Highlights
- •Alexithymia but not emotional repression predicted chronic pain after surgery.
- •Alexithymia predicted postoperative pain independently of anxiety and depression.
- •Alexithymia and emotional repression are not simply measures of the same construct.
- •Dysregulation in emotional processing promoted the development of persistent pain.
Abstract
Alexithymia, the inability to identify and express emotions, and emotional repression,
a defensive mechanism used to avoid unpleasant emotional experience, have been associated
with chronic pain and medical illness including breast cancer, but whether these constructs
might predict pain after breast cancer surgery has not been assessed. The present
study was conducted to assess the predictive value of alexithymia and emotional repression
in postoperative pain. Anxiety, depression, catastrophizing, and psychological adjustment
were also assessed. Data were collected before surgery, and then at 2 days and 2,
3, 6, and 12 months after surgery. We included 100 pain-free women, 96% of whom were
followed for up to 12 months. Separate multivariate analyses identified anxiety as
a significant predictor of postsurgical pain at 3 months, alexithymia at 3, 6, and
12 months, and body image and catastrophizing predicted acute or subacute pain at
2 months. In contrast, emotional repression was not predictive of pain. The generalized
estimating equation approach was used and identified alexithymia as the only significant
predictor of pain during the 12-month period after surgery. Alexithymia, but not emotional
repression, predicted the development of persistent pain after breast surgery independently
of anxiety and depression. Thus, alexithymia might be involved in mechanisms of pain
chronicity.
Perspective
This prospective study, conducted in women with breast cancer surgery, showed that
alexithymia but not emotional repression predicted postsurgical pain. These results
highlight the role of dysfunction in emotional processing in the development of postsurgical
pain.
Key words
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Article info
Publication history
Published online: October 14, 2015
Accepted:
October 3,
2015
Received in revised form:
September 3,
2015
Received:
April 30,
2015
Footnotes
A.M.-D. received funding from the French Society of Pain-Janssen-Cilag for this study.
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.
