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Sheri E. Pegram, Mark A. Lumley, Matthew J. Jasinski, John W. Burns, Psychological Trauma Exposure and Pain-Related Outcomes Among People with Chronic Low Back Pain: Moderated Mediation by Thought Suppression and Social Constraints, Annals of Behavioral Medicine, Volume 51, Issue 2, April 2017, Pages 316–320, https://doi.org/10.1007/s12160-016-9838-0
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Chronic low back pain (CLBP) affects approximately one third of adults in the USA [1] and impacts the three core adjustment or outcome domains: pain, physical functioning, and emotional functioning [2]. Although CLBP is influenced by biological, psychological, and social factors, the experience of psychologically traumatic life events appears to be a particularly potent risk factor for increased pain intensity, interference, and depression [3]. The mechanisms linking trauma exposure to these pain-related outcomes, however, are not clear. This study examined two related but distinct cognitive and social mechanisms through which traumatic life events might affect pain adjustment in people with CLBP: thought suppression and social constraints.
Exposure to a traumatic event commonly results in intrusive thoughts, that is, uncontrollable and distressing cognitions about the event. Intrusive thoughts appear to arise from attempts to inhibit or suppress memories and emotions related to the traumatic event and contribute to the development and persistence of negative emotions and physical symptoms [4]. Wegner's ironic process model accounts for the influence of thought suppression on symptoms. Thought suppression paradoxically increases the accessibility of the thoughts, resulting in increased rumination and distress [4, 5]. Thought suppression has been shown to predict psychopathology among trauma-exposed people, beyond the influence of coping strategies and emotion regulation [6]. More generally, cognitive-affective avoidance strategies, including thought suppression, contribute to pain. For example, compared to healthy controls, patients with chronic pelvic pain have higher levels not only of traumatic experiences such as abuse but also of emotion and thought suppression [7].
