Anger Management Style and Associations With Self-Efficacy and Pain in Male Veterans

The aim of this study was to explore if self-rated pain intensity and severe pain differed significantly between immigrants from different regions, and if other socio-economic, or clinical, characteristics could predict severe pain. A total of 129 men and 217 women at a primary health centre in Stockholm, Sweden, 27-45 years, on long-term sick leave, were recruited in consecutive order and grouped into a Turkish (n = 122), Southern European (n = 52), Middle East (n = 69) and one Mixed (n = 173) group of immigrants. All were employed in service jobs. Somatic status, depression and level of psychosocial stressors, including pain anxiety, were established by standardized procedures. All reported long-standing disabling back pain. Patients rated intensity of pain ''right now'' on a 0-100 mm visual analogue scale (VAS) as a last part of the consultation with two doctors. Severe pain was defined as VAS 75-100. Median values (md) with inter-quartile ranges (IQR) were calculated for interval and ordinal data. Non-parametric statistics were used to calculate significant differences between groups. Crude and age-standardized odds ratios (OR) with 95% confidence intervals (95% CI) as rating severe pain were calculated by binary and forward conditional logistic regression. Men and women were analyzed separately. Women had more tender points, (P \ 0.001), and reported pain anxiety more often (P \ 0.01). Frequency of depression did not differ between the immigrant groups. The VAS-values varied, but not significantly, between the immigrant groups of men and women. Men had lower VAS values than women (md 50, IQR 36-69 vs. md 72, IQR 51-85), (P \ 0.001). Women had a three-fold risk to rate severe pain (OR 2.9, 95% CI 1.8-4.7). By sex, no immigrant group had significantly elevated OR to rate severe pain. Being 40-45 year old doubled the OR as rating severe pain. Men with depression, or little education, had high risks as rating severe pain (age-standardized ORs 4.1; 95% CI 1.7-10.0 and 2.7; 95% CI 1.1-6.8, respectively), and so had depressed women (age-standardized OR 1.9; 95% CI 1.1-3.4). Women with pain anxiety had a doubled, not statistically significant, elevated risk (age-standardized OR 2.0, 95% CI 0.95-4.3). The groups did not differ significantly in pain intensity or severe pain. Severe pain was predicted by depressed mood and probably linked to gender, age and sick roles.

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“…Pain severity might correlate to anxiety and fears [8,12], poor pain coping [28], anger in men [21], and pain duration [28].…”

Section: Fear Anger and Durationmentioning

confidence: 99%

“…Some health professionals believe that these patients deliberately exaggerate pain (personal comments). However, severe pain could also be attributed to learned factors [6,26,36], to work load [19], emotional distress [2,12,21,22] or doctor-patient interactions [15].…”

Section: Introductionmentioning

confidence: 99%

Pain intensity and severe pain in young immigrant patients with long-standing back pain

Löfvander

Taloyan

2007

Eur Spine J

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“…Anger control refers to an active anger regulation strategy in which anger is experienced and appropriately addressed through nonaggressive behaviors, and is thus often inversely related to anger-out in pain studies (13). Studies have shown that those with effective and appropriate anger regulation abilities have been shown to have better pain outcomes (14). As for those with maladaptive or situationally-inappropriate anger management techniques, implementing appropriate interventions may be helpful in maximizing healthy pain coping styles.…”

Section: Introductionmentioning

confidence: 99%

The Role of Anger in Psychosocial Subgrouping for Patients With Low Back Pain

Nisenzon¹,

George²,

Beneciuk³

et al. 2014

The Clinical Journal of Pain

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Low back pain (LBP) is a common and costly condition that often becomes chronic if not properly addressed. Recent research has shown that psychosocial symptoms can complicate LBP, necessitating more comprehensive screening measures. The present study investigated the role of psychosocial factors, including anger regulation, in pain and disability using a screening measure designed for LBP treated with physical therapy. One-hundred and three LBP patients initiating physical therapy completed an established screening measure to assess risk for developing chronic pain, as well as psychosocial measures assessing anger, depression, anxiety, fear-avoidance, and pain-catastrophizing before and after four weeks of treatment. Dependent variables were pain intensity, physical impairment, and patient-reported disability. Risk subgrouping based on anger and other psychosocial measures was examined using established screening methods and through employing an empirical statistical approach. Analyses revealed that risk subgroups differed according to corresponding levels of negative affect, as opposed to anger alone. General psychosocial distress also predicted disability post-treatment, but, interestingly, did not have a strong relationship to pain. Subsequent hierarchical agglomerative clustering procedures divided patients into overall High and Low Distress groups, with follow-up analyses revealing that the High Distress group had higher baseline measures of pain, disability, and impairment. Findings suggest that anger may be part of generalized negative affect rather than a unique predictor when assessing risk for pain and disability in LBP treatment. Continued research in the area of screening for psychosocial prognostic indicators in LBP may ultimately guide treatment protocols in physical therapy for more comprehensive patient care.

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“…Individuals with low levels of self-efficacy beliefs may increase anticipatory anxiety and pain experience in the face of anticipatory stress and pain. 6,7 Because of changes in the sex hormones and their related central nervous system alterations during the menstrual cycle in women, individual responses to anticipatory stress and pain stimuli can differ according to the timing of pain delivery, pain intensity, interoception or exteroception of the stimulus, and controllability of pain. Until now, the relation between the menstrual cycle and pain and pain-related unpleasantness has not been mentioned in many clinical and neuroimaging studies.…”

mentioning

confidence: 99%

Different Brain Activation Patterns to Pain and Pain-related Unpleasantness during the Menstrual Cycle

Choi¹,

Park²,

Kim

et al. 2006

Anesthesiology

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Background:The changes in the functional magnetic resonance imaging signal during anticipation, pain stimulation, and the poststimulation periods were investigated to determine whether changes in sex hormones affect brain activity.Methods: Eighteen participants were examined twice, once in the follicular phase and once in the luteal phase. Half the participants were tested first during the follicular phase, and the other half were tested first in the luteal phase.Results: The pain and unpleasantness ratings were significantly higher in the luteal phase than in the follicular. During the anticipation of pain, the prefrontal cortices were activated during the follicular phase, whereas the parahippocampal gyrus and amygdala were activated during the luteal phase. During the pain stimulation, putamen and cerebellum and precentral gyrus involving motor preparation and defense mechanism related to antinociceptive behavior were activated during the follicular phase, whereas the thalamus was activated during the luteal phase. During the poststimulation periods, the prefrontal cortices were activated during the follicular phase, whereas parahippocampal gyrus was activated during the luteal phase. The temporal pole was activated during the anticipation, pain stimulation, and poststimulation periods of the luteal phase.Conclusions: During surgical and medical procedures, requirements of anesthetic and analgesic and anxiolytic drugs may be reduced during the follicular phase and increased during the luteal phase. These results highlight the need to consider the effects of the sex hormones in women when designing clinical or neuroimaging studies or when treating patients for pain and pain-related unpleasantness.

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Anger Management Style and Associations With Self-Efficacy and Pain in Male Veterans

Cited by 34 publications

References 23 publications

Pain intensity and severe pain in young immigrant patients with long-standing back pain

Pain intensity and severe pain in young immigrant patients with long-standing back pain

The Role of Anger in Psychosocial Subgrouping for Patients With Low Back Pain

Different Brain Activation Patterns to Pain and Pain-related Unpleasantness during the Menstrual Cycle

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