Anger Expression, Endogenous Opioids and Acute Pain

描述（由申请人提供）：情绪调节在一定程度上决定了个体对生理和心理压力源的适应；包括疼痛。先前的研究表明，愤怒表达方式（愤怒发泄）可能通过内源性阿片系统功能障碍与高疼痛敏感性有关。这种生物心理关系的关键因素仍有待探索。两项研究将使用一个实验模型来检验愤怒对痛苦刺激反应的影响。他们将测试是否：1)愤怒的唤醒对于与愤怒特质相关的内源性阿片差异的充分表达是必要的；2)与高特质愤怒输出相关的阿片系统功能障碍受愤怒唤醒时实际（行为）愤怒表达的影响。研究1受试者在接受任务前随机接受安慰剂或阿片类阻断剂（纳曲酮）。他们将经历一个计算机化的迷宫任务和骚扰（愤怒诱导），然后是缺血性疼痛任务，或者将以相反的顺序进行任务。显著的愤怒-输出x任务顺序x药物相互作用预期表明，由于内源性阿片类疼痛调节功能障碍，高愤怒输出具有更大的疼痛敏感性，并且当愤怒先于疼痛引起时，这种功能障碍最为突出。研究2将筛选高/低特质愤怒，并在进行任务前随机接受安慰剂或纳曲酮。所有的实验对象都将在被骚扰的情况下完成迷宫任务，并被指示压抑或公开表达在任务中激起的愤怒；随后是缺血性疼痛任务。愤怒-发泄x药物x表达/抑制的显著相互作用，预期高愤怒发泄会有更大的疼痛敏感性，由于阿片调节功能障碍，但高愤怒发泄的行为愤怒表达将触发阿片系统激活，以抑制愤怒唤起的影响。本项目将补充和扩展情绪调节的神经体液底物研究，并将加深对愤怒调节和内源性阿片在调节压力和疼痛中的相互作用的理解。

DESCRIPTION (provided by applicant): Emotional regulation partly determines individuals' adaptation to physical and psychological stressors; pain included. Previous work shows that an anger expressive style (anger-out) may be related to high pain sensitivity via dysfunction in the endogenous opioid system. Crucial elements of this biopsychological relationship remain to be explored. Two studies will use an experimental model to examine effects of anger-out on responses to painful stimuli. They will test whether: 1) arousal of anger is necessary for full expression of endogenous opioid differences linked to trait anger-out; 2) the opioid system dysfunction related to high trait anger-out is influenced by actual (behavioral) expressions of anger during anger arousal. Study 1 subjects will randomly receive either placebo or opioid blockade (naltrexone) prior to undergoing tasks. They will undergo a computerized maze task with harassment (anger induction) followed by an ischemic pain task, or will undergo tasks in reverse order. Significant Anger-Out x Task Order x Drug interactions are expected to show that high anger-outs have greater pain sensitivity due to endogenous opioid pain regulatory dysfunction, and that this dysfunction is most prominent when anger is induced prior to pain. Study 2 subjects will be screened for High/Low trait anger-out, and will randomly receive either placebo or naltrexone prior to undergoing tasks. All subjects will undergo the maze task with harassment, with instructions to either suppress or overtly express anger aroused during the task; an ischemic pain task follows. Significant Anger-Out x Drug x Express/Suppress interactions are expected such that high anger-outs will have greater pain sensitivity due to opioid regulatory dysfunction, but that behavioral anger expression in high anger-outs will trigger opioid system activation to dampen effects of anger arousal. This project will complement and expand research about the neurohumoral substrates of emotional regulation, and will enhance understanding of the interplay of anger regulation and endogenous opioids in the modulation of stress and pain.