title: Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function.
abstract: OBJECTIVE
  The objective of this study was to determine the degree to which patient anger arousal and behavioral anger regulation (expression, inhibition) occurring in the course of daily life was related to patient pain and function as rated by patients and their spouses.
  
  
  METHODS
  Married couples (N = 105) (one spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. Patients completed items on their own state anger, behavioral anger expression and inhibition, and pain-related factors. Spouses completed items on their observations of patient pain-related factors. Hierarchical linear modeling was used to test concurrent and lagged relationships.
  
  
  RESULTS
  Patient-reported increases in state anger were related to their reports of concurrent increases in pain and pain interference and to spouse reports of patient pain and pain behavior. Patient-reported increases in behavioral anger expression were related to lagged increases in pain intensity and interference and decreases in function. Most of these relationships remained significant with state anger controlled. Patient-reported increases in behavioral anger inhibition were related to concurrent increases in pain interference and decreases in function, which also remained significant with state anger controlled. Patient-reported increases in state anger were related to lagged increases in spouse reports of patient pain intensity and pain behaviors.
  
  
  CONCLUSIONS
  Results indicate that in patients with chronic pain, anger arousal and behavioral anger expression and inhibition in everyday life are related to elevated pain intensity and decreased function as reported by patients. Spouse ratings show some degree of concordance with patient reports.
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center.
authors.forename: John W
authors.initials: JW
authors.lastname: Burns
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center.
authors.forename: James I
authors.initials: JI
authors.lastname: Gerhart
authors.affiliation: Department of Anesthesiology, Vanderbilt University Medical Center.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bruehl
authors.affiliation: Department of Psychology, University of Notre Dame.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Peterson
authors.affiliation: Department of Psychology, University of Notre Dame.
authors.forename: David A
authors.initials: DA
authors.lastname: Smith
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Porter
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center.
authors.forename: Erik
authors.initials: E
authors.lastname: Schuster
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center.
authors.forename: Ellen
authors.initials: E
authors.lastname: Kinner
authors.affiliation: Department of Anesthesiology, Rush University Medical Center.
authors.forename: Asokumar
authors.initials: A
authors.lastname: Buvanendran
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Fras
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
mesh_terms: D000328:Adult; D000786:Anger / Q000502:physiology*; D001143:Arousal / Q000502:physiology*; D059350:Chronic Pain / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D057566:Self Report; D018454:Spouses / Q000523:psychology
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