Anger Suppression and Subsequent Pain Behaviors among Chronic Low Back Pain Patients: Moderating Effects of Anger Regulation Style

Background  

Suppression of anger is linked to subsequent pain intensity among chronic low back patients, but it is not clear whether anger regulation style (trait anger-out, anger-in) moderates these effects or if aroused anger accounts for links between anger regulation style and pain.     

Cerebral Responses to Warmth and Heat and Cold Pain Measured by Positron Emission Tomography

Phasic heat and tonic cold stimuli that have different temporal patterns, afferent fiber activations, and perceived pain characteristics produce a shared pattern of cerebral activation in addition to modality specific activations. These patterns are different from the cerebral representation of innocuous temperature sensation. Functional brain imaging techniques provide an opportunity to study somatosensory organization in conscious humans under physiologic conditions, despite certain limitations of imaging modalities.     

Psychophysical Responses to Experimentally Induced Heat and Cold Pain Before,During, and After Transcutaneous Electrical Nerve Stimulation

Objective. The outcomes of different modes of TENS (transcutaneous electrical nerve stimulation) in relieving experimental heat and cold pain were studied. Materials and methods. Three modes of stimulation, conventional, burst, and high rate frequency modulation (HRFM) including placebo, were trancutaneously applied to 20 right handed healthy volunteers (10 males and 10 females). Stimulation was carried out using two pad electrodes placed over the median nerve for 120 s in each case. Heat pain was induced to the right and left hands of each subject by means of a hot water bath and cold pain by means of frozen bottles. Pain scores based on Verbal Rating Scale (VRS) were recorded at 60 s intervals before, during, and after stimulation. Results. All stimulation modes except placebo decreased VRS values down to statistically significant levels in each case (p < 0.05). HRFM was the most effective mode of TENS causing a decrease of 53.1% to perception of heat pain during its application and 43.8% after HRFM in the right hand. In the left hand, these values were recorded as 46.8% and 40.3%, respectively. HRFM also decreased the perception of cold pain by 47.2% during stimulation and 44.5% after stimulation in the right hand. In the left hand, cold pain scores were reduced by 52.8% and 45.1%, respectively. There were no statistically significant sexual differences and no recorded statistically significant difference between the right or left sided stimulation. Conclusions. All modes of stimulation statistically decreased both heat and cold pain when compared to placebo. HRFM was the most effective mode of TENS. It might be worthwhile to test the patterns of stimulation in chronic pain patients.     

Effect of the Cold Pressor Test on Memory and Cognitive Flexibility

Cognitive flexibility is affected by stress. The cold pressor test is a known adrenergic stressor that impairs memory, but the effect on cognitive flexibility is unknown. Sixteen subjects were given cognitive flexibility and memory tasks with and without one hand immersed in cold water. Memory was impaired in the cold pressor condition but there was no effect on cognitive flexibility. The lack of a cold pressor effect on cognitive flexibility may result from an isolated effect on the peripheral noradrenergic system, whereas indirect effects due to nociception on memory may occur.     

Emotional Responses to Pleasant and Unpleasant Oral Flavour Stimuli

The hedonic valence of taste perception plays a crucial role in the control of responses related to feeding behaviour. Taste and olfaction perception can induce autonomic responses, such as heart rate variability (HRV), which are involved in the evoked emotional reactions. Analysis of HRV can help distinguish sympathetic from parasympathetic regulation of the sinoatrial node. In this work, we analysed the HRV associated with oral flavour stimuli with opposite hedonic dimension and assessed their sympathovagal balance. ECGs were recorded continuously on 11 men and 12 women before and after stimulations. Experiments were performed in two sessions for comparison. ANOVA highlighted the decreases and increases of sinusal rhythm associated with pleasant and unpleasant flavour stimulations, respectively. Time and frequency domain analysis of HRV indicates that bradycardia induced by the pleasant stimulus can be attributed to an increase in the vagal tone, whilst tachycardia evoked by the unpleasant stimulus denotes a reduction of the vagal tone in women and an increase of the sympathetic tone in men. In conclusion, our data suggest that the HRV analysis may represent a valuable tool for autonomic nervous system response characterization associated to the hedonic dimension of the complex flavour sensations induced by food and/or beverages.     

Social Isolation and Stress-related Cardiovascular,Lipid, and Cortisol Responses

Background  Social support is a strong and consistent predictor of health outcomes, and social isolation predicts increased morbidity and mortality. The mediating processes are not completely understood. Purpose  The purpose of the study is to investigate associations between social isolation and cardiovascular and lipid responses to acute stress in the laboratory, and cortisol profiles over the day. Methods  Cardiovascular and lipid responses to acute stress tasks, and salivary cortisol monitoring, were carried out in 238 healthy middle-aged men and women from the Whitehall II cohort. Social isolation was measured using an adapted version of the Close Persons Questionnaire. Results  Social isolation was associated with slower post-task recovery of systolic blood pressure in men and women, a higher cholesterol response to stress in men only, and also with larger cortisol awakening responses and greater cortisol output over the day in both men and women. Conclusions  The impact of social isolation on cardiovascular disease risk may be mediated through stress-related dysregulation of cardiovascular, metabolic, and neuroendocrine processes.     

Low Testosterone Level as a Predictor of Poststroke Emotional Disturbances: Anger Proneness and Emotional Incontinence

Background

The role of sex hormones in poststroke mood and emotional disturbances is unclear. We aimed to evaluate the impact of sex hormones on poststroke emotional disturbance, especially anger proneness (AP) and emotional incontinence (EI). We also investigated whether statins, which are widely used for stroke prevention, affect sex hormone levels or the presence of poststroke AP/EI based on the hypothesis that intensive treatment with statins would inhibit the synthesis of cholesterol, the preferred substrate of testosterone.

Anger Responses in Adolescents: Relationship with Punishment and Reward Sensitivity

Child Psychiatry & Human Development - A substantial proportion of youth with anxiety disorders shows comorbid behavioral (anger) problems. Such comorbid profile is associated with low...     

Role of Different Subtypes of Adrenoceptors in Pressor Responses to Catecholamines Released From Sympathetic Nerve Endings

The role of α₁- and α₂-adrenoceptors in the vascular effects of catecholamines, either released locally from sympathetic nerve endings (e.g., in vascular smooth muscle) or derived from the adrenal medulla or administered intravenously, was studied using selective antagonists of these adrenoceptors. The ganglionic stimulant dimethylphenyl-piperazinium-iodide (DMPP) exerted dual actions on blood pressure: a rapid and short-term pressor reaction (phase I) resulting from catecholamine release elicited by ganglion stimulation, followed by a more sustained blood pressure elevation (phase II) resulting from the circulating catecholamines released from the adrenal medulla. The selective α₂-adrenoceptor, but a not subtype selective, antagonist 7,8-(methylenedioxi)-14-alpha-alloberbane HCl (CH-38083) (50–100 μg/kg, IV) significantly (p < 0.05) inhibited the pressor effects of epinephrine and norepinephrine given intravenously and phase II of the DMPP-induced pressor reaction. Idazoxan exerted similar effects, but at higher doses (400–600 μg/kg, IV). WB-4101 (50–100 μg/kg, IV) and BRL-44408 (2–3 mg/kg, IV), two selective α_2A-adrenoceptor antagonists, had the same activity as CH-38083, except did not inhibit the pressor effect of intravenously administered norepinephrine. The α_2B-adrenoceptor selective antagonist, ARC-239 (150 μg/kg, IV) did not influence phase II of DMPP-induced pressor reaction. Prazosin (200 μg/kg, IV), an antagonist of α₁ and α_2B-adrenoceptors, reduced blood pressure, the pressor response to intravenously administered epinephrine, and phase I of the DMPP-induced pressor effect. In addition, it completely inhibited the pressor responses to DMPP remaining after administration of CH-38083. These results suggest that the postsynaptically located α₁- and α_{2(A and B)}-adrenoceptors are involved in pressor response to norepinephrine and epinephrine, and are sensitive and accessible to catecholamines released locally from the axon terminals, and from the circulation to a different extent. These results may have great therapeutical importance in hypertension, for which the involvement of both a high level of circulating and locally released catecholamines may be indicative of the usefullness of a combination (α₁- and α₂-adrenoceptors- and Ca-channel-blocking agents) therapy. Copyright © 1997 Elsevier Science Inc.     

Posttraumatic Stress Among Syrian Refugees: Trauma Exposure Characteristics,Trauma Centrality,and Emotional Suppression

Objectives: This study revisited the prevalence of posttraumatic stress disorder (PTSD) and examined a hypothesized model describing the interrelationship between trauma exposure characteristics, trauma centrality, emotional suppression, PTSD, and psychiatric comorbidity among Syrian refugees. Methods: A total of 564 Syrian refugees participated in the study and completed the Harvard Trauma Questionnaire, General Health Questionnaire (GHQ-28), Centrality of Event Scale, and Courtauld Emotional Control Scale. Results: Of the participants, 30% met the cutoff for PTSD. Trauma exposure characteristics (experiencing or witnessing horror and murder, kidnapping or disappearance of family members or friends) were associated with trauma centrality, which was associated with emotional suppression. Emotional suppression was associated with PTSD and psychiatric comorbid symptom severities. Suppression mediated the path between trauma centrality and distress outcomes. Conclusions: Almost one-third of refugees can develop PTSD and other psychiatric problems following exposure to traumatic events during war. A traumatized identity can develop, of which life-threatening experiences is a dominant feature, leading to suppression of depression with associated psychological distress.     

Cardiovascular and Steroid Responses to Graded Haemorrhage in Rats with Adrenal Regeneration Hypertension

Blood pressure (BP) and plasma steroid responses to haemorrhage (2 ml + 1 ml + 1 ml at 20-min intervals) were assessed in sham-operated (SO) rats and in rats with adrenal regeneration hypertension (ARH). Experiments were carried out between 0700 and 1000 h (a.m.) and between 1400 and 1700 h (p.m.), because rats with ARH have BPs that are higher a.m. than p.m. There were no differences in the BP responses following haemorrhage in SO or ARH rats either a.m. or p.m., although ARH rats were unable to increase their plasma steroid levels. Pretreatment with captopril alone, d(CH₂)₅ DAVP alone, or captopril and d(CH₂)₅DAVP augmented the early hypotensive responses to haemorrhage but did not influence the later compensated levels of BP in either group of rats. There were no clear-cut a.m. to p.m. differences in the changes in BP in any of the drug-treated groups of SO or ARH rats. Under all conditions studied, the compensated level of systolic BP in ARH rats, 20 min after the final bleed, remained higher a.m. than p.m., indicating that this difference was not dependent on the renin-angiotensin system and vasopressin and suggesting that the sympathetic nervous system and/or other factors might be involved.     

Anger, disability, and demands in the family

Parents' tendency to perceive children with behavior problems as "disabled" frequently represents a projection of helplessness, and can be interpreted as a defense against anger. Shared family presumptions regarding the disabling effects of "anger" may lead to revision of behavioral goals or preclude adoption of effective problem-solving tactics. Implications for therapy are offered.     

创伤后应激障碍与抑郁症患者对小剂量地塞米松抑制试验的反应

目的 通过小剂量的地塞米松抑制试验来比较抑郁症与创伤后应激障碍（PTSD）患者的垂体-肾上腺轴功能.方法 采用酶联免疫吸附法（ELISA）测定30例抑郁症和PTSD 患者的血浆中皮质醇、促肾上腺皮质激素基线水平,并行小剂量地塞米松（0.35 mg）抑制试验后再测定两组血浆的皮质醇、促肾上腺皮质激素水平.结果 抑郁症和PTSD 患者的的血浆皮质醇、促肾上腺皮质激素（ACTH）基线水平的差异无统计学意义（P＞0.05）;PTSD 患者对小剂量地塞米松抑制试验与抑郁症组比较,表现为皮质醇和ACTH的降低,即呈现超敏反应（P〈0.05）.结论 PTSD 患者对小剂量地塞米松抑制试验呈现超敏现象,这恰恰为该类PTSD 患者存在持久亢进的垂体-肾上腺轴功能的假说提供了证据.     

Anger assessment and reactivity to stress

This study compared a questionnaire method to an interview method of anger assessment in predicting reactivity to a stressor and explored possible associations between anger expression and reactivity to a stressor. Blood pressure, heart rate and plasma catecholamines were measured in 40 normotensive subjects before and after a 5 min mental arithmetic task. The questionnaire and interview anger scores were related (p = 0.03). Anger expressed outward was associated with lower heart rate (p = 0.005) and norepinephrine (p = 0.01) reactivity to the stressor. The results suggest that self report questionnaires may be a reliable and inexpensive way to evaluate anger in the context of reactivity to stressors and that anger expression, particularly anger expressed outward, may be related to decreased heart rate and norepinephrine reactivity. The relationship between anger expression and reactivity to stressors may provide insight into the mechanisms linking anger, blood pressure and incidence of cardiovascular disease.     

Salivary Cortisol and Cold Pain Sensitivity in Female Twins

Background

There is a dearth of knowledge about the link between cortisol and pain sensitivity.

Purpose

We examined the association of salivary cortisol with indices of cold pain sensitivity in 198 female twins and explored the role of familial confounding.

Methods

Three-day saliva samples were collected for cortisol levels and a cold pressor test was used to collect pain ratings and time to threshold and tolerance. Linear regression modeling with generalized estimating equations examined the overall and within-pair associations.

Results

Lower diurnal variation of cortisol was associated with higher pain ratings at threshold (p?=?0.02) and tolerance (p?<?0.01). The relationship of diurnal variation with pain ratings at threshold and tolerance was minimally influenced by familial factors (i.e., genetics and common environment).

Conclusions

Understanding the genetic and non-genetic mechanisms underlying the link between HPA axis dysregulation and pain sensitivity may help to prevent chronic pain development and maintenance.