Anger management style moderates effects of emotion suppression during initial stress on pain and cardiovascular responses during subsequent pain-induction

Abstract

Suppression of emotion, anger in particular, may be linked to heightened pain intensity during a subsequent painful event, but it is not clear whether an individual's anger management style (trait anger-out or trait anger-in) moderates effects on pain intensity and cardiovascular responses during pain. To determine whether (a) trait anger-out and/or trait anger-in moderate effects of Emotion-Induction (anger, anxiety)xEmotion Suppression (nonsuppression, experiential, expressive) manipulations during mental arithmetic on pain intensity and cardiovascular responses during and following a cold pressor pain task, such that "mismatch" relationships emerge (preferred anger management style is discrepant from situation demands), and (b) general emotional expressivity accounts for these effects. Healthy nonpatients (N=187) were assigned to 1 of 6 conditions for a mental arithmetic task. Cells were formed by crossing 2 Emotion-Induction (anxiety, anger)x3 Emotion Suppression (nonsuppression, experiential, expressive) conditions. After mental arithmetic, participants underwent a cold pressor followed by recovery. Systolic blood pressure (SBP), diastolic BP (DBP), heart rate (HR), and pain intensity ratings were recorded. Spielberger Anger Expression Inventory tapped anger management style. General Linear Model procedures tested Emotion-Induction x Emotion SuppressionxAnger-Out or Anger-In (continuous)xPeriod (baseline, cold pressor, recovery) effects on pain intensity, SBP, DBP, and HR. A 4-way interaction emerged for pain intensity: Only for those in the anger-induction/experiential suppression condition, anger-out was related significantly to pain recovery. Three-way interactions emerged for SBP and DBP: Only for those in expressive suppression condition, anger-out was related significantly to SBP during and following cold pressor and to DBP following cold pressor. General emotion expressivity did not account for anger-out effects. A mismatch situation may apply for high anger-out people who suppress emotion in a certain circumstance and thus may suffer greater discomfort and physiological responsiveness to subsequent pain than high anger-out people not having to suppress.