The relationship between anger regulation, mood, pain, and pain‐related disability in women treated for breast cancer

Abstract

Objective: Anger, depressive symptoms, and anxiety are known reactions to cancer and suggested to modulate pain experience. We examined the association between anger regulation, mood, and pain in 952 breast cancer patients followed for 3 years.Methods: Preoperatively, the patients completed questionnaires about depressive symptoms (BDI), state anxiety (STAI), anger regulation (STAXI-2), and pains in the surgical and other areas. Experimental pain sensitivity was tested. In the follow-up, BDI and STAI were assessed at 1 and at 6 months and at 1, 2, and 3 years after surgery.Pain in the surgical area was evaluated during the first 7 days and at 1 and 3 years after surgery. Pain-related disability was assessed at 3 years after surgery. Latent profile analyses were performed to identify mood profiles, and regression analyses to find independent predictors for mood and pain variables.Results: Anger inhibition and pain had associations with ongoing depressive symptoms and anxiety. Pain-related disability was associated with high anxiety at a hazard ratio (HR) of 2.24 (95% CI, 1.17-4.27), with older age (HR 1.07, 95% CI, 1.01-1.13), and with pain in the surgical area (HR 3.04, 95% CI, 2.41-3.85), but not with anger variables. Any relationship between anger regulation and pain intensity disappeared after controlling for age and mood.Conclusions: Different forms of pain are important to recognize and treat to support breast cancer patients' psychological well-being. Anger inhibition could be a target for psychotherapeutic intervention, to help with ongoing mood symptoms. The relationship between anger regulation and pain is not straightforward. KEYWORDS anger regulation, breast cancer, depressive symptoms, oncology, pain, pain-related disability, state anxiety 1 | BACKGROUND The quality of life of cancer survivors has become an important issue as improvements in cancer treatments have increased the survival rates. 1 Both depression and anxiety are well-recognized reactions to a breast cancer diagnosis. 2 Feelings of anger are also natural in connection with serious conditions such as cancer and pain. 3 Anger regulation, referringto how a person usually behaves when feeling angry, is thought to be a fairly stable trait. 4 Anger inhibition (anger-in) reflects a tendency to suppress angry feelings, whereas expression of anger (anger-out) reflects the opposite tendency. Previous studies suggest that anger regulation interrelates with quality of life, 5,6 somatic well-being, 5,7,8 and pain. 9,10 Persistent pain after breast cancer treatments is common. Approximations of the prevalence vary from 14% to 60%. 11,12 Systematic risk factors have been found to include, for example, anxiety, radiotherapy, more invasive surgery, and greater preoperative and acute postoperative pain. 11,12 Research suggests that there is an association between anger regulation and both acute and chronic pain. 9,10,[13][14][15] Compared with anger-in, anger-out has been reported to have a more independent effect on pain. [14][15][16] However, negativ...

Validation of the Korean Adaptation of the State-Trait Anger Expression Inventory-2 (K-STAXI-2)

“…뿐만 아니라 분노는 다양한 질병 또는 부적응과 연관이 있는 것으로 나타나고 있다: 암 [5], 심장 질환 [6], 뇌졸중 [7], 당뇨병 [8], 고혈압 [9], 소화계 질환 [10], 요통 [11], 불안 장 애 [12], 우울 장애 [13], 간헐적 폭발 장애 [14], 외상 후 스 트레스 장애 [15], 자살 [16], 비만 [17], 흡연 [18], 알코올 중독 [19], 도박 [20], 가정 폭력 [21], 학교 폭력 [22], 직장 내 폭력 [23], 탈진 [24], 교정 [25].…”

Self-care behaviors mediates the relationship between resilience and quality of life in breast cancer patients

“…Studies have shown that women with breast cancer are more likely than women without breast cancer to experience a number of factors that lead to perceptions of reduced quality of life. These factors include greater anxiety, depression [ 5 ], anger [ 6 ], aggression, hostility [ 7 ], sadness, decreased sexual function [ 8 ], dysfunctional interpersonal relationships [ 9 ], suicide ideation [ 10 ], and thoughts of mortality [ 11 ]. Quality of life is defined as a feeling of well-being that results from satisfaction or dissatisfaction with aspects of life that are important to the individual, including the interactions of physical and psychological health, spiritual wellbeing, social capital, socio-economic status, and social support [ 12 , 13 ].…”