The painful consequences of anger suppression. Emotion, 7, 400–414.PubMedCrossRefGoogle Scholar
  118. Quartana, P. J., & Burns, J. W. (under review). Cardiovascular responses to discrete laboratory stressors: Immediate and delayed effects of experiential versus expressive emotion suppression.Google Scholar
  119. Quartana, P. J., Yoon, K. L., & Burns, J. W. (2007). Anger suppression, ironic processes and pain. Journal of Behavioral Medicine, 30, 455–469.PubMedCrossRefGoogle Scholar
  120. Rainville, P. (2002). Brain mechanisms of pain affect and pain modulation. Current Opinion in Neurology, 12, 195–294.Google Scholar
  121. 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.PubMedCrossRefGoogle Scholar
  122. 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.CrossRefGoogle Scholar
  123. Riley, W. T., & Treiber, F. A. (1989). The validity of multidimensional self-report anger and hostility measures. Journal of Clinical Psychology, 45, 397–404.PubMedCrossRefGoogle Scholar
  124. Rucker, D. D., & Petty, R. E. (2004). Emotion specificity and consumer behavior: Anger, sadness, and preference for activity. Motivation and Emotion, 28, 3–21.CrossRefGoogle Scholar
  125. Sayar, K., Gulec, H., & Topbas, M. (2004). Alexithymia and anger in patients with fibromyalgia. Clinical Rheumatology, 23, 441–448.PubMedCrossRefGoogle Scholar
  126. 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.Google Scholar
  127. 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.CrossRefGoogle Scholar
  128. 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.PubMedCrossRefGoogle Scholar
  129. 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.Google Scholar
  130. Sukhodolsky, D. G., Golub, A., & Cromwell, E. N. (2001). Development and validation of the anger rumination scale. Personality and Individual Differences, 31, 689–700.CrossRefGoogle Scholar
  131. 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.PubMedCrossRefGoogle Scholar
  132. Szasz, T. S. (1957). Pain and pleasure: A study of bodily feelings. London: Tavistock.Google Scholar
  133. 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.PubMedCrossRefGoogle Scholar
  134. 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.CrossRefGoogle Scholar
  135. 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.CrossRefGoogle Scholar
  136. Vassend, O., & Knardahl, S. (2004). Cardiovascular responsiveness to brief cognitive challenges and pain sensitivity in women. European Journal of Pain, 8, 315–324.PubMedCrossRefGoogle Scholar
  137. 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.CrossRefGoogle Scholar
  138. 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.PubMedCrossRefGoogle Scholar
  139. Wager, T. (2005). The neural bases of placebo effects in pain. Current Directions in Psychological Science, 14, 175–179.CrossRefGoogle Scholar
  140. 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.PubMedCrossRefGoogle Scholar
  141. Watson, D., & Pennebaker, J. W. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234–254.PubMedCrossRefGoogle Scholar
  142. Weber, H. (2004). Explorations in the social construction of anger. Motivation and Emotion, 28, 197–219.CrossRefGoogle Scholar
  143. Weber, H., Wiedig, M., & Freyer, J. (2004). Social anxiety and anger regulation. European Journal of Personality, 18, 573–590.CrossRefGoogle Scholar
  144. Wegner, D. M. (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.PubMedCrossRefGoogle Scholar
  145. Wegner, D. M., & Erber, R. (1992). The hyperaccessibilty of suppressed thoughts. Journal of Personality and Social Psychology, 63, 903–912.CrossRefGoogle Scholar
  146. 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.PubMedCrossRefGoogle Scholar
  147. 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.PubMedCrossRefGoogle Scholar
  148. 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.PubMedCrossRefGoogle Scholar
  149. 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.PubMedCrossRefGoogle Scholar
  150. Wenzlaff, R. M., & Wegner, D. M. (2000). Thought suppression. Annual Review of Psychology, 51, 59–91.PubMedCrossRefGoogle Scholar
  151. 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.PubMedCrossRefGoogle Scholar
  152. Whitmer, A. J., & Banich, M. T. (2007). Inhibition versus switching deficits in different forms of rumination. Psychological Science, 18, 546–553.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • John W. Burns
    • 1
    Email author
  • Phillip J. Quartana
    • 1
  • Stephen Bruehl
    • 2
  1. 1.Department of PsychologyRosalind Franklin University of Medicine and ScienceNorth ChicagoUSA
  2. 2.Vanderbilt University School of MedicineNashvilleUSA

Personalised recommendations