tag:blogger.com,1999:blog-21605329.post7286580250417767589..comments2024-03-14T23:52:09.893-07:00Comments on The Neurocritic: Suffering from the pain of social rejection? Feel better with TYLENOL®The Neurocritichttp://www.blogger.com/profile/08010555869208208621noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-21605329.post-61952554237232866202010-07-27T00:44:01.414-07:002010-07-27T00:44:01.414-07:00Thanks for providing a link to this new article, w...Thanks for providing a link to this new article, which is challenging indeed to the notion of a "Pain Matrix".The Neurocritichttps://www.blogger.com/profile/08010555869208208621noreply@blogger.comtag:blogger.com,1999:blog-21605329.post-53591637754076423222010-07-25T23:44:36.210-07:002010-07-25T23:44:36.210-07:00The hypothesis that "social pain" is exp...The hypothesis that "social pain" is experienced through a "mirror activation" of the so-called "pain matrix" is based on a very strong assumption: that this so-called "pain matrix" is actually pain-specific...<br /><br />See "From the neuromatrix to the pain matrix, and back" (Mouraux & Iannetti 2010 EBR) for a critical review of the specificity of the brain regions "responding to pain".<br /><br />http://www.ncbi.nlm.nih.gov/pubmed/20607220Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-21605329.post-46577298828971294162010-07-02T02:41:41.410-07:002010-07-02T02:41:41.410-07:00The mechanism of action of paracetamol is interest...The mechanism of action of paracetamol is interesting because it's <a href="http://en.wikipedia.org/wiki/AM404" rel="nofollow">metabolized into AM404</a> which modulates the endocannabinoid system.<br /><br />I don't know how important that is in the real world analgesic effects, but it does suggest it at least might have central properties.<br /><br />Also, that could cause its mechanism of action to be longer than the 4 hrs would suggest...<br /><br />But this Gulf Atlantic Funding Group is rather mysterious.Neuroskeptichttps://www.blogger.com/profile/06647064768789308157noreply@blogger.comtag:blogger.com,1999:blog-21605329.post-89098883921731827212010-06-30T21:34:00.317-07:002010-06-30T21:34:00.317-07:00It is possible that when people report things like...It is possible that when people report things like "loneliness" and "emotional pain", they're reporting a very general negative affective state, which could be caused in part by cumulative aches and pains. Also, it's known that negative affect can cause a greater sensitivity to normal, marginally painful sensation. Maybe provoking loneliness for 10 days increased people's sensitivity to their normal, slightly painful sensations, and then paracetamol helped this, which improved their mood over the people who didn't get the drug.<br /><br />Sorry, I didn't have time to hunt for the paper, just my thoughts based on your post.Mike Mikehttps://www.blogger.com/profile/07650701412022872445noreply@blogger.comtag:blogger.com,1999:blog-21605329.post-60427828805450475022010-06-30T09:04:19.048-07:002010-06-30T09:04:19.048-07:00Regardless of the weakness of individual papers in...Regardless of the weakness of individual papers in their statistical analyses (which I am unqualified to judge) the overlap between the affective component of physical pain and the suffering of emotional pain in the dorsal anterior cingulate is well-replicated. Here's another reference:<br />Marco L. Loggia, Jeffrey S. Mogil, Catherine Bushnell<br />Empathy hurts: Compassion for another increases both sensory<br />and affective components of pain perception Pain 136 (2008) 168–176<br />Thus, any analgesic that works centrally is likely affect both physical and emotional pain. Obviously, Tylenol doesn't have as big an impact as morphine, which is why this interesting but minor fact has escaped people's attention.Rick Hellerhttp://thenewhumanism.orgnoreply@blogger.comtag:blogger.com,1999:blog-21605329.post-64542729567116446992010-06-29T05:09:34.009-07:002010-06-29T05:09:34.009-07:00It's possible that if tylenol has a delayed ef...It's possible that if tylenol has a delayed effect that numbs emotional pain, it wouldn't be noticed and picked up by addicts. If it was associable within hours of taking the drug, however, reduced social pain is something people notice profoundly and addicts seek intentionally.<br /><br />This is a primary effect of SSRI's: and to those who are oversensitive to rejection and otherwise socially sensitive, lifting that is an amazing relief. This is why SSRI's help in cases of addiction driven by depression that is primarily about social fears.<br /><br />SSRI's aren't "addictive" in the sense of causing compulsive use despite negative consequences (the DSM addiction definition, basically) however because they take weeks to take effect-- so you don't connect the drug and the effect. If there was an instant SSRI, I'd bet money it would soon be classified as a controlled substance.Maia Szalavitzhttps://www.blogger.com/profile/09374512270335764119noreply@blogger.comtag:blogger.com,1999:blog-21605329.post-28914871348837056952010-06-28T17:21:06.175-07:002010-06-28T17:21:06.175-07:00I'd consider it important if acetaminophen tur...I'd consider it important if acetaminophen turned out to have any detectable effect on social pain at all. This would demonstrate a linkage between two systems that was not previously established, and open the door to many important research questions (and potentially to the development of more targeted drugs that would be practically useful). <br /><br />I actually don't know whether to assume that people should have already noticed any psychoactive effects of acetaminophen. I can't think of any other drugs that have psychological effects with no subjective physical, emotional, or cognitive effects (all it does is _stop_ something from happening). That could mean that: 1) drugs like that don't exist, or they're very rare, or 2) there are others; we're just not very good at noticing them.<br /><br /><br />I don't think tolerance is a good explanation for the loneliness / pain findings -- the study induced acute loneliness, rather than studying people who'd had a chance to get used to it. The authors do go into some detail regarding their hypothesis that loneliness activates a regulatory system that reduces all kinds of pain, in the same way that an injury to one part of your body could lead to an opioid response that dulls pain in other parts of your body as well. They highlighted the fact that the differences caused by the loneliness induction looked more like reduced sensitivity or numbness, rather than like increased executive control (which I imagine is what the original poster was thinking about when expressing skepticism that one kind of pain would increase tolerance for another kind). <br /><br />Any vagueness here is primarily my fault -- my neuropsych is weak, but the article goes into a fair bit of detail.Michael Cohnhttps://www.blogger.com/profile/16939466411432555103noreply@blogger.comtag:blogger.com,1999:blog-21605329.post-62439931264046920882010-06-28T16:58:38.555-07:002010-06-28T16:58:38.555-07:00Hmm. As an aside, here's another puzzling obse...Hmm. As an aside, here's another puzzling observation. If it's been claimed that "social exclusion hurts" (Macdonald & Leary, 2005), then why does the experience of social exclusion result in higher tolerance for physical pain and higher pain thresholds (DeWall & Baumeister, 2006)? <br />**************<br /><br />The same reason experiencing physical pain does: tolerance. If you experience pain over long periods of time, you get better able to manage it (unless you sensitize and develop a chronic pain disorder). <br /><br />This study would have made sense if they used opioids, which are known to reduce the emotional aspect of physical pain. There's also a high concentration of opioid receptors in the cingulate. Of course, the result wouldn't have been novel or surprising: junkies wouldn't exist if opioids didn't kill emotional pain.<br /><br />Indeed, if acetaminophen could numb emotional pain, this would have been discovered by addicts by now. The fact that the drug remains boringly OTC suggests that this effect is either so small it can only be detected in the lab or nonexistent as the blog suggests.Maia Szalavitzhttps://www.blogger.com/profile/09374512270335764119noreply@blogger.comtag:blogger.com,1999:blog-21605329.post-83101598022128142762010-06-26T19:24:48.274-07:002010-06-26T19:24:48.274-07:00(sorry to multi-post, but it looks like blogger wa...(sorry to multi-post, but it looks like blogger was rejecting excessively long comments.) <br /><br />Regarding the details of informed consent: Psychological Science is a short-report format journal. If you page through an issue, I doubt you will find any articles that devote more than half a sentence to informed consent procedures. Part of the review process for journal publication is affirming that your study was approved by an accepted IRB. As for your question about whether there was oversight by a physician, there may well have been. It's pretty common for pharmaceutical studies to be required to have a medical professional physically present or available on call. Also, I think that warnings about consulting a doctor before prolonged medication use are in large part concerned with making sure the medication isn't masking a more serious problem (e.g., someone using acetaminophen to try and treat pain that's being caused by a serious infection). <br /><br />If you think that the authors may have skipped some aspect of human subjects approval, or written their consent information in a way that misrepresented the risks of acetaminophen, you can probably FOIA their original consent forms (since it's federally funded research) and ruin their careers. NIH takes this kind of thing seriously. <br /><br />The risk of liver damage from acetaminophen use was probably not very high. Acute toxicity requires a dose of ~10,000mg, or ~6,000 per day for several days. A large <a href="http://www.atypon-link.com/PPI/doi/abs/10.1592/phco.27.9.1219" rel="nofollow">meta-analysis</a> found no evidence of acute liver failure or of substantial liver damage in prospective studies with healthy subjects and controlled dosing. Some of these studies used a daily dose of 4,000mg, four times higher than that used in this study. That said, I do hope that the authors screened for known, suspected, or elevated risk of liver damage while recruiting -- it would have been phenomenally stupid not to.Michael Cohnhttps://www.blogger.com/profile/16939466411432555103noreply@blogger.comtag:blogger.com,1999:blog-21605329.post-16677133900065524072010-06-26T19:24:48.273-07:002010-06-26T19:24:48.273-07:00Regarding the use of acetaminophen rather than oth...Regarding the use of acetaminophen rather than other drugs: Naproxen, ibuprofen, and all other over-the-counter pain relievers are non-steroidal anti-inflammatories (NSAIDs), which work by reducing inflammation, which is often a cause of pain. Acetaminophen is an analine analgesic, the only one currently in use. In addition to having some NSAID-like anti-inflammatory properties, It actually reduces the subjective experience of pain, probably via activity at anadamide receptors. The pain in social rejection studies is not hypothesized to result from peripheral inflammation, so one would predict that even if acetaminophen works, other pain relievers would not. <br /><br />I actually don't find the hypothesis that outrageous. It's pretty common for evolution to piggyback new capacities on older ones, as in the case of moral disgust that looks a lot like physical disgust, or adult attachment showing many similarities to one's infant attachment. Why not check to see if various painful emotions respond to pain-relieving drugs? (and acetaminophen is the only good choice here, since showing that morphine reduced social pain wouldn't exactly surprise anyone).Michael Cohnhttps://www.blogger.com/profile/16939466411432555103noreply@blogger.com