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Anger Management Style and Hostility: Predicting Symptom-Specific Physiological Reactivity Among Chronic Low Back Pain Patients

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Abstract

It was hypothesized that anger management style (anger-in or anger-out) and hostility affect the aggravation of chronic low back pain (CLBP) through symptom-specific (i.e., lower paraspinal muscle) reactivity during stress. Subjects were 102 CLBP patients who performed mental arithmetic and an Anger Recall Interview (ARI) while trapezius and lower paraspinal EMG, SBP, DBP, and HR were recorded. Results showed anger-in × hostility and anger-out × gender interactions for lower paraspinal but not trapezius reactivity, and only during the ARI. Further analyses revealed that (1) hostility was related positively to lower paraspinal reactivity among high anger suppressors, (2) hostility was related negatively to lower paraspinal reactivity among low anger suppressors, and (3) anger expression was related positively to lower paraspinal reactivity only among men. Anger management style and hostility may contribute to the exacerbation of CLBP by influencing stress reactivity only in muscles near the site of pain or injury.

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REFERENCES

  • Beutler, L. E., Engle, D., Oro'-Beutler, M. E., and Daldrup, R. (1986). Inability to express intense affect: A common link between depression and pain? J. Consult. Clin. Psychol. 53: 354–364.

    Google Scholar 

  • Burns, J. W. (1995). Interactive effects of traits, states, and gender on cardiovascular reactivity during different situations. J. Behav. Med. 18: 279–303.

    Google Scholar 

  • Burns, J. W., and Katkin, E. S. (1993). Psychological, situational, and gender predictors of cardiovascular reactivity to stress: A multivariate approach. J. Behav. Med. 16: 445–465.

    Google Scholar 

  • Burns, J. W., Johnson, B. J., Mahoney, N., Devine, J., and Pawl, R. (1996). Anger management style, hostility and spouse responses: Gender differences in predictors of adjustment among chronic pain patients. Pain 64: 445–453.

    Google Scholar 

  • Burns, J. W., Wiegner, S., Derleth, M., Kiselica, K., and 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 Psychol. 16: 319–326.

    Google Scholar 

  • Cook, W., and Medley, D. (1954). Proposed hostility and pharisaic-virtue scales for the MMPI. J. Appl. Psychol. 238: 414–418.

    Google Scholar 

  • Dimsdale, J. E., Stern, M. J., and Dillon, E. (1988). The Stress Interview as a tool for examining physiological reactivity. Psychosom. Med. 50: 64–71.

    Google Scholar 

  • Dolce, J. J., and Raczynski, J. M. (1985). Neuromuscular activity and electromyography in painful backs: Psychological and biomechanical models in assessment and treatment. Psychol. Bull. 97: 502–520.

    Google Scholar 

  • Engebretson, T. O., Matthews, K. A., and Scheier, M. F. (1989). Relations between anger expression and cardiovascular reactivity: Reconciling inconsistent findings through a matching hypothesis. J. Personal. Soc. Psychol. 57: 513–521.

    Google Scholar 

  • Engel, G. L. (1959). “Psychogenic” pain and the pain-prone patient. Am. J. Med. 26: 899.

    Google Scholar 

  • Faber, S. D., and Burns, J. W. (1996). Anger management style, degree of expressed anger, and gender influence cardiovascular recovery from interpersonal harassment. J. Behav. Med. 19: 31–53.

    Google Scholar 

  • Fernandez, E., and Turk, D. C. (1995). The scope and significance of anger in the experience of chronic pain. Pain 61: 165–175.

    Google Scholar 

  • Flor, H., and Turk, D. C. (1989). Psychophysiology of chronic pain: Do chronic pain: patients exhibit symptom-specific psychophysiological responses? Psychol. Bull. 105: 215–259.

    Google Scholar 

  • Flor, H., Turk, D. C., and Birbaumer, N. (1985). Assessment of stress-related psychophysiological reactions in chronic back pain patients. J. Consult. Clin. Psychol. 53: 354–364.

    Google Scholar 

  • Flor, H., Birbaumer, N., Schulte, W., and Roos, R. (1991). Stress-related electromyographic responses in patients with chronic temporomandibular pain. Pain 46: 145–152.

    Google Scholar 

  • Flor, H., Birbaumer, N., Schugens, M. M., and Lutzenberger, W. (1992). Symptom-specific psychophysiological responses in chronic pain patients. Psychophysiology 29: 452–460.

    Google Scholar 

  • Harburg, E., Blakelock, E. H., and Roeper, P. J. (1979). Resentful and reflective coping with arbitrary authority and blood pressure: Detroit. Psychosom. Med. 41: 189–202.

    Google Scholar 

  • Hatch, J. P., Schoenfeld, L. S., Boutros, N. N., Seleshi, E., Moore, P. J., and Cyr-Provost, M. (1991). Anger and hostility in tension-type headache. Headache 31: 302–304.

    Google Scholar 

  • Kelsey, R. M. (1993). Habituation of cardiovascular reactivity to psychological stress: Evidence and implications. In Blascovich, J., and Katkin, E. S. (eds.), Cardiovascular Reactivity to Psychological Stress and Disease, APA Press, Washington, DC.

    Google Scholar 

  • Kerns, R. D., Rosenberg, R., and Jacob, M. C. (1994). Anger expression and chronic pain. J. Behav. Med. 17: 57–67.

    Google Scholar 

  • Lai, J. Y., and Linden, W. (1992). Gender, anger expression style, and opportunity for anger release determine cardiovascular reaction to and recovery from anger provocation. Psychosom. Med. 54: 297–310.

    Google Scholar 

  • Siegman, A. W., Anderson, R., Herbst, J., Boyle, S., and Wilkinson, J. (1993). Dimensions of anger-hostility and cardiovascular reactivity in provoked men. J. Behav. Med. 15: 257–272.

    Google Scholar 

  • Smith, T. W., and Frohm, K. D. (1985). What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale. Health Psychol. 4: 503–520.

    Google Scholar 

  • Spielberger, C. D., Johnson, E. H., Russell, S. F., Crane, R. J., Jacobs, G. A., and Worden, T. J. (1985). The experience and expression of anger: Construction and validation of an anger expression scale. In Chesney, M. A., and Rosenman, R. H. (eds.), Anger and Hostility in Cardiovascular and Behavioral Disorders, Hemisphere, Washington DC.

    Google Scholar 

  • Sternbach, R. A. (1966). Principles of Psychophysiology, Academic Press, New York.

    Google Scholar 

  • Stone, A. A., Valdimarsdottir, H. B., Katkin, E. S., Burns, J., Cox, D. S., Lee, S., Fine, J., Ingle, D., and Bovbjerg, D. H. (1993). Effects of mental, stressors on mitogen-induced lymphocyte responses in the laboratory. Psychol. Health 8: 269–284.

    Google Scholar 

  • Suarez, E. C., and Williams, R. B. (1990). The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics. Psychosom. Med. 52: 558–570.

    Google Scholar 

  • Wade, J. B., Price, D. D., Hamer, R. M., Schwartz, S. M., and Hart, R. P. (1990). An emotional component analysis of chronic pain. Pain 40: 303–310.

    Google Scholar 

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Burns, J.W. Anger Management Style and Hostility: Predicting Symptom-Specific Physiological Reactivity Among Chronic Low Back Pain Patients. J Behav Med 20, 505–522 (1997). https://doi.org/10.1023/A:1025564707137

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