Affective Subscale Research Articles

A longitudinal examination of the measurement properties and predictive utility of the Center for Epidemiologic Studies Depression Scale among North American Indigenous adolescents.

We examined the longitudinal measurement properties and predictive utility of the Center for Epidemiologic Studies Depression Scale (CES-D) from early to late adolescence among a sample of North American Indigenous youths. Participants were 632 North American Indigenous adolescents (n = 632; 50.3% girls; M age at baseline = 11.11 years) participating in an 8-year, 8-wave longitudinal study. Via in-person interviews, participants completed the CES-D at Waves 1, 3, 5, and 7, and the major depressive disorder (MDD) module of the Diagnostic Interview Schedule for Children at Waves 1, 4, 6, and 8. Confirmatory factor analyses indicated that responses to the CES-D were similarly explained by 2-, 3-, and 4-factor models, as well as a 1-factor model with correlations between the error variances for the positively worded items. Longitudinal measurement equivalence analyses indicated full structural (i.e., factor structure), metric (i.e., factor loadings), and scalar (i.e., observed item intercepts) equivalence for each factor structure. Substantive analyses showed that the CES-D was significantly associated with MDD both concurrently and prospectively, although these effects were smaller than might be expected. Finally, the CES-D negative affect and somatic complaints subscales were the strongest and most consistent predictors of MDD. Among our sample of North American Indigenous youths, the measurement properties of the CES-D were stable from early to late adolescence. Moreover, somatic difficulties and depressed affect were the strongest predictors of MDD.

The Relationship Between Religious Commitment with Meta-Cognitive Skills and Philosophical Mindedness of the Graduate Students of Kerman City Universities in the Academic Year 2011–2012

Religious commitment is one of the many factors that affect individual's characteristics, including perceptions affections, emotions, interpersonal relationships, and aspirations. The purpose of the present study was to examine for the possible relationship between religious commitment with meta-cognitive skills and philosophical mindedness among the graduate students. The target population was graduate students of Kerman universities during the academic year 2011-2012. The sample includes 394 graduate students who were selected using stratified random sampling with proportional allocation. Standardized questionnaires were employed and completed by the individuals to measure religious commitment (with subscales of religious commitment, duality, and non-commitment), meta-cognitive skills (with the Cognitive and Affective Subscales), and philosophical mindedness (with subscales of comprehensiveness, penetration, and flexibility). According to the most important findings of the study, there was a significant relationship between subscale of religious commitment and both the subscales and the total score of metacognition. In addition, there was significant relationship between both the subscale of religious commitment and its total score with the subscales and the total score of philosophical mindedness. Moreover, there was significant and negative relationship between the subscale of religious duality with the subscales and the total score of philosophical mindedness. Finally, multiple linear regression analysis showed that religious commitment subscale was the significant predictor of Cognitive and Affective Subscale of meta-cognitive skills and its total score. The subscale of duality was also the most important and significant predicators of the subscales and total score of philosophical mindedness.

Distinct associations of insula and cingulate volume with the cognitive and affective dimensions of alexithymia

Alexithymia (“no words for feelings”) is a major risk factor for psychosomatic and psychiatric conditions characterized by affect dysregulation. The alexithymia personality construct comprises an affective dimension, the level of subjective emotional experience (emotionalizing and fantasizing), and a cognitive dimension, referring to the cognitive control of emotions (identifying, analyzing, and verbalizing feelings). These two dimensions may differentially put individuals at risk for psychopathology, but their specific neural bases have rarely been investigated. Therefore, the aim of the present study was to find out whether the two alexithymia dimensions are associated with discriminable neural correlates. By means of voxel-based morphometry (VBM), differences in gray matter volumes were compared between 20 (10 male) high-scorers and 20 (9 male) low-scorers on the Toronto Alexithymia Scale (TAS-20), reflecting the cognitive alexithymia dimension. In a subset of 32 subjects, the impact of the affective alexithymia dimension was tested in addition, as assessed with the affective subscale of the Bermond–Vorst Alexithymia Questionnaire (BVAQ). Analysis 1 (cognitive alexithymia dimension) revealed significantly larger gray matter volumes in the right posterior insula in high-scorers compared to low-scorers on the TAS-20. Analysis 2 (affective alexithymia dimension) revealed that the affective alexithymia dimension, specifically the emotionalizing factor indicative of low emotional reactivity, was associated with larger gray matter volumes of the right cingulate cortex. These results suggest that the two alexithymia dimensions are associated with distinct structural correlates.

Association of Obesity and Eating in the Absence of Hunger Among College Students in a Mexican-USA Border City

Few studies have examined disinhibited eating behaviors in Mexico. However eating in the absence of hunger (EAH), defined as eating in response to the presence of palatable foods in the absence of physiological hunger, is one of the more frequently examined behaviors. The purpose of this study was to assess the association between obesity and EAH among college students in a large Mexican-USA border city. Two-hundred and one sophomore college students completed the EAH questionnaire (EAH-C). Weight and height were measured. To assess reproducibility a test-retest was conducted in a subset sample (n = 20). Test-retest correlations ranged from ρ = 0.44 to 0.86, p < 0.01. Data obtained from the EAH-C were subjected to a principal components analysis with a varimax rotation. The mean age of participants was 21.0 ± 2.0 years, 52 % were female. The prevalence of overweight and obesity was 29 and 14 % respectively. The internal validity was assessed by Cronbach's alph. Internal consistency for all subscales was: external eating (α = 0.83), negative affect (α = 0.92) and fatigue/boredom (α = 0.86). Principal component analysis generated four subscales for the EAH-C: external eating, negative affect, fatigue and boredom. Comparing normal weight students versus obese students, normal weight students (57.1%) had higher scores on boredom subscale than obese students (p < 0.008). Female students had higher scores in the negative affect subscale than the males (p < 0.001). We conclude that the EAH-C had internal consistent subscales with good convergent validity. In this study population we found no association between EAH and obesity.

Affective temperaments and antidepressant response in the clinical management of mood disorders

BackgroundThe aim of this study was to investigate the presence of a relationship between affective temperament and antidepressant treatment response in mood disorder patients. MethodsThe lifetime history of antidepressant response of 90 bipolar disorder patients and 88 major depressive disorder patients were retrospectively evaluated and then assigned to one of four subgroups: complete response (CR), partial response (PR), no response (NR), and antidepressant associated mania response (AAMR). Using TEMPS-Rio de Janeiro – the brief Brazilian version of TEMPS-A – we compared affective temperament subscale scores across these groups. ResultsWe observed a statistically significant relationship between depressive and anxious affective temperaments and no antidepressant response. In bipolar disorder patients, cyclothymic temperament (p<0.01) and hyperthymic temperament (p<0.05) were associated with antidepressant-associated mania. Hyperthymic temperament was associated with complete antidepressant responses in major depressive disorder patients. LimitationsThe evaluation of antidepressant response was retrospective. ConclusionsOur data are consistent with the theory that affective temperament traits are factors that can influence the antidepressant response and the recovery from depressive episodes, but more longitudinal studies are needed to confirm this theory and our findings.

Confirmatory factor analysis and measurement invariance by gender, age and levels of psychological distress of the short TEMPS-A

BackgroundThe Temperament Evaluation of Memphis, Pisa, Paris and San Diego – Autoquestionnaire (TEMPS-A) is a widely used self-reported tool aimed at measuring the affective temperaments that define the bipolar spectrum, with cyclothymic, depressive, irritable, hyperthymic, and anxious subscales. Confirmatory factor analysis (CFA) was rarely used to confirm the expected five-factor model. Measurement invariance was never tested. MethodsCross-sectional, survey design involving 649 Italian college students (males: 47%). The short 39-item TEMPS-A and the 12-item General Health Questionnaire (GHQ-12) were used as measures of the affective temperaments and of psychological distress, respectively. CFA was applied to the TEMPS-A. Measurement invariance by gender, age and levels of psychological distress on the GHQ-12 was calculated with the establishment of subsequent equivalence constraints in the model parameters across groups. ResultsThe expected five-factor model had the best fit for all CFA indexes. Configural, metric and scalar invariance of the five-factor model of the TEMPS-A was proved across gender, age and levels of psychological distress of the participants. The hyperthymic temperament subscale has low or no links with the other affective temperament subscales, which were interrelated with medium to large effect sizes. LimitationsCollege students might be not representative of the general population. No information on the clinical status of the students was available beyond self-report data. ConclusionThe study proved the measurement invariance of the (short) TEMPS-A, which is a pre-requisite to compare groups or individuals in cross-sectional and longitudinal surveys. Generalizability cannot be assumed without replication of the findings in clinical samples.

Family environment in adolescent trichotillomania

We examined family environment variables and parenting stress in a cohort of adolescents with trichotillomania (TTM; N=49), their parents (N=55) and matched control adolescents (N=23) and their parents (N=23). TTM youth vs. controls endorsed significantly more expression of anger, aggression and conflict in their families and less family support on the Family Relationship Index (FRI) of the Family Environment Scale (FES). Pulling distress but not severity was correlated with these variables. Greater pulling severity, distress or both were correlated with impairment on the cohesion subscale of the FES and the task accomplishment and affective expression subscales of the Family Assessment Measure (FAM). Mothers of TTM youth vs. controls endorsed more anxiety, depression and anger, plus more total parenting stress and problems in their offspring on the Stress Index for Parents of Adolescents (SIPA). On the FES, mothers of TTM youth vs. controls reported less emphasis on intellectual and cultural orientation and less organization in the family. TTM youth and their mothers were discordant in their ratings of several family environment variables. These findings warrant further study and merit attention when designing treatment interventions for adolescents with TTM.

Positive Affect and Survival in Patients With Stable Coronary Heart Disease

Positive affect can improve survival, but the mechanisms responsible for this association are unknown. We sought to evaluate the association between positive affect and mortality in patients with stable coronary heart disease and to determine biological and behavioral factors that might explain this association. The Heart and Soul Study is a prospective cohort study of 1,018 outpatients with stable coronary heart disease. Participants were recruited between September 11, 2000, and December 20, 2002, and were followed up to June 2011. Baseline positive affect was assessed by using the 10-item positive affect subscale of the Positive and Negative Affect Schedule. Cox proportional hazards regression was used to estimate the risk of mortality (primary outcome measure) and cardiovascular events (heart failure, myocardial infarction, stroke, transient ischemic attack) associated with positive affect, adjusting for baseline cardiac disease severity and depression. We also evaluated the extent to which these associations were explained by potential biological and behavioral mediators. A total of 369 patients (36%) died during a mean ± SD follow-up period of 7.1 ± 2.5 years. Positive affect was not significantly associated with cardiovascular events (hazard ratio [HR]: 0.89; 95% CI, 0.79-1.00; P = .06). However, each standard deviation (8.8-point) increase in positive affect score was associated with a 16% decreased risk of all-cause mortality (HR: 0.84; 95% CI, 0.76-0.92; P = .001). After adjustment for cardiac disease severity and depressive symptoms, positive affect remained significantly associated with improved survival (HR: 0.87; 95% CI, 0.78-0.97; P = .01). The association was no longer significant after adjustment for behavioral factors, and particularly physical activity (HR: 0.92; 95% CI, 0.82-1.03; P = .16). Further adjustment for C-reactive protein and omega-3 fatty acids did not result in any meaningful changes (HR: 0.94; 95% CI, 0.84-1.06; P = .31). In this sample of outpatients with coronary heart disease, positive affect was associated with improved survival. This association was largely explained by physical activity.

Nonverbal expressive behaviour in schizophrenia and social phobia

Expressive behaviour plays a crucial role in the success of social interactions. Abnormality of expressive behaviour has been reported in interpersonal interactions of patients suffering from schizophrenia and social phobia, two debilitating mental disorders with important social deficits. However, no study has compared the expressive behaviour in these two disorders. Thirty schizophrenia patients, 21 social phobia patients and 30 healthy controls were evaluated and compared on expressive, cognitive and clinical dimensions. Expressive behaviour was assessed using the Motor Affective subscale of the Motor-Affective-Social-Scale (MASS). Covariables include the Positive and Negative Syndrome Scale (PANSS), the anxiety level Liebowitz-Social-Anxiety-Scale (LSAS) and cognitive tasks. After controlling for depression, schizophrenia and social phobia patients both exhibited significantly fewer expressive behaviours compared to healthy controls. Moreover, our results showed specific signatures: schizophrenia patients performed fewer spontaneous gestures (hand gestures and smiles) whereas social phobia patients had an impaired ability to produce voluntary smiles in comparison to healthy controls. Interestingly, poor social functioning was significantly correlated with a decrease of expressive behaviour for schizophrenia patients. Expressive behaviour is impaired in different ways in social phobia and schizophrenia and is associated in schizophrenia with poorer social functioning. The Motor Affective subscale of the MASS is an interesting tool for assessing the dysfunction of interpersonal expressive behaviour in mental disorders.

Intergenerational Support and the Emotional Well-being of Older Jews and Arabs in Israel.

This investigation examined the cultural context of intergenerational support among older Jewish and Arab parents living in Israel. The authors hypothesized that support from adult children would be more positively consequential for the psychological well-being of Arab parents than of Jewish parents. The data derived from 375 adults age 65 and older living in Israel. Psychological well-being was measured with positive and negative affect subscales of the Positive and Negative Affect Schedule. Overall, positive affect was highest when filial expectations for support were congruent with whether or not instrumental support was received. Findings by cultural background revealed that, among older Jews, receiving instrumental support raised positive affect and stronger filial expectations lowered it. Among older Arabs, receiving financial support raised positive affect and receiving instrumental support lowered it. Culture appears to serve as a potent force in determining which types of intergenerational support functions are expected and accepted means of serving the everyday needs of older parents.

Perceived breathlessness and psychological distress among patients with chronic obstructive pulmonary disease and their spouses

The purpose of this study was to describe the impact of breathlessness on Jordanian patients with chronic obstructive pulmonary disease (COPD) and their spouses' perception of the patients' breathlessness. A cross-sectional, descriptive, correlational design was used with a sample of 67 Jordanian patients with COPD related breathlessness and their spouses. The Dyspnoea 12 Scale (D-12) and Hospital Anxiety and Depression Scale (HADS) were administered to both patients and spouses. There was a significant positive correlation between total patients' D-12 scores and total HADS scores. Spouses who perceived the patients to have more severe breathlessness affect (D-12 affect subscale) were more likely to experience a higher level of psychological distress (HADS total). Both patients and spouses reported clinically significant levels of anxiety and depression. There was no statistical difference in total D-12 and HADS scores between COPD patients and their spouses. The finding of this study indicates the importance of healthcare providers in supporting both patients with breathlessness and their spouses and the need to develop family-centred services.

Designing an Energy Literacy Questionnaire for Middle and High School Youth

A measurement scale has been developed to assess secondary students’ energy literacy—a citizenship understanding of energy that includes cognitive as well as affective and behavioral items. Instrument development procedures followed psychometric principles from educational and social psychology research. Initial exploration of the measure yielded promising results: internal consistencies for the cognitive, affective, and behavioral subscales, measured by Cronbach's α, ranged from 0.75 to 0.83; average discrimination indices ranged from 0.27 to 0.46. The instrument's validity was supported with contrasted-groups and developmental-age progression comparisons, as well as factor analyses. The energy literacy questionnaire provides an opportunity to measure baseline levels of energy literacy and to assess broader impacts of educational interventions.

Symptoms of Depression and Smoking Behaviors Following Treatment with Transdermal Nicotine Patch

Subscales from the Center for Epidemiologic Studies Depression Scale (CESD), assessed prior to treatment, were examined as predictors of withdrawal, craving, and affect during the first week of abstinence, as well as smoking abstinence during the first week of abstinence and at the end of treatment. The negative affect and somatic features CESD subscales were related to higher levels of nicotine withdrawal. The relationship between the interpersonal disturbance CESD subscale and nicotine withdrawal approached significance. This study suggests the need to examine novel psychological mechanisms that may account for the relationship between depression symptoms and smoking cessation.

Deficient fear conditioning in psychopathy as a function of interpersonal and affective disturbances.

The diminished fear reactivity is one of the most valid physiological findings in psychopathy research. In a fear conditioning paradigm, with faces as conditioned stimulus (CS) and electric shock as unconditioned stimulus (US), we investigated a sample of 14 high psychopathic violent offenders. Event related potentials, skin conductance responses (SCR) as well as subjective ratings of the CSs were collected. This study assessed to which extent the different facets of the psychopathy construct contribute to the fear conditioning deficits observed in psychopaths. Participants with high scores on the affective facet subscale of the Psychopathy Checklist-Revised (PCL-R) showed weaker conditioned fear responses and lower N100 amplitudes compared to low scorers. In contrast, high scorers on the affective facet rated the CS+ (paired) more negatively than low scorers regarding the CS− (unpaired). Regarding the P300, high scores on the interpersonal facet were associated with increased amplitudes to the CS+ compared to the CS−, while the opposed pattern was found for the antisocial facet. Both, the initial and terminal contingent negative variation indicated a divergent pattern: participants with pronounced interpersonal deficits, showed increased cortical negativity to the CS+ compared to the CS−, whereas a reversed CS+/CS− differentiation was found in offenders scoring high on the antisocial facet. The present study revealed that deficient fear conditioning in psychopathy was most pronounced in offenders with high scores on the affective facet. Event related potentials suggest that participants with distinct interpersonal deficits showed increased information processing, whereas the antisocial facet was linked to decreased attention and interest to the CS+. These data indicate that an approach to the facets of psychopathy can help to resolve ambiguous findings in psychopathy research and enables a more precise and useful description of this disorder.

88. Psychological resilience is associated with markers of inflammation and angiogenesis in pre-surgical ovarian cancer patients

Although psychological distress has been linked to biological processes that may promote ovarian cancer, little is known about the role that psychological resilience plays in this context. To address this issue, we examined how scores on a multi-faceted index of psychological resilience related to biomarkers of inflammation (interleukin-6; IL-6) and angiogenesis (vascular endothelial growth factor; VEGF) in a sample of 200 ovarian cancer patients assessed prior to diagnostic surgery. Using confirmatory factor analysis, a psychological resilience factor with the best fit was determined (Chi-square = 7.28, p = .20; RMSEA = 0.05; CFI = 0.99; TLI = 0.98). Factors included in the measurement model as indicators of resilience include psychological well-being (Psychological Well-Being Scales), positive affect (CESD-D positive affect subscale), and the spiritual, emotional, and functional well-being subscales of the Functional Assessment of Cancer Therapy scale. This psychological resilience index was then used in a structural equation model with IL-6 and VEGF regressed on the latent variable, controlling for cancer stage and grade, age, BMI, and fatigue. Greater psychological resilience was significantly associated with lower levels of IL-6 (beta = −0.20, SE=.09, p = 0.026) but was unrelated to levels of VEGF (beta = −0.11, SE=.09, p = .241). This suggests that protective psychological factors may be linked to inflammatory biology in ovarian cancer. Additional research is needed to examine how psychological risk and resilience factors interact to predict clinical outcomes in ovarian cancer patients.

Does the third culture kid experience predict levels of prejudice?

The study sought to explore whether levels of exposure (as measured by number of years spent abroad and number of countries lived in) predicted levels of prejudice (as measured by the Quick Discrimination Index and the Social Dominance Orientation Scale) in Adult Third Culture Kids (ATCKs), as well as whether there was a significant difference in levels of prejudice between American ATCKs and non-American ATCKs.One hundred and ninety-six ATCKs completed a web-based survey including measures of discrimination and social dominance, as well as demographic information. Only number of countries lived in significantly predicted scores on the Affective subscale of the Quick Discrimination Index (QDI). American ATCKs reported significantly higher levels of prejudice than non-American ATCKs on the Cognitive subscale of the QDI and the Social Dominance Orientation scale (SDO).

Diagnostic utility of the Structured Inventory of Malingered Symptomatology for identifying psychogenic non-epileptic events

The Structured Interview of Malingered Symptomatology (SIMS) is a self-report instrument that asks patients whether they experience atypical or implausible symptoms. The instrument has not been evaluated in an epilepsy population, and the potential for it to accurately distinguish between patients with psychogenic non-epileptic events (PNEE) and epileptic event groups has not been established. The SIMS was administered to patients in long-term video-EEG monitoring of these patients, 91 with PNEE and 29 with epilepsy were included in this study. Structured Interview of Malingered Symptomatology total scores as well as neurological and affective subscales were found to be predictors of group membership. Sensitivity and specificity across several different base rates of PNEE as well as maximum level likelihood ratios are presented. The findings not only demonstrate the utility of marked score elevations in differentiating PNEE from epilepsy but also point to considerable caution in interpreting mild elevations. Implications for the utility of this instrument in epilepsy evaluations are discussed.

Long-term impact of intrauterine fetal death on quality of life and depression: a case–control study

BackgroundIntrauterine fetal death (IUFD) is a serious incidence that has been shown to impact mothers’ psychological well-being in the short-term. Long-term quality of life (QOL) and depression after IUFD is not known. This study aimed to determine the association between intrauterine fetal death and long-term QOL, well-being, and depression.MethodsAnalyses were performed on collected data among 106 women with a history of intrauterine fetal death (IUFD) and 262 women with live births, 5–18 years after the event. Univariable and multivariable linear and logistic regression models were used to quantify the association between previous fetal death and long-term QOL, well-being and depression. QOL was assessed using the QOL Index (QLI), symptoms of depression using the Center for Epidemiological Studies Depression Scale (CES-D), and subjective well-being using the General Health Questionnaire 20 (GHQ-20).ResultsMore of the cases had characteristics associated with lower socioeconomic status and did not rate their health as good as did the controls. The QLI health and functioning subscale score was slightly but significantly lower in the cases than in the controls (22.3. vs 23.5, P = .023). The CES-D depressed affect subscale score (2.0 vs 1.0, P = 0.004) and the CES-D global score (7.4 vs 5.0, P = .017) were higher in the cases. Subjective well-being did not differ between groups (20.6 vs 19.4, P = .094). After adjusting for demographic and health-related variables, IUFD was not associated with global QOL (P = .674), subjective well-being (P = .700), or global depression score (adjusted odds ratio = 0.77, 95% confidence interval 0.37–1.57).ConclusionsWomen with previous IUFD, of which the majority have received short-term interventions, share the same level of long-term QOL, well-being and global depression as women with live births only, when adjusted for possible confounders.Trial registrationThe study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.

The effects of group reminiscence therapy on depression, self-esteem, and affect balance of Chinese community-dwelling elderly

ObjectivesTo study the effects of group reminiscence therapy on depressive symptoms, self-esteem, and affect balance among community dwelling elderly. MethodsEight communities were randomly selected from 372 eligible communities in Changsha city. They were randomly divided into four experimental groups and four control group. Geriatric Depression Scale (GDS) was used to screen entire 478 older adults living in these 8 communities. One hundred and sixty five of them had a GDS score between 11 and 25; among them, 125 participated in the study finally. The elderly group who were in the control group received health education, while the intervention group received both health education and group reminiscence therapy for 6 weeks. Both groups were assessed with the GDS, Self-Esteem Scale (SES), and Affect Balance Scale (ABS) before and after the 6-week-intervention. The results were analyzed using a mixed effect model with fixed effect of the intervention and random effect of the community, incorporating the structured randomness at the community level. ResultsAfter 6 weeks’ therapy, the GDS scores in the intervention group decreased significantly compared to those in the control group (p<0.001). Scores on the positive affect subscale and affect balance in the intervention group increased significantly higher than control group, and scores on the negative affect subscale decreased significantly lower than control group (p<0.01). After the intervention, there were no statistically significant differences in self-esteem scores between intervention and control groups. ConclusionsGroup reminiscence therapy was effective in reducing symptoms of depression, improving affect balance, and promoting mental health of community-dwelling elderly.

Neuroimaging in Exercise Sciences

It is world knowledge that regular physical exercise increases physical fitness and reduces general health risk factors like overweight or hypertension. There is emerging evidence that regular physical exercise does also have profound effects on the brain: It affects many aspects of the brain like increasing perfusion or inducing hippocampal growth. Neurogenesis is stimulated as well as angiogenesis and increased synaptic plasticity is observed. Up to date, most data are mainly supported by animal models but human data become more and more available. There is also emerging evidence that exercise has an positive effect on pain processing: One can find anecdotal reports that runners continue to run despite stress fractures, angina and or sever blisters. But there is also experimental evidence, that athletes have increased pain thresholds and show reduced responses to noxious stimuli. Indirect measures such as raised endorphin levels in peripheral blood and cerebrospinal fluid as well as the reversibility of exercise-induced mood changes and pain perception effects by naloxone (unspecific opioid receptor antagonist) presented strong arguments for an opioidergic involvement in exercise („endorphin hypothesis”). This was also supported lately by showing opioidergic activation effects in fronto-limbic brain regions after sustained physical exercise. Based on this work and assuming central opioidergic mechanisms, we examined in an fMRI-study the effect of a two hours outdoor RUN, as compared to a control condition (two hours outdoor WALK) on pain processing in 20 right-handed male athletes (age 39.0±9.2 years, average training distance: 59.3±29.2km/week). Physical exercise was expected to affect pain processing on the behavioural and the systemic (activation) level. On the behavioural level we found a significant time x treatment interaction of the euphoria ratings, and a post-hoc significant reduction of the McGill affective subscale in the post-run condition. All other measures (including pain and sensory thresholds) were not affected. The peripheral blood endorphin levels were drastically elevated after the RUN-condition and the fMRI-analysis revealed a reduced time x treatment interaction in the antinociceptive pathway (rACC, PAG) and reduced functional connectivity of the PAG (trend). These findings suggest, that the brain seems to be in a less pain sensitive state after exercise and, therefore, the necessity to recruit the descending pain network is reduced. In conclusion, the demonstration of elevated beta-endorphin levels in plasma (RIA), the specific effect on the affective dimension of pain, and the loco-regional convergence with previous ligand PET and naloxone pharma-fMRI studies suggest an underlying opioidergic effect promoted by exercise.