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Pain and Anger Management Style: What's the Relationship?
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Posted on: 08/22/2007
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Anger management styles vary among people but generally fall into two groups. There's the anger-in style: holding anger in without expressing it (hiding emotion). And there's the anger-out style: verbally or physically showing anger.
In this study, researchers look to see if anger management style affects endogenous opioid levels in response to pain. Endogenous opioids refer to narcotic-like chemicals released naturally by the body in response to pain.
Two groups of subjects were included. One group included healthy adults without back pain. They were between the ages of 18 and 55. The second group was matched by age and gender but had chronic low back pain (LBP). LBP was defined as pain lasting at least three months. The pain was rated at least a three on a scale from zero (no pain) to 10 (worst pain).
Blood levels of beta-endorphin (BE) were measured before and after three trials of pain. Pain was delivered by pressure to the index finger, cutting off blood supply to the forearm, and applying heat to the underside of the forearm. Everyone also filled out several surveys on pain, anxiety, depression, and anger.
They analyzed the blood samples and correlated them with the results of the surveys. They found that:
Both groups had increased pain with all three types of pain
The anger-out group perceived greater pain intensity
Anger-in people had higher BE levels in response to the increased pain
The anger-out group did not have any increase in BE
There was no difference between the sexes (men versus women)
The cause of the anger-related opioid dysfunction is unknown. Scientists aren't sure if the anger-out group has fewer opioid receptors or just less sensitive receptors. On the other hand, it's possible the anger-out individual just doesn't release as much BEs as the anger-in group.
In this study, the people in the two groups were not provoked to anger. The BEs were measured at rest without a change in behavior. The results might be different under more authentic conditions.
And finally, the authors propose that it might be possible that the anger-out group may not have an opioid dysfunction at all. Perhaps they just have a higher threshold for triggering release of the BEs. The idea of an opioid triggering mechanism is the next item to be studied.
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References:
Stephen Bruehl, et al. Trait Anger Expressiveness and Pain-Induced Beta-Endorphin Release: Support for the Opioid Dysfunction Hypothesis. In Pain. August 2007. Vol. 130. No. 3. Pp. 208-215.
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