John Burns, Ph.D. Professor
Phone: 847-578-8751 Email: john.burns@rosalindfranklin.edu
Emotion Regulation and Pain
Over the past decade, we have been pursuing lines of research that examine mechanisms by which the regulation of negative emotions – anger in particular -- impact acute and chronic pain. Early on, we examined relationships among self-report measures of anger variables and adjustment factors in chronic low back pain (CLBP) patients, and also examined links between such trait anger variables and physiological reactivity to lab stressors. More recently, we have designed and implemented studies that involve experimental manipulations of different conditions. Finally, we have begun to explore some genetic underpinnings of links between overt anger regulatory behavior and deficits in endogenous inhibitory systems.
Bruehl, S., Burns, J., Chung, O., Ward, P., Johnson, B. (2002). Anger and pain sensitivity in chronic low back pain patients and pain‑free controls: The role of endogenous opioids. Pain, 99, 223-233.
Bruehl, S., Chung, O.Y., Donahue, B.S., & Burns, J.W. (2006). Anger regulation style, postoperative pain, and relationship to the A118G mu opioid receptor gene polymorphism: A pilot study. Journal of Behavioral Medicine, 29, 161-169.
Burns, J.W. (2006). Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients. Emotion, 6, 309-319.
Burns, J.W., Bruehl, S., & Quartana, P.J. (2006). Anger management style and hostility among chronic pain patients: Effects on symptom-specific physiological reactivity during anger- and sadness- recall interviews. Psychosomatic Medicine, 68, 786-93.
Quartana, P. & Burns, J.W. (2007). The painful consequences of anger suppression. Emotion 7, 400-414.
Burns, J.W., Quartana, P.J., Gilliam, W., Gray, E., Matsuura, J., Nappi, C., Wolfe, B., & Lofland, K. (in press). Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: Evaluation of an ironic process model. Health Psychology.
Attention-Strategy, Repression, Catastrophizing and Pain
Another line of research on emotion regulation and pain adapts the ironic process paradigm to study the effects of suppressing pain-related thoughts during pain on subsequent responses to stress or further physical stimulation. The moderating effects of “pain catastrophizing” is also examined.
Burns, J.W. (2000). Repression predicts outcome following multidisciplinary treatment or chronic pain. Health Psychology, 19, 75-84.
Michael, E., & Burns, J.W. (2004). Catastrophizing and pain tolerance among chronic pain patients: Moderating effects of sensory and affect focus. Annals of Behavioral Medicine, 27, 185‑19.
Burns, J.W. (2006).The role of attentional strategies in moderating links between acute pain‑induction and subsequent emotional stress: Evidence for symptom‑specific reactivity among chronic pain patients versus healthy nonpatients. Emotion, 6, 180-192.
Elfant, E., Burns, J.W. & Zeichner, A. (2008). Repressive coping style and suppression of pain-related thoughts: Effects on responses to acute pain induction. Cognition & Emotion, 22, 671-696.
Quartana, P., Burns, J.W., & Lofland, K. (2007). Attentional strategy moderates effects of pain catastrophizing on symptom-specific physiological responses in chronic low back pain patients. Journal of Behavioral Medicine, 30, 30, 221-231.
Couples’ Interactions and Patient Adjustment to Chronic Pain
A new area for us. Specifically, we focus on the role of spousal criticism/hostility. Research in this area is largely correlational, leaving causal directions indeterminate, and theoretical models do not specify mechanisms through which spouse criticism/hostility and patient pain are related. We believe that links between spousal criticism/hostility and patient adjustment to chronic low back pain (CLBP) may be illuminated through a synthesis of an Expressed Emotion (EE) model, in which spousal criticism of how the patient is managing their condition and spousal criticism/hostility toward the patient undermine patient adjustment, and an Interpersonal model, in which persistent and exaggerated signs of poor adjustment by patients elicit critical/hostile reactions from patients’ spouses. We propose that chronic pain symptoms elicit negative spouse responses, and that such responses then worsen and maintain symptoms; a vicious spiral, which leads to poor adjustment. We are launching a new grant-funded project to explore these issues.
Therapeutic Change Processes in Chronic Pain and Cardiac Rehabilitation Settings
Over the past decade, we also have examined therapeutic processes in multidisciplinary chronic pain programs and cardiac rehabilitation programs. The guiding principle is that, although these programs seem to be effective in reducing pain and depressed mood, increasing activities and getting people back to work, the therapeutic mechanisms – or processes -- by which these gains are accomplished have not been clearly established.
Burns, J.W., Kubilus, A., Bruehl, S., Harden, R.N., & Lofland, K. (2003). Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain? A cross-lagged panel analysis. Journal of Consulting and Clinical Psychology, 71, 81‑91.
Burns, J.W., Glenn, B., Bruehl, S., Harden, R.N., & Lofland, K. (2003). Cognitive factors influence outcome following multidisciplinary treatment: A replication and extension of a cross‑lagged panel analysis. Behaviour Research and Therapy, 41, 1163‑1182.
Glenn, B., & Burns, J.W. (2003). Pain self‑management in the process and outcome of multidisciplinary treatment of chronic pain: Evaluation of a stage of change model. Journal of Behavioral Medicine, 26, 417‑433.
Evon, D. & Burns, J.W. (2004). Process and outcome in cardiac rehabilitation: An examination of cross‑lagged effects. Journal of Consulting and Clinical Psychology, 72, 605‑616.
Burns, J.W. & Evon, D. (2007). Common and specific process factors in cardiac rehabilitation: Independent and interactive effects of the working alliance and self-efficacy, Health Psychology, 26, 684-692