Is anger management style associated with descending modulation of spinal nociception?

Anger management styles (i.e., anger-in and anger-out) characterize a person's typical response to anger. Anger-in, the suppression of anger, and anger-out, the outward expression of anger, have been associated with increased acute and chronic pain. Previous research suggests that anger-in is related to pain because of its shared variance with negative affect; anger-out is believed to be related to pain because of a disruption of endogenous opioid systems. It is currently unknown whether anger management styles promote pain by facilitating central sensitization or spinal nociception. This study assessed the relationship between anger management styles and markers of central sensitization (i.e., temporal summation of pain [TS-pain] and nociception flexion reflex [TS-NFR]), spinal nociception (nociception flexion reflex [NFR] threshold), and measures of pain experience. One hundred nine healthy pain-free individuals completed the study. A bootstrapped mediation analysis was conducted to test whether negative affect mediated relationships with anger-in. Results suggested that anger-in and anger-out were associated with lower NFR thresholds (facilitated spinal nociception), but no other outcome. Negative affect did not mediate either of these relationships. These results suggest that anger management styles may amplify spinal nociceptive processes in healthy humans without altering central sensitization.