The Role of Emotion Regulation in Chronic Pain Self-Management

Journal of psychosomatic research, 2018

Emotion regulation (ER) includes a set of cognitive and attentional processes used to change or maintain emotional state. A small but growing body of research suggests that maladaptive ER might be a risk factor for the development of chronic pain. This review aims to summarize existing literature on the association between ER and chronic pain, and to determine whether the construct of ER may further enhance our understanding of the risk and protective factors that may contribute to the onset and maintenance of chronic pain. A systematic search was conducted using the search terms "chronic pain" and "emotion regulation." Studies that measured both constructs across all age groups were included. We found 15 studies that met our inclusion criteria. Nine studies were completed within the last five years, suggesting that the evaluation of ER as it relates to pain is a new line of research. Studies that measured "response-focused" ER found associations betwee...

Cognitive Therapy and Research, 2000

Adjustment to chronic pain is examined within the context of a model that emphasizes goal-centered self-regulatory processing. Individual differences in adjustment to chronic illness have typically been examined from within the framework of stressful person-environment transactions. However, it may be useful to examine a broader array of person-environment transactions encountered in the context of working toward personal goals. Self-regulation may be especially challenging for people with chronic pain because of the link between pain and emotion. Consistent with this perspective, we will focus on the role of emotion as an energizing force in self-regulation and discuss the implications for managing pain. We will suggest that pain and concomitant negative emotion pervasively bias information processing, constrain the selection of goals, and the ongoing process of self-regulation.

PLOS ONE, 2021

Cognitive reappraisal and acceptance strategies have been shown to be effective in reducing pain experience and increasing pain tolerance. However, no systematic reviews have focused on the relationship between the use of these two strategies and peripheral physiological correlates when pain is experimentally induced. This systematic review aims to summarize the existing literature that explores the relationship between emotion regulation strategies (i.e., cognitive reappraisal and acceptance) and peripheral correlates of the autonomic nervous system and facial electromyography, such as affect-modulated responses and corrugator activity, on laboratory tasks where pain is induced. The systematic review identifies nine experimental studies that meet our inclusion criteria, none of which compare these strategies. Although cognitive reappraisal and acceptance strategies appear to be associated with decreased psychological responses, mixed results were found for the effects of the use of...

Health Psychology Review, 2013

Current developments in chronic pain research are changing the focus in the study of pain–emotion relations from the identification of general patterns to the study of dynamic and context-related interactions manifesting both within and between individuals. This shift towards understanding variation at both intra- and interpersonal levels has significant clinical implications for psychological adjustment to chronic pain conditions, and thus represents an important topic for both clinical and health psychology. This article reviews the existing theoretical explanations of these dynamics and their emerging empirical support, and suggests further areas of investigation. A literature search identified research on moderators of pain–emotion relations in chronic pain; existing theories were also examined from this perspective. A theoretical analysis revealed several important contributions, including the concepts of affect differentiation, generalised discrimination ability, resilience, vulnerability, coping, emotion regulation and desynchrony, which are described here together with the relevant empirical research and clinical implications. Important areas for development are the clarification of the common elements and opposing predictions and the empirical examination of mediating mechanisms. Several methodological issues are discussed. This review identifies a rich theoretical basis for research into pain–emotion moderation, and suggests that further examinations of such relationships might hold important clinical consequences.

Journal of Clinical Psychology, 2014

Objective: Research suggests that emotions and emotion regulation processes can influence both the sensory (e.g., intensity) and the affective (unpleasantness) components of pain. The purpose of this study was to investigate the factor structure and validity of the Difficulties in Emotion Regulation Scale (DERS; in medical sample with persistent pain. Method: Data were collected from 207 chronic pain patients (82.6% female; mean age = 51.96). We applied confirmatory factor analysis (CFA) to test measurement model of emotion dysregulation and CFA with covariates to test construct and convergent validity of the DERS. Results: The original factor structure of the DERS was not supported in our medical sample. However, after some modifications the DERS yielded good fit. Validity of the DERS was confirmed. All the subscales had significant relationship with depression measure, and all the subscales except one correlated with Difficulties in Identifying Feelings component of alexithymia. Conclusions: The DERS proved to be an adequate measure of clinically relevant dimensions of emotional dysregulation in chronic pain patients. C 2013 Wiley Periodicals, Inc. J. Clin. Psychol. 70:589-600, 2014.

Emotional regulation is an important variable in the experience of pain. Currently, there are no experimental investigations of the relation between emotional regulation and pain. The goal of the present study work was to analyze differences in pain perception and mood generated by the cold-pressor (CPT) experimental paradigm in women with high and low emotional regulation. Two groups of women were formed as a function of their level of emotional regulation: women with high emotional repair (N = 24) and women with low emotional repair (N = 28), all of whom performed the CPT. The results show that the women with a high score in emotional repair reported having experienced less sensory pain and affective pain during the immersion, as well as a more positive affective state before beginning the task. During the experimental task, they also reported a better mood, thus displaying lower impact of the experience of pain.

The purpose of this study is to investigate the effectiveness of treatment base on emotional regulation in improving chronic pain of patients who suffer from chronic pain in the city of Tehran. In this semi-experimental pre-test-post-test, 30 patients with chronic pain who referred to the pain specialized center of Tajrish martyrs Hospital were randomly assigned into two experimental and control groups. Initially the graded chronic pain questionnaire (GPQ) and multidimensional pain inventory (MPI) were implemented as pre-test in two groups. Then experimental group received 8 sessions treatment base on emotional regulation and after one month and half post-test was implemented for both groups. The data was analyzed using covariance analysis (Anoka). The results showed that emotional regulation group therapy effectively reduced pain intensity and improved the dimension and consequences of chronic pain include pain frequency, dysfunction of daily life, emotional disorder and support variable (P>0/05). Regarded to acquire results, psychotherapy base on emotional regulation reduce pain intensity, improve the dimension and consequences of chronic pain and increase life quality of patients who suffer from chronic pain. INTRODUCTION Pain is a common phenomenon that almost everyone in their lifetime experienced it. International Association of Pain Study (1979) defines pain as an unpleasant sense and emotional experience that associated with actual or potential texture trauma (Dehqan, 2004). In fact, "emotional and unpleasant" phrases revealed that affection, emotional and cognitive factors have significant role in explaining this experience. Although, the pain is necessary for human survival, but the effects of this phenomenon makes it as second most common cause for using medical care (Turk and Okifuji, 1998). Chronic pain is pain that existed at least for three months during the past six months (Crombie and Oakley Devis, 1999). Researches that carried out in Iran, reported the prevalence of continued chronic pain in the adults population of (18 to 65 years) %9 to %21. Chronic pain often affects person's ability for performing different activities (International Association of Pain Study, 2003). However in many studies, pain and physical injury are considered as important predictors of disabilities. Studies have shown that disability is a complex phenomenon that simply cannot be explained by biological-medical factors and range of different factors such as pain time length, pain avoidance, depression etc impact it (Linton, 2000). The economic costs of chronic pain lonely are more than the costs caused by heart disease, cancer, and AIDS (Cousins, 1995). Research results that has been done in the Netherlands (Van Tulder, 1995) shows that the economic cost of back pain lonely is equivalent to 1.7 percent of GDP (four billion and six hundred and five million America dollars) in the country. Only 7 percent of this amount (365 million dollars) is spent on health services and health care and rest of it is spent (93percent or 4 billion and six hundred million dollars) on indirect costs that are related to the back pain indemnification. Some evidence suggests that patients with chronic pain show certain psychological problems due to the failure in achieving pain relief. Living with chronic pain requires considerable emotional pressure. Also pain reduces the emotional abilities of individual and the constant desire of person to get rid of the pain is

Journal of Pain, 2010

Emotional regulation is an important variable in the experience of pain. Currently, there are no experimental investigations of the relation between emotional regulation and pain. The goal of the present study work was to analyze differences in pain perception and mood generated by the cold-pressor (CPT) experimental paradigm in women with high and low emotional regulation. Two groups of women were formed as a function of their level of emotional regulation: women with high emotional repair (N = 24) and women with low emotional repair (N = 28), all of whom performed the CPT. The results show that the women with a high score in emotional repair reported having experienced less sensory pain and affective pain during the immersion, as well as a more positive affective state before beginning the task. During the experimental task, they also reported a better mood, thus displaying lower impact of the experience of pain.

Iranian Evolutionary Educational Psychology Journal, 2021

This study aimed to predict chronic pain and self-regulation based on positive and negative emotions in patients with chronic pain. From all patients with chronic pain sent to hospitals in Bandar Abbas, Iran, 165 people were selected by cluster random sampling using the Morgan table as a statistical sample. To collect data, the Positive and Negative Emotion (PANAS) questionnaire, chronic pain, and self-regulation (SRI-S) were used. Multiple regression was used to test the research hypotheses. The results showed that positive emotion significantly explains about 45% of the variance of the criterion variable (Chronic pain) and negative emotion about 40% of the variance significantly. Also, positive emotion significantly explains 29% of the variance of the criterion variable (self-regulation), and negative emotion about 26% of the variance. In general, the findings of the present study supported the role of emotions in pain perception, tolerance, and self-regulation in patients with chronic pain.

Nature Reviews Neuroscience, 2013

Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and arthritis. To address this growing problem, many people are turning to mind-body therapies, including meditation, yoga and cognitive behavioural therapy. This article will review the neural mechanisms underlying the modulation of pain by cognitive and emotional states-important components of mind-body therapies. It will also examine the accumulating evidence that chronic pain itself alters brain circuitry, including that involved in endogenous pain control, suggesting that controlling pain becomes increasingly difficult as pain becomes chronic. Pain is a complex sensory and emotional experience that can vary widely between people and even within an individual depending on the context and meaning of the pain and the psychological state of the person. Cognitive and emotional factors have a surprisingly important influence on pain perception. A negative expectation can completely reverse the analgesic effect of a clinical dose of the opioid agonist remifentanil 1 , whereas the expectation of pain relief is an important component of placebo analgesia 2. Clinical and experimental studies show that even a simple psychological manipulation, such as distraction, can have a powerful effect on our perception of pain 3. Our emotional state also has an enormous influence on pain; a negative emotional state increases pain, whereas a positive state lowers pain 4. Not surprisingly, complex emotional states such as empathy, which incorporate emotional and cognitive factors, alter the way an individual feels pain 5. Brain imaging studies have allowed us to examine the neural basis of psychological modulation of pain (BOX 1). These studies reveal that activity in afferent pain pathways is altered by the attentional state, positive and negative emotions, empathy and the administration of a placebo 6. Additionally, imaging studies show that psychological factors activate intrinsic modulatory systems in the brain, including those involved in opioid-related