Background: Research links people’s lifetime frequency of traumatic events to chronic pain. Attempts to suppress intrusive thoughts about trauma can paradoxically increase rumination, distress, and pain. Moreover, trauma-exposed individuals may experience social constraints against disclosure about their trauma, which might amplify thought suppression’s effect on pain.
Purpose: This study extends previous research on chronic pain by examining thought suppression and social constraints as mechanisms through which trauma might influence pain severity, pain interference, and depressive symptoms.
Methods: 292 adults with chronic low back, recruited from local pain clinics, completed self-report surveys. Mediation and conditional process analyses were conducted to examine associations among trauma, thought suppression, social constraints, and pain-related outcomes.
Results: Consistent with hypotheses, moderated-mediation analyses indicated that experiencing more traumatic life events was associated with greater suppression of intrusive thoughts, which in turn was associated with greater pain severity, pain interference, and depressive symptoms. Further, elevated levels of social constraints on emotional expression interacted with the indirect effect of thought suppression to augment pain severity and interference. Depressive symptoms were independently predicted by trauma, thought suppression, and social constraints.
Conclusions: We conclude that the combination of trauma, suppressing one’s thoughts, and social constraints against disclosure can be particularly deleterious for pain patients. Providing social environments that support the expression of trauma-related thoughts and feelings might improve pain outcomes.