A conceptual framework for the intersection of hyperalgesia and hyperkatifeia in alcohol addiction.

Addiction as a Coping Response: Hyperkatifeia, Deaths of Despair, and COVID-19.

Current theories suggest that social and physical pain overlap in their neurological and physiological outcomes. We investigated how social and physical pain overlap in their psychological responses by testing the hypothesis that both social and physical pain would thwart satisfaction on four human needs, worsen mood, and increase desire to aggress. In Experiment 1, recalling an experience of social or physical pain produced overlapping effects in the form of thwarted self‐esteem and control needs and increased negative affect and desire to aggress. In Experiment 2, we induced social (Cyberball ostracism) or physical pain (cold pressor) within the laboratory session, and found that both pain types produced feelings of being ignored and excluded, and thwarted belonging, self‐esteem, control, and meaningful existence. Our results provide further support to pain overlap theories and indicate that social and physical pain cause common psychological consequences, resulting in new ways to understand and manage pain. Copyright © 2011 John Wiley & Sons, Ltd.

Although social and physical pain recruit overlapping neural activity in regions associated with the affective component of pain, the two pains can diverge in their phenomenology. Most notably, feelings of social pain can be re-experienced or “relived,” even when the painful episode has long passed, whereas feelings of physical pain cannot be easily relived once the painful episode subsides. Here, we observed that reliving social (vs. physical) pain led to greater self-reported re-experienced pain and greater activity in affective pain regions (dorsal anterior cingulate cortex and anterior insula). Moreover, the degree of relived pain correlated positively with affective pain system activity. In contrast, reliving physical (vs. social) pain led to greater activity in the sensory-discriminative pain system (primary and secondary somatosensory cortex and posterior insula), which did not correlate with relived pain. Preferential engagement of these different pain mechanisms may reflect the use of different top-down neurocognitive pathways to elicit the pain. Social pain reliving recruited dorsomedial prefrontal cortex, often associated with mental state processing, which functionally correlated with affective pain system responses. In contrast, physical pain reliving recruited inferior frontal gyrus, known to be involved in body state processing, which functionally correlated with activation in the sensory pain system. These results update the physical-social pain overlap hypothesis: while overlapping mechanisms support live social and physical pain, distinct mechanisms guide internally-generated pain.

A visual analog scale to measure psychological and physical pain: A preliminary validation of the PPP-VAS in two independent samples of depressed patients

Examining emotional pain among individuals with chronic physical pain: Nomothetic and idiographic approaches

Can studies of pain help to bridge the gap between sensory and social impairments in autism?

Abstract. Empathy is known as the ability to share and understand someone else’s feelings. Previous research has either addressed the neural correlates of empathy for pain or social exclusion, but no study has examined empathy for physical and psychological (social) pain simultaneously. Forty-seven participants completed our novel “Social Interaction Empathy Task” during electroencephalogram (EEG) recording. Participants had to observe and rate the intensity of physical and psychological pain in social interactions from a first- and third-person perspective. At the behavioral level, subjects did not differentiate between the perspectives and rated physically painful scenarios as more painful than psychologically painful and neutral interactions. Psychologically painful pictures were also rated as more painful than neutral pictures. Analysis of event-related potentials (ERPs) revealed an early and a late response with a higher ERP response to physical and psychological pain compared to neutral interactions. Moreover, a significant difference emerged between the two dimensions of painful interactions. Furthermore, we found that the activity over frontal regions for discrimination of painful interactions was lateralized to the right hemisphere. Moreover, we detected significant correlations with the self-rated perspective taking ability. This suggests the psychological and physical pain qualities are processed differently but both are related to empathic traits. We further suggest that the right hemisphere may be specifically involved in the processing of empathy-related tasks.

Objective Effective suicide prevention is hindered by a limited understanding of the neurobiology leading to suicide. We aimed to examine the association between changes in the experience of pain and disturbances in sleep quantity and quality in patients with elevated risk for suicide. Methods Three groups of adult depressed individuals, including patients following a recent suicide attempt (n = 79), patients experiencing current suicidal ideation (n = 131), and patients experiencing depression but no suicidal ideation or behavior in at least 6 months (n = 51), were examined in a case-control study for sleep quantity and quality, physical and psychological pain, pressure pain threshold, suicidal ideation, and recent suicidal behavior. Results Sleep quality, physical and psychological pain were positively associated with suicidal ideation severity. In both cases in which sleep quality was added to a model with either physical or psychological pain, physical or psychological pain became more significantly associated with suicidal ideation severity. Pressure pain threshold was elevated in patients suffering from any type of insomnia. There was no significant association between pressure pain threshold and suicidal ideation severity. Conclusions The impact of these findings lies in the identification of both psychological and physical pain, and sleep quality as potential biological mechanisms underlying suicidal risk. HIGHLIGHTS We assessed the association between pain and sleep quality in suicidal patients. Sleep quality, physical and psychological pain were associated with suicide risk. Pain perception may mediate the progression to suicidal behavior.

Accurate pain assessment is essential for effective management; however, most studies have focused on differentiating pain from non-pain or estimating pain intensity rather than distinguishing between distinct pain types. We present a machine learning method for classifying physical and social pain using physiological signals. Seventy-three healthy adults participated in experiments involving baseline, neutral, and pain-inducing stimuli related to both types of pain. Physical pain was elicited by pressure cuff inflation, whereas social pain was induced by watching a video depicting a loved one's death. The electrocardiogram, electrodermal activity, photoplethysmogram, respiration, and finger temperature were recorded, and 12 physiological features were extracted. Three machine learning algorithms-logistic regression, support vector machine, and random forest-were employed to classify the input data into baseline versus painful states and physical versus social pain. Our findings demonstrated high accuracy in identifying social pain (0.82) and physical pain (0.90) compared to the baseline. Classification accuracy between physical and social pain was moderate (0.63) when using painful state data alone but improved to 0.77 when incorporating reactivity from neutral to painful states. This study highlights the potential of multimodal physiological signals for differentiating pain types and enhancing personalized pain management strategies.

Emerging evidence has shown that social pain--the painful feelings that follow from social rejection, exclusion, or loss--relies on some of the same neural regions that process physical pain, highlighting a possible physical-social pain overlap. However, the hypothesis that physical pain and social pain rely on shared neural systems has been contested. This review begins by summarizing research supporting the physical-social pain overlap. Next, three criticisms of this overlap model are presented and addressed by synthesizing available research. These criticisms include the suggestions that (a) neural responses to social pain are indicative of conflict detection processes, rather than distress; (b) all negative affective processes, rather than social pain specifically, activate these pain-related neural regions; and (c) neural responses to social (and physical) pain reflect the processing of salience, rather than hurt. Implications of these findings for understanding social and physical pain are discussed, and key next steps are suggested.

IntroductionBorderline personality manifests in female adolescence and youth by higher frequency of deviant behaviors and suicidal ideations. Psychological models suggests that both perception and relationship to physical pain (Joiner, 2005, O’Connor, Kirtley, 2018, Galynker, 2017) as well as psychological pain (Eisenberger et al., 2003) could increase the risk.ObjectivesThis study concentrates on the relationship between relationship to physical and psychological pain and reported deviant behavior in female adolescents.Methods204 female adolescents (13-21 years old) filled checklist appraising alcohol use, drug use, aggressive behavior, suicidal ideations and emotional difficulties (Cronbach’s alphas .67-.89), Interpersonal Needs Questionnaire (Van Orden et al., 2012), Discomfort Intolerance Scale (Schmidt et al., 2006), The Pain Catastrophizing Scale (Sullivan et al., 1995).ResultsElder females more frequently reported substance use (r=.23-.28) and less frequently aggressive behavior (r=-.19) while suicidal ideations were unrelated to age. Females reporting higher perceived burdensomeness and emotional difficulties also reported higher alcohol use (r=.25-.29), aggressive behavior (r=.37-.42) and suicidal ideations (r=.64-.84). Thwarted belongingness correlated with suicidal ideations (r=.50) and aggressive behavior (r=.26). Higher alcohol use was associated with catastrophizing of pain in the form of magnification and helplessness (r=.17) while suicidal ideations and aggressive behavior were related to ruminations, magnification and helplessness (r=.23-.33). Only correlations between aggression and pain catastrophizing remained significant after statistical control of psychological pain (r=.15-.22).ConclusionsAfter control for psychological pain, only aggressive behavior is related to catastrophizing of physical pain. Study is supported by Russian science Foundation, project 22-28-01524.DisclosureStudy is supported by Russian Science Foundation, project 22-28-01524.

Objective: Psychological pain is a transdiagnostic factor in mental health and a key clinical dimension to understand suicide in patients with mood disorders. However, less is known about the clinical characteristics that predict high psychological pain. The aim of this study was to fill this gap in a sample of patients with mood disorders.Methods: Inpatients admitted for a major depressive episode, according to DSM-IV criteria, from 2010 to 2017 were divided into 3 groups: 178 recent suicide attempters (within the last 7 days), 101 past suicide attempters (lifetime history of suicide attempt), and 93 nonattempters (no lifetime history of suicidal act). At inclusion, current psychopathology, medication, personality traits (impulsivity, anxiety, hopelessness), and childhood trauma were assessed. At inclusion and at 1-year follow-up, depressive symptomatology and current and maximal (within the 15 last days) psychological and physical pain were assessed.Results: At baseline, maximal psychological pain was higher in recent than in past suicide attempters (odds ratio [OR] = 1.18 [1.04-1.35]) and nonattempters (OR = 1.32 [1.16-1.50]). In the multivariate model, depression severity (OR = 1.11 [1.08-1.16]) and worst physical pain (OR = 2.53 [1.28-5.02]) predicted high psychological pain, whereas bipolar disorder (OR = 0.54 [0.29-0.98]) predicted low psychological pain. During the follow-up, the change in maximal psychological pain was predicted by changes in depressive symptomatology (β = 0.46, P < .001) and maximal physical pain (β = 0.42, P < .003). Finally, among depressive symptoms, guilt, lack of initiative, and loss of appetite better explained maximal psychological pain, both at inclusion and at 1 year (all P < .050).Conclusions: Psychological pain is associated with a recent suicidal act and depressive severity. Due to the strong link between psychological pain and physical pain, future studies should investigate whether psychotropic drugs with analgesic effects protect from psychological pain and therefore from suicide.

Although fibromyalgia (FM) has been traditionally defined by the extent of physical pain sites alongside other non-pain symptoms, recent evidence has highlighted the importance of social dimension in definition of pain perception. Social pain or invalidation, which denotes painful feeling following social conflicts or misunderstanding about illness legitimacy, is an important but ignored issue in the FM lexicon. While physical and social pain seem to be different and separate entities, we hypothesize that they are completely intertwined with indistinct borders in FM. Accumulating emergent neuroscience and behavioral evidence highlights the overlapping of physical and social pain in different painful conditions. However, this overlapping seems to reach its maximum in FM. This review sheds more light on the tight interconnectivity between physical and social pain in FM from the perspective of intuitional commonalities, clinical aspects, and shared neural pathways. The conceptualization of FM as an integrative physical-social pain paradigm will move us closer to necessitating the incorporation of social pain in future models of FM diagnosis and management. Key Points • Considering of social pain as one key concept is relatively mute in FM literature. • Overlapping of physical and social pain seems to be unique in FM due to its nature. • Acknowledging social pain in the FM lexicon could shift the paradigm of diagnosis and management of FM patients.

Those who self-harm have been shown to be less sensitive to physical pain, but more sensitive to emotional pain, appearing to contradict social neuroscience research that suggests that individuals who are more sensitive to physical pain are also more sensitive to emotional pain. The current study investigated the relationship between self-reported emotional pain sensitivity and physical pain distress in those who think (ideate) about and engage in (enact) self-harm. A total of 351 healthy adults completed a battery of anonymous online questionnaires assessing emotional sensitivity, physical pain distress and sensitivity, and lifetime history of self-harm, as well as depressive symptoms, self-critical style, perfectionistic cognitions, and perfectionistic self-presentation. Emotional sensitivity and physical pain distress were higher in both the self-harm ideation and enactment groups than in controls and there was a significant ordered effect, such that the enactment group was more sensitive to emotional and physical pain than the ideation group. A similar significant ordered effect in physical pain sensitivity was observed only when controlling for previous suicide attempt. Within the ideation group, physical pain distress and self-critical style were the only factors significantly associated with emotional pain sensitivity, but only the presence of perfectionistic cognitions was significantly associated with emotional pain sensitivity in the enactment group. Taken together, the findings suggest an association between self-perceived emotional sensitivity and physical pain distress in self-harm ideation, but possibly a disconnection between self-perceived and behavioral sensitivity to physical pain in self-harm enactment. Furthermore, self-criticism and perfectionism may be differentially associated with emotional sensitivity in self-harm ideation and enactment.

It is difficult to "prove" pain and suffering-particularly emotional suffering. Neuroimaging technology might bolster pain claims in civil cases by making pain seem less subjective. We examined how neuroimaging of physical and emotional pain influences judgments of pain and suffering across nonlegal and legal contexts. We hypothesized that participants would rate pain assessed using neuroimaging as more severe and award higher compensation than pain assessed using self-report measures. We also hypothesized that participants would rate physical (vs. emotional) pain as more severe, except when the pain claim was bolstered by a neuroimaging assessment. In two experiments, we tested how pain assessment techniques influence perceptions of pain severity and monetary compensation differently for physical or emotional pain. Using a within-subjects design, participants (Experiment 1, N = 411, 59% male, 80% White) read 6 vignettes that described a person's chronic physical or emotional pain, evaluated using a clinical assessment, neuropsychological assessment, or neuroimaging assessment. We conceptually replicated Experiment 1 in a legal context (Experiment 2, N = 353, 42% male; 80% White) and tested whether the neuroimaging effect was due to knowing that the pain was assessed by neuroimaging or also required the inclusion of a neuroimage. When pain was assessed using neuroimaging (vs. non-neuroimaging assessments), participants rated the pain as more severe and gave larger monetary awards. When a person alleged physical (vs. emotional) pain, participants rated the pain as more severe and gave larger monetary awards. We conceptually replicated these findings in Experiment 2 and found that the neuroimaging effect was due to hearing about neuroimaging assessment and did not necessitate the inclusion of a neuroimage. Neuroimaging technology could be extremely useful for plaintiffs trying to overcome the difficult hurdle of proving their pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).