Momentary Emotion Regulation Strategies and Pain Experience among Adults with Chronic Pain: An Ecological Momentary Assessment Study.

OBJECTIVES:Chronic pain is a significant public health concern. Psychological treatments are effective for treating chronic pain, but long term follow up studies are limited, and treatment effects sizes are small. Identifying modifiable treatment targets, such as emotion regulation, is critical to improve interventions. Emotion regulation (ER; i.e., cognitive and attentional strategies to modulate or maintain emotional experience) has been linked to psychopathology and pain experience in adults. Yet, the existing work is limited and has largely focused on the relationship between emotional experience, not ER, and pain. METHODS:The current study utilized ecological momentary assessment (EMA) to characterize real time, momentary relationships between ER strategies and pain experience (intensity, interference, and negative affect) among 53 (77.4% female; Mage=27.10 y, SD=5.16 y) adults with chronic pain. Participants completed EMA assessments of pain experience and ER strategies five times a day for seven days. RESULTS:Results of the current study provide evidence for the association between within-person maladaptive ER strategies and pain intensity (b=2.11, se=0.37, P<0.001), pain interference (b=1.25, se=0.40, P=0.002), and pain-related negative affect (b=2.20, se=0.41, P<0.001). Associations by specific strategy type were also examined, highlighting the importance of worry, experiential avoidance, rumination, and expressive suppression in pain experience. DISCUSSION:Given that emotion regulation is readily targeted in psychological treatments for chronic pain, the results from the current study provide initial evidence to target these ER strategies in treatment.