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Relationships among patient hostility, anger expression, depression, and the working alliance in a work hardening program

  • Other Empirical Articles
  • Published:
Annals of Behavioral Medicine

Abstract

Hostility, anger expression, and depression may adversely affect the response of chronic pain patients to pain or functional restoration programs by hampering the development of good working alliances between patients and physical or occupational therapists. Measures of hostility, anger expression, and depression and the Working Alliance Inventory (WAI) were completed by 71 patients with chronic pain (stemming from work-related injuries) prior to starting a “work hardening” program. The physical or occupational therapist acting as any given patient's “program manager” completed the WAI, as well. Hostility and anger expression were correlated negatively only with patient ratings of the working alliance. Therapist ratings were predicted by the interaction of patient anger expression and depression, such that therapists reported their poorest alliances with patients who were both depressed and expressed anger. Results imply that hostility and the propensity to express anger may diminish a pain patient's capacity to foster a collaborative relationship with physical or occupational therapists, while therapists may readily become alienated from depressed and irritable patients.

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Authors and Affiliations

  1. Department of Psychology, Finch University of Health Sciences/The Chicago Medical School, Building 51, 3333 Green Bay Road, 60064, North Chicago, IL

    John W. Burns, Laura J. Higdon & John T. Mullen

Authors
  1. John W. Burns
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  2. Laura J. Higdon
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  3. John T. Mullen
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  4. David Lansky
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  5. Ju Mei Wei
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Additional information

Center for Medical Psychology

Healthsouth

The authors wish to thank the physical and occupational therapists and staff of the Healthsouth Industrial Rehabilitation Centers at Avondale Avenue in Chicago. IL, and in Oak Lawn. IL, for facilitating the conduct of this study.

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Burns, J.W., Higdon, L.J., Mullen, J.T. et al. Relationships among patient hostility, anger expression, depression, and the working alliance in a work hardening program. ann. behav. med. 21, 77–82 (1999). https://doi.org/10.1007/BF02895037

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  • DOI: https://doi.org/10.1007/BF02895037

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