Burns John W, Bruehl Stephen, Chont Melissa
Department of Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Chicago, IL, 60612, USA,
J Behav Med. 2014 Aug;37(4):642-53. doi: 10.1007/s10865-013-9511-z. Epub 2013 Apr 28.
Findings suggest that greater tendency to express anger is associated with greater sensitivity to acute pain via endogenous opioid system dysfunction, but past studies have not addressed the role of anger arousal. We used a 2 × 2 factorial design with Drug Condition (placebo or opioid blockade with naltrexone) crossed with Task Order (anger-induction/pain-induction or pain-induction/anger-induction), and with continuous Anger-out Subscale scores. Drug × Task Order × Anger-out Subscale interactions were tested for pain intensity during a 4-min ischemic pain task performed by 146 healthy people. A significant Drug × Task Order × Anger-out Subscale interaction was dissected to reveal different patterns of pain intensity changes during the pain task for high anger-out participants who underwent pain-induction prior to anger-induction compared to those high in anger-out in the opposite order. Namely, when angered prior to pain, high anger-out participants appeared to exhibit low pain intensity under placebo that was not shown by high anger-out participants who received naltrexone. Results hint that people with a pronounced tendency to express anger may suffer from inadequate opioid function under simple pain-induction, but may experience analgesic benefit to some extent from the opioid triggering properties of strong anger arousal.
研究结果表明，通过内源性阿片系统功能障碍，更高的愤怒表达倾向与对急性疼痛的更高敏感性相关，但过去的研究尚未探讨愤怒唤起的作用。我们采用了2×2析因设计，药物条件（安慰剂或用纳曲酮进行阿片类药物阻断）与任务顺序（愤怒诱导/疼痛诱导或疼痛诱导/愤怒诱导）交叉，并结合持续的愤怒外显子量表得分。对146名健康人在4分钟缺血性疼痛任务期间的疼痛强度进行了药物×任务顺序×愤怒外显子量表交互作用测试。对显著的药物×任务顺序×愤怒外显子量表交互作用进行剖析，以揭示与以相反顺序处于高愤怒外显状态的参与者相比，在愤怒诱导前接受疼痛诱导的高愤怒外显参与者在疼痛任务期间疼痛强度变化的不同模式。也就是说，在疼痛前被激怒时，高愤怒外显参与者在安慰剂作用下似乎表现出低疼痛强度，而接受纳曲酮的高愤怒外显参与者则未表现出这种情况。结果提示，有明显愤怒表达倾向的人在简单疼痛诱导下可能存在阿片类药物功能不足的情况，但强烈的愤怒唤起的阿片类药物触发特性可能会在一定程度上使他们获得镇痛益处。
