Pain and aggression: Some findings and implications

The role of attentional strategies in moderating links between acute pain induction and subsequent psychological stress: Evidence for symptom-specific reactivity among patients with chronic pain versus healthy nonpatients

Vulnerability to stressors after pain may depend on the degree to which the strategy used to process information about pain perpetuates thoughts of suffering and distress. Patients with chronic low back pain (CLBP) may show susceptibility to stress after pain through symptom-specific (lower paraspinal [LP]) muscle reactivity. Patients with CLBP (n = 100) and healthy nonpatients (n = 105) underwent a cold pressor, under sensory focus, distraction, suppression, or control conditions, and then performed mental arithmetic. Only patients under the suppression condition revealed increased LP tension during pain that was sustained during mental arithmetic and sustained systolic blood pressure after mental arithmetic. Patients with CLBP who suppress pain may detrimentally affect responses to the next noxious event, particularly through prolonged LP muscle tension, that may contribute to a cycle of pain-stress-pain.

An evaluation of the measurement of pain catastrophizing by the coping strategies questionnaire

Measurement and conceptual issues of pain catastrophizing have been raised in the literature. The issues of construct redundancy and measurement overlap have received particular attention, with suggestions that measures of pain catastrophizing are confounded with measures of negative mood, namely depression. The current study sought to investigate these issues in the coping strategies questionnaire-catastrophizing subscale (CSQ-CAT), a widely used measure of pain catastrophizing. Chronic pain patients (n=152) were recruited from the University of Florida pain clinics and completed a battery of psychological measures. Regression analyses indicated that measures of depression, anxiety, and anger accounted for 69% and 19% of the variance in measures of pain catastrophizing and pain, respectively. Trait anger and the cognitive and fearful dimensions of depression and anxiety were uniquely associated with pain catastrophizing. After controlling for measures of negative mood, pain catastrophizing contributed minimally to the prediction of pain. This study suggests that the CSQ-CAT is highly related to measures of negative mood and raises doubts about its measurement of the construct of pain catastrophizing. Results also provide support for theoretical accounts of the relationships between pain catastrophizing, negative mood, and pain. Clinical implications, future research directions, and alternative measures of pain catastrophizing are discussed.

The relationship between anger and pain

Anger is defined with reference to a cognitive-motivational perspective. This forms the basis for identifying the variety of reasons why pain sufferers are angry and the many ways in which they react when angry. Statistics are provided for the comorbidity of anger in chronic pain and headache. Going beyond such statistics, five dynamic interactions between anger and pain are emphasized and empirical evidence is provided for each of these interactions.

Why Does Social Exclusion Hurt? The Relationship Between Social and Physical Pain

The authors forward the hypothesis that social exclusion is experienced as painful because reactions to rejection are mediated by aspects of the physical pain system. The authors begin by presenting the theory that overlap between social and physical pain was an evolutionary development to aid social animals in responding to threats to inclusion. The authors then review evidence showing that humans demonstrate convergence between the 2 types of pain in thought, emotion, and behavior, and demonstrate, primarily through nonhuman animal research, that social and physical pain share common physiological mechanisms. Finally, the authors explore the implications of social pain theory for rejection-elicited aggression and physical pain disorders.

Toward an understanding of the determinants of anger

Research bearing on several popular conceptions of the major determinants of anger arousal indicates that the particular appraisals often identified as causes of anger frequently only serve to affect the intensity of the anger that is generated. Research into effects of physical pain or other physically unpleasant conditions or involving social stresses suggests that decidedly aversive conditions are a major spur to anger. Experiments are also reviewed showing that anger-related muscular movements can also lead to anger-related feelings, memories, cognitions, and autonomic responses. Alternative explanations for the findings are discussed. The authors urge emotion theorists to widen their methodology and analyses so that they give careful, detailed attention to the many different factors that can influence anger.

The effects of failing to control pain: an experimental investigation

Chronic pain patients are often confronted with repeated failure to achieve pain relief. The aim of this study was to experimentally investigate the effects of repeated failing attempts to control pain on pain impact (pain intensity, emotional and physiological responses). Perceived control over an electrocutaneous pain stimulus was manipulated between subjects by success or failure feedback on a task by which control over pain could be acquired. In addition, success or failure at the task was manipulated without suggesting a possibility to control pain. It was hypothesized that successful control would lead to lowest pain impact, whereas failure to control pain would lead to even higher pain impact than absent control. Furthermore, it was hypothesized that failure feedback would increase pain impact when compared to success feedback. Results indicated that repeated failure to control pain increased anger and heart rate responses compared to the other conditions, but not pain intensity. It is concluded that persistent efforts to control pain in the face of failure may lead to the maintenance or exacerbation of physiological and emotional responses.

The structure and content of verbal and physical aggression among Israeli youths

The aim of this study is to test an aggression model. Data were obtained from 943 students in the 7th, 8th, and 9th grades of junior high schools in a northern Israeli city and its suburbs. A structural equation model analysis confirmed that there is a significant positive correlation between the constructs of perception (i.e., aggressor and aggression), means (i.e., behavioral and emotional capabilities), and guidelines (i.e., scripts) and that behavioral performance (i.e., aggressive or nonaggressive behavior) is influenced significantly only by guidelines and means. In addition, it was found that boys and younger youths tend to present higher levels of aggressiveness across all constructs as compared to girls and older youths. Theoretical and practical implications are discussed.

Human aggression

Research on human aggression has progressed to a point at which a unifying framework is needed. Major domain-limited theories of aggression include cognitive neoassociation, social learning, social interaction, script, and excitation transfer theories. Using the general aggression model (GAM), this review posits cognition, affect, and arousal to mediate the effects of situational and personological variables on aggression. The review also organizes recent theories of the development and persistence of aggressive personality. Personality is conceptualized as a set of stable knowledge structures that individuals use to interpret events in their social world and to guide their behavior. In addition to organizing what is already known about human aggression, this review, using the GAM framework, also serves the heuristic function of suggesting what research is needed to fill in theoretical gaps and can be used to create and test interventions for reducing aggression.

Pain sensitivity and stability of physical aggression in boys

It is unclear whether stably aggressive boys would be characterized by high or low pain sensitivity. Adolescent boys in whom physical aggression, executive functioning, anxiety, and family adversity had been assessed longitudinally formed three groups who differed in stability of physical aggression: stable, unstable, and non-aggressive. Stable aggressives were the least pain sensitive, whereas unstable aggressives were the most pain sensitive. While at low levels of executive functioning pain sensitivity could not be distinguished between the aggressive groups, at high levels unstable aggressives reported even more pain, whereas stable aggressives reported even less pain. Variations in anxiety were associated strongly with pain sensitivity in unstable aggressives. High pain ratings were found in boys who had a moderate level of family adversity, and low pain ratings in boys with low or high adversity. The differences in pain sensitivity between the groups may be motivationally important to the frequency and type of aggression.