Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., North Chicago, IL, USA Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Pain. 2009 Dec;146(3):276-282. doi: 10.1016/j.pain.2009.07.024. Epub 2009 Aug 13.
Evidence suggests that anger and pain are related, yet it is not clear by what mechanisms anger may influence pain. We have proposed that effects of anger states and traits on pain sensitivity are partly opioid mediated. In this study, we test the extent to which analgesic effects of acute anger arousal on subsequent pain sensitivity are opioid mediated by subjecting healthy participants to anger-induction and pain either under opioid blockade (oral naltrexone) or placebo. Participants were 160 healthy individuals. A double-blind, placebo-controlled, between-subjects opioid blockade design is used, with participants assigned randomly to one of two drug conditions (placebo or naltrexone), and to one of two Task Orders (anger-induction followed by pain or vice versa). Results of ANOVAs show significant Drug Condition x Task Order interactions for sensory pain ratings (MPQ-Sensory) and angry and nervous affect during pain-induction, such that participants who underwent anger-induction prior to pain while under opioid blockade (naltrexone) reported more pain, and anger and nervousness than those who underwent the tasks in the same order, but did so on placebo. Results suggest that for people with intact opioid systems, acute anger arousal may trigger endogenous opioid release that reduces subsequent responsiveness to pain. Conversely, impaired endogenous opioid function, such as that found among some chronic pain patients, may leave certain people without optimal buffering from the otherwise hyperalgesic affects of anger arousal, and so may lead to greater pain and suffering following upsetting or angry events.
有证据表明，愤怒和疼痛是相关的，但愤怒如何影响疼痛的机制尚不清楚。我们提出，愤怒状态和特质对疼痛敏感性的影响部分是由阿片类物质介导的。在这项研究中，我们通过让健康参与者在阿片类物质阻断（口服纳曲酮）或安慰剂的情况下接受愤怒诱导和疼痛，来测试急性愤怒唤醒对随后疼痛敏感性的镇痛作用在多大程度上是由阿片类物质介导的。参与者为 160 名健康个体。采用双盲、安慰剂对照、被试间阿片类物质阻断设计，参与者随机分配到两种药物条件（安慰剂或纳曲酮）和两种任务顺序（愤怒诱导后疼痛或反之亦然）之一。方差分析的结果显示，在感觉疼痛评分（MPQ-感觉）和疼痛诱导期间的愤怒和紧张情绪方面，药物条件与任务顺序之间存在显著的交互作用，即与在阿片类物质阻断（纳曲酮）下进行疼痛前先进行愤怒诱导的参与者相比，那些按照相同顺序但在安慰剂下进行这些任务的参与者报告了更多的疼痛、愤怒和紧张。结果表明，对于阿片类物质系统完整的人来说，急性愤怒唤醒可能会引发内源性阿片类物质释放，从而降低对随后疼痛的反应性。相反，内源性阿片类物质功能受损，如一些慢性疼痛患者中发现的那样，可能会使某些人在愤怒唤醒的痛觉过敏影响下无法得到最佳缓冲，因此在情绪激动或愤怒事件后可能会感到更大的疼痛和痛苦。
