Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: evaluation of an ironic process model

OBJECTIVE: Evidence for links between anger inhibition or suppression and chronic pain severity is based mostly on studies with correlation designs. Following from ironic process theory, we proposed that attempts to suppress angry thoughts during provocation would increase subsequent pain intensity among chronic low back pain (CLBP) patients, and do so through paradoxically enhanced accessibility of anger. DESIGN: CLBP patients (N = 58) were assigned to suppression and nonsuppression conditions while performing a computer maze task with a harassing confederate. A structured pain behavior task (SPBT) followed. MAIN OUTCOME MEASURES: Self-reported anger, anxiety, and sadness following maze task. Self-reported pain severity and number of observed pain behaviors during SPBT. RESULTS: Patients told to suppress during provocation: (a) reported greater anger following the maze task, reported greater pain intensity during the SPBT, and exhibited more pain behaviors than patients not suppressing; (b) postmaze anger levels significantly mediated group differences on pain behaviors. CONCLUSION: Attempts by CLBP patients to suppress anger may aggravate pain related to their clinical condition through ironically increased feelings of anger.     

The avoidance cocoon: Examining the interplay between attachment and caregiving in predicting relationship satisfaction

In the present research, we examined the hypothesis that low avoidance enables the activation of the caregiving system, and therefore, among people low in avoidance, caregiving would affect relationship satisfaction, whereas among people high in avoidance, caregiving would not affect relationship satisfaction. One‐hundred seventy‐nine Israeli adults, currently involved in romantic relationships, participated in Study 1, in which we examined whether attachment avoidance moderated the associations between caregiving and relationship satisfaction. In Study 2, we sought to replicate this finding in a sample of Israeli couples (N = 194). Finally, in Study 3 (N = 44), we examined links between attachment, caregiving, and relationship satisfaction over a period of 1 year among Israeli married couples. Results indicated that caregiving deactivation and/or hyperactivation predicted lower relationship satisfaction, yet only among people low in avoidance or among people whose partners were low in avoidance. Results are discussed in relation to the important interplay between behavioral systems on individual and dyadic levels. Copyright © 2014 John Wiley & Sons, Ltd.     

Somebodiness and Its Meaning to African American Men

The psychological functioning of African American men is often described in negative terms. One way to correct these distorted depictions is to identify culturally grounded concepts that can make a fair‐minded assessment of their psychological functioning. The literature has suggested that “somebodiness” is a culturally relevant, but understudied, concept. In this investigation, an interpretive phenomenological analysis approach was used to explore somebodiness and its meaning to African American men.     

Hostility and the clinical course of outpatients with congestive heart failure

Objective: The role of depression and quality of life on clinical outcomes of congestive heart failure (CHF) is well recognised. However, there are fewer studies investigating the prognostic role of subclinical psychological distress and well-being impairments. The aims of this study were to evaluate clinical/subclinical psychological distress and well-being in CHF outpatients, and the influence of these psychological factors on adverse cardiac events (re-hospitalisation, cardiac death), at 4-year follow-up.

Design: Sixty-eight CHF outpatients underwent psychological assessment at baseline and, after 4 years, information about cardiac events was collected in 60 patients by means of clinical records.

Main outcome measures: Psychological assessment included structured clinical interview for DSM (major/minor depression), Interview for diagnostic criteria for psychosomatic research (demoralisation), symptom questionnaire, psychological well-being scales.

Results: At follow-up, 39.7% of the baseline sample reported cardiovascular events (14 CHF-related re-hospitalisations and 13 cardiac deaths) and 5.9% other causes for death. Among the variables examined as potential risk factors for adverse cardiovascular outcomes, only hostility was significant, even after controlling for disease severity (hazard ratio = 2.38, 95%confidence interval: 1.04–5.45, p = .040).

Conclusion: In outpatients with CHF, psychological assessment should include both clinical and subclinical distress such as hostility, in order to better address psychological risk factors for cardiac outcomes.     

Breast Cancer Risk Perceptions among Relatives of Women with Uninformative Negative <Emphasis Type="Italic">BRCA1/2</Emphasis> Test Results: The Moderating Effect of the Amount of Shared Information

The most common result of BRCA1/2 mutation testing when performed in a family without a previously identified mutation is an uninformative negative test result. Women in these families may have an increased risk for breast cancer because of mutations in non-BRCA breast cancer predisposition genes, including moderate- or low-risk genes, or shared environmental factors. Genetic counselors often encourage counselees to share information with family members, however it is unclear how much information counselees share and the impact that shared information may have on accuracy of risk perception in family members. We evaluated 85 sisters and daughters of women who received uninformative negative BRCA1/2 results. We measured accuracy of risk perception using a latent variable model where accuracy was represented as the correlation between perceived risk (indicators = verbal and quantitative measures) and calculated risk (indicators = Claus and BRCAPRO). Participants who reported more information was shared with them by their sister or mother about her genetic counseling session had greater accuracy of risk perception (0.707, p?=?0.000) than those who reported little information was shared (0.326, p?=?0.003). However, counselees shared very little information; nearly 20 % of family members reported their sister or mother shared nothing with them about her genetic counseling. Family members were generally not aware of the existence of a genetic counseling summary letter. Our findings underscore the need for effective strategies that facilitate counselees to share information about their genetic counseling sessions. Such communication may help their relatives better understand their cancer risks and enhance risk appropriate cancer prevention.     

Emotion, directed forgetting, and source memory

We investigated the role of emotion on item and source memory using the item method of directed forgetting (DF) paradigm. We predicted that emotion would produce source memory impairment because emotion would make it more difficult to distinguish between to-be-remembered (R items) and to-be-forgotten items (F items) by making memory strength of R and F items similar to each other. Participants were presented with negatively arousing, positively arousing, and neutral pictures. After each picture, they received an instruction to remember or forget the picture. At retrieval, participants were asked to recall both R and F items and indicate whether each item was an R or F item. Recall was higher for the negatively arousing than for the positively arousing or neutral pictures. Further, DF occurred for the positively arousing and neutral pictures, whereas DF was not significant for the negatively arousing pictures. More importantly, the negatively arousing pictures, particularly the ones with violent content, showed a higher tendency of producing misattribution errors than the other picture types, supporting the notion that negative emotion may produce source memory impairment, even though it is still not clear whether the impairment occurs at encoding or retrieval.     

Transactional models between personality and alcohol involvement: a further examination

Although correlated changes between personality and alcohol involvement have been shown, the functional relation between these constructs is also of theoretical and clinical interest. Using bivariate latent difference score models, we examined transactional relations (i.e., personality predicting changes in alcohol involvement, which in turn predicts changes in personality) across two distinct but overlapping developmental time frames (i.e., across college and during young adulthood) using two large, prospective samples. Across college, there was some evidence that alcohol involvement predicted changes in personality; however, these findings were limited to models that included more proximal measures of alcohol use. When examined across a longer timeframe, we found no evidence that alcohol involvement significantly predicted changes in personality but found some evidence that personality predicted changes in alcohol use. We did find reliable evidence of correlated changes between personality and alcohol use, especially during emerging adulthood. The findings from our datasets highlight that the impact of alcohol involvement on personality change may be limited to shorter intervals during specific developmental time-frames and that the relation between changes in personality and alcohol involvement may be best viewed from a noncausal perspective.