La gestion des émotions et ses déficits,chez les personnes atteintes de douleur chronique : une revue systématisée des études relatives à l’alexithymie, à l’intelligence émotionnelle, à la régulation émotionnelle et au coping

The goal of this review is to synthesize the data of scientific literature on emotional management and its deficits in chronic pain. We used terms referenced in databases and MesH terms (of the United States National Library of Medicine) to perform a literature search in a powerful online search engine (EBSCOhost research databases). Four hundred and forty-nine papers, taken from international reviews and published of 1994 (because it is in the middle of the 1990s that this theme begins to be handle) to the end of January, 2015, are identified by a total 5 electronic databases with predefined keywords about emotions and chronic pain. Forty-six of which met the inclusion criteria, according to their title, their summary and their complete text. The findings suggest that some emotional management strategies and its deficits can maintain a vicious circle of negative emotional states with physiological and psychopathological consequences. Several studies show that alexithymia, emotional ambivalence and emotional suppression have a deleterious impact on pain, emotional distress (depression, anxiety) and disability. In spite of some contradictions concerning the nature of this effect (sensory or affective pain intensity or even duration of pain), it seems that alexithymia is a major variable implied in chronic pain. Inversely, experiential acceptance has a beneficial effect on psychological distress (depression, anxiety and stress). Emotional disclosure (of stressful or traumatic events) can decrease pain intensity but not disability and mental health. Likewise, emotional expression in daily life seems beneficial, but when the expression of the positive and negative feelings are distinguished, emotional expression of negative feelings increases pain, disability and distress. The whole of these findings emphasize the need to further research about emotional management in chronic non-cancer pain. It is necessary to identify and control the source of potential bias. Some hypotheses have been proposed to explain these findings. In the future, it would be interesting to use a multifactorial approach to investigate the interactions between various processes of emotional management in chronic pain patients.     

Schmerz ist nicht gleich Schmerz

Pain is an emotional state that is inextricably linked to the mental state and sociocultural background of the person experiencing the pain. The basis of our current understanding of the pain are the bio-psycho-social model and knowledge regarding complex physiological and pathophysiological mechanisms. Nociceptive pain is caused by a painful stimulus; upon activation of peripheral nociceptors, signals are sent to the brain for processing. It has a protective function because it leads to reflexes or behavior-based reactions to minimize damage to tissue. Neuropathic pain is—apart from a few exceptions—a chronic, non-malignant pain condition that is caused by diseases of the central and peripheral nervous system. In contrast to acute pain, the causes of chronic pain are usually not known and remain even when no tissue damage is present.     

Emotion and Pain: A Functional Cerebral Systems Integration

Emotion and pain are psychological constructs that have received extensive attention in neuropsychological research. However, neuropsychological models of emotional processing have made more progress in describing how brain regions interact to process emotion. Theories of emotional processing can describe inter-hemispheric and intra-hemispheric interactions during emotional processing. Due to similarities between emotion and pain, it is thought that emotional models can be applied to pain. The following review examines the neuropsychology of emotion and pain using a functional cerebral systems approach. Specific comparisons are made between pain and anger. Attention is given to differences in cerebral function and physiology that may contribute to the processing of emotion and pain. Suggestions for future research in emotion and pain are given.     

The affective politics of policy making spaces: Gendered and racial embodiments of neoliberal deservingness and power in a city council meeting

Bringing together feminist works on affect, neoliberalism, and the racial dimensions of dependency discourse, this paper discusses affective politics in policy making spaces by examining a Durham (North Carolina, USA) City Council meeting. We focus on a 2017 Housing Needs Hearing where bodily gestures and speech acts were crucial parts of emotional interactions that defined, maintained, and challenged subject positions and power structures. We argue that embedded within legacies of racial and gender inequality, neoliberal sensibilities work through embodied emotional performances that impact policy conversations. Our analysis reveals how, despite progressive aspirations and accomplishments in Durham, the meeting's extractive set up perpetuates inequities by positioning those seeking assistance to prove their worth through a contradictory performance of desperation and self-actualization while enabling supporters of housing affordability, including city officials, to adopt the role of caring advocates. We find that a performance of pain and the rhetorical proof of self-responsibility opens up potential access to affordable housing and in doing so reveals both the limits and impact of a broken housing system. We thus extend analysis of the neoliberal condition of US housing inequality by deepening understanding of how neoliberal deservingness is embodied and shapes racialized, classed, and gendered subject positions.     

A passion of the soul: an introduction to pain for consciousness researchers

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self.     

Anger management style and emotional reactivity to noxious stimuli among chronic pain patients and healthy controls: the role of endogenous opioids.

OBJECTIVE: Previous work suggests that elevated trait anger-out exacerbates pain responses in part through endogenous opioid dysfunction. The authors examined whether this opioid dysfunction affects not only perceived pain intensity, but also emotional responses to being hurt. DESIGN: 79 chronic low back pain (LBP) patients and 46 healthy controls received opioid blockade (8 mg naloxone i.v.) and placebo in randomized, counterbalanced order in separate sessions. During each session, participants sequentially experienced finger pressure pain and ischemic forearm pain tasks, with emotional state assessed at baseline and postpain. MAIN OUTCOME MEASURES: Blockade effects indexing opioid modulation of emotional reactivity were derived by subtracting placebo from blockade condition emotional reactivity. RESULTS: Significant Participant Type x Anger-Out interactions on blockade effects indicated that in LBP participants but not in controls, greater anger-out was associated with deficient opioid modulation of anxiety, anger, and fear reactivity to noxious stimulation. Across participant types, greater anger-in was associated with impaired opioid modulation of anxiety and fear reactivity. Anger-in opioid effects were partially due to overlap with general negative affect. CONCLUSIONS: Opioid dysfunction associated with trait anger-out may affect not only perceived pain intensity, but also pain-related suffering in individuals with chronic pain conditions. Implications for understanding the health effects of anger management styles are discussed.     

Integrating Pain Management in Clinical Practice

There is much evidence to suggest that psychological and social issues are predictive of pain severity, emotional distress, work disability, and response to medical treatments among persons with chronic pain. Psychologists can play an important role in the identification of psychological and social dysfunction and in matching personal characteristics to effective interventions as part of a multidisciplinary approach to pain management, leading to a greater likelihood of treatment success. The assessment of different domains using semi-structured clinical interviews and standardized self-report measures permits identification of somatosensory, emotional, cognitive, behavioral and social issues in order to facilitate treatment planning. In this paper, we briefly describe measures to assess constructs related to pain and intervention strategies for the behavioral treatment of chronic pain and discuss related psychiatric and substance abuse issues. Finally, we offer a future look at the role of integrating pain management in clinical practice in the psychological assessment and treatment for persons with chronic pain.     

Invited Special Review: Psychological Approaches for Managing Chronic Pain

Psychologists have had an important impact on the conceptualization, assessment, and treatment of chronic pain. Their contributions have been in the areas of emotional distress, behavioral limitations, cognitive mediating events, and psychosocial disruption of chronic pain. These foci have enabled them to clarify the multidimensional nature of chronic pain and to support the biopsychosocial framework as a conceptual guide for research and clinical purposes. Clinically, along with members of an interdisciplinary team, psychologists have a key role in the assessment and treatment of patients with chronic pain. Interdisciplinary collaboration allows the team to recognize important interactions between biomedical and psychosocial dimensions and to appreciate a broader conceptualization of patients' problems. The literature documents strong empirical support for operant-behavioral and cognitive-behavioral therapies for the treatment of chronic pain. On the other hand, although widely accepted from a clinical perspective, the use of motivational interviewing and motivational enhancement therapies is more recent and less well documented for use with patients with chronic pain.     

情绪劳动：表层动作与深层动作，哪一种效果更好？

情绪劳动（表层动作和深层动作）,哪一种情绪劳动的效果更积极？该项研究结合“情绪调节”和“双任务”的实验范式,以指导语引起不同的情绪劳动,以电影片段诱发负情绪（以悲伤为主）,同时测量情绪劳动过程情绪的变化,并通过数学成绩和自我真实感检测情绪劳动对后续工作和心理上的作用。结果表明：（1）操作表层动作与深层动作都具有一定的难度,需要付出一定的努力;且深层动作引起更多的精力集中;（2）表层动作和深层动作都可以减弱已被诱发的悲伤情绪,深层动作引起了更大的生理激活（R-R间期增加较小）;（3）表层动作导致后续工作成绩降低,自我真实感减弱。结论：如果需要在负情绪（悲伤）状态下展现正情绪（微笑）,深层动作是更积极的情绪劳动方式     

I suffer more from your pain when you act like me: Being imitated enhances affective responses to seeing someone else in pain

Social–psychological research has suggested that being imitated changes the way that we experience others: We like someone who imitates us more, and the interaction with this person runs more smoothly. Whether being imitated also affects basic social reactions, such as empathy for pain, is an open question. Empathy for pain refers to the observation that perceiving another person in pain results in pain-related brain activation in the observer. The aim of the present study was to combine the two lines of research, to investigate whether being imitated can influence empathy for pain. To this end, we developed an experimental approach combining an imitation task with a pain perception task. Subjective reports, as well as physiological responses, indicated that being imitated enhances affective responses to seeing someone else in pain. Furthermore, using rubber hand illusion measures, we provided evidence for the role of shared representations in the sensory and motor domains as a core underlying mechanism. In this way, our study integrated social–psychological research on being imitated with cognitive research on empathy for pain. This has broad implications, since imitation plays a crucial role in our daily social interactions, and our study provides insights into a basic cognitive mechanism that might underlie these social situations.     

Hormonal contraception usage is associated with altered memory for an emotional story

Substantial evidence now documents sex-related influences on the neurobiology of emotional memory. Robust sex influences exist, for example, on the amygdala’s role in emotional memory formation, as well as on retention of central information (gist) and detail for an emotional event. Evidence also suggests that the well-documented effects of stress hormones on memory depend upon sex hormone levels. Since hormonal contraception alters sex hormone levels, and must by extension alter sex/stress hormone interactions in memory, we examined whether the use of hormonal contraception also alters memory for an emotional story. Two groups of healthy female subjects—one naturally cycling, one using hormonal contraception—viewed either a brief, emotionally arousing story, or a closely matched, but more emotionally neutral story. Each subject’s eye movements and pupil dilation changes were recorded as they viewed the story. Additionally, saliva samples were taken throughout the experimental session to examine salivary alpha-amylase, a biomarker for norepinephrine. A surprise free recall test one week later measured story memory in all subjects. Naturally cycling women exhibited enhanced memory of story details, but not of central information (gist), in the emotional compared with neutral story conditions. In contrast, women using hormonal contraception exhibited enhanced memory of gist, but not story details, in the emotional compared with neutral story conditions. Analysis of eye movements made while watching the stories indicated that the differences in memory could not be attributed either to a differential attention focus or to the degree of arousal induced by the stories in the two groups. These findings suggest that the use of hormonal contraception alters memory for an emotional event, perhaps by altering sex/stress hormone interactions in memory formation. They also suggest that further investigation of the mnemonic effects of these very widely used treatments is warranted.     

Biopsychology research in China

The early studies on biopsychology in China were classified under the name of physiological psychology and comparative psychology. In 1979 the Division of Physiological Psychology of the Chinese Psychological Society was founded. Fifteen years later, the Brain‐Behavior Research Center was founded at the Institute of Psychology, Chinese Academy of Sciences. The objective of the Center was to establish a multidisciplinary scientific environment for conducting experimental research on the relationship between brain and behaviour as well as the interactions of the mind and body. A wide range of studies in biopsychology has been conducted in China. The most major research areas are: (1) Behavioural and physiological studies of stress: Research work includes the effect of early environment on stressful responses, interactions of behavioural and endocrine responses under stress, effects of emotional stress on immune function, stress and hypertension and the related role of interleukin‐1. (2) Conditioning and immunity: Studies focus on the effects of conditioning in the modulation of bidirectional immune function. Data from different experiments demonstrate that psychological processes are capable of influencing immune function. The neural substrates are also explored. (3) Memory and learning: Studies mostly concentrate on types of memory formation and training stimulus, effect of light exposure and corticosterone on learning and memory, and the role of the hippocampus in learning and memory. (4) Drug addiction: Work mainly focuses on long‐term aspects of addiction, including memory, novelty seeking, motivation‐related models, and the brain mechanisms underlying morphine psychological dependence.     

Frontal Lobe Function and Pain in the Elderly

We review the literature on pain and aging and conclude that evidence supports a hypothesis that right frontal cortex contributes to the mediation of the chronic pain experience in elderly persons with chronic pain syndromes. Evidence for the right frontal pain hypothesis comes from clinical, neurocognitive, and neuroimaging studies, which implicate right inferior and orbitofrontal cortex in (1) the persistent pain experience, (2) negative emotional states, (3) retrieval of negative emotional and autobiographical memories, (4) regulation of autonomic arousal, and (5) regulation of attentional and pain functions of the anterior cingulate region. Right frontal dysfunction is also implicated in the effects of cognitive aging. If right frontal neurocognitive systems are affected in cognitively impaired elderly, and if (by hypothesis) the right frontal cortex also plays a major role in the experience of chronic pain, then cognitively impaired elderly with right frontal dysfunction should be protected to some extent from persistent pain syndromes. Available evidence supports this proposition.     

Visual attention and emotional memory: recall of aversive pictures is partially mediated by concurrent task performance

The emotional enhancement of memory is often thought to be determined by attention. However, recent evidence using divided attention paradigms suggests that attention does not play a significant role in the formation of memories for aversive pictures. We report a study that investigated this question using a paradigm in which participants had to encode lists of randomly intermixed negative and neutral pictures under conditions of full attention and divided attention followed by a free recall test. Attention was divided by a highly demanding concurrent task tapping visual processing resources. Results showed that the advantage in recall for aversive pictures was still present in the DA condition. However, mediation analyses also revealed that concurrent task performance significantly mediated the emotional enhancement of memory under divided attention. This finding suggests that visual attentional processes play a significant role in the formation of emotional memories.     

Psychosexual Dysfunction Among Gynecological Cancer Survivors

The purpose of this paper is to summarize the empirical findings related to the assessment and treatment of sexual difficulties commonly experienced by gynecological cancer survivors and to make suggestions for future research and practice in this area. First, we describe the sexual problems that are most frequently reported by gynecological cancer patients and some of their common medical and psychological correlates. These include pain, premature ovarian failure, changes in vaginal anatomy, emotional distress, body image, and sexual self-concept. The complex interaction of physiological and psychological variables plays an important role in the development of sexual dysfunction in this patient population. Furthermore, we review the empirical studies that have examined the effects of sexual rehabilitation therapy on the sexual functioning of gynecological cancer survivors and provide relevant research and clinical recommendations. We also discuss reasons to involve patients' sexual partners in psychosocial oncology research, given the complex interplay between patients' and partners' psychosexual issues.     

On the primacy of the brain

It is well established that emotion is a product of complex interactions among the biological subsystems of the organism. The human nervous system must play a fundamental role in organizing and controlling the manifestation of these interactions. Since emotional disturbance is one of the major phenomena underlying maladaptive behavior, a solid understanding of its nature and mechanisms is essential for enhancing therapeutic practices. Although an increasing number of scholars now advocate the notion of the dependence of emotion on antecedent cognitive processes (e.g., Lazarus, 1982, 1984), and the relevance of both central and peripheral processes of the nervous system to emotional behavior (e.g., Panksepp, 1988; Pribram, 1984), Zajonc (1984) views emotion as independent of cognitive processes. This paper provides a critical evaluation of the basis of Zajonc’s (1984) argument from a neurobiological and psychotherapeutic point of view.     

疼痛恐惧的神经机制及其消退

疼痛恐惧是疼痛基础和临床研究中的一个重要课题。个体对疼痛信息产生过度警觉,诱发不恰当的回避行为,扰乱机体的正常功能,加剧疼痛的现象即为疼痛恐惧。疼痛恐惧可影响个体的疼痛感知以及疼痛相关的注意和回避行为,且在慢性疼痛(如慢性肌骨骼疼痛)的发展、维持个体正常生理功能的丧失中起着重要作用。疼痛恐惧的形成与表达涉及杏仁核、海马、背侧前扣带回皮层、和前额叶皮层等脑区的参与。当前的疼痛恐惧消退的心理-行为干预方法可在疼痛恐惧加工的不同阶段(巩固、再巩固和消退)消退个体的疼痛恐惧。然而,由于恐惧记忆形成过程较为复杂并受多种因素影响,疼痛恐惧记忆消退方法效果较不稳定,其基础研究与临床应用之间仍存在较大的鸿沟。将来研究有必要考虑到疼痛恐惧形成环境的差异以及个体人格特质/心理状态的差异,逐步完善相关消退方法并将其引入临床镇痛,以期帮助患者弱化、擦除甚至改写困扰他们的疼痛恐惧,从而缓解甚至消除病患的疼痛。     

On the primacy of the brain

It is well established that emotion is a product of complex interactions among the biological subsystems of the organism. The human nervous system must play a fundamental role in organizing and controlling the manifestation of these interactions. Since emotional disturbance is one of the major phenomena underlying maladaptive behavior, a solid understanding of its nature and mechanisms is essential for enhancing therapeutic practices. Although an increasing number of scholars now advocate the notion of the dependence of emotion on antecedent cognitive processes (e.g., Lazarus, 1982, 1984), and the relevance of both central and peripheral processes of the nervous system to emotional behavior (e.g., Panksepp, 1988; Pribram, 1984), Zajonc (1984) views emotion as independent of cognitive processes. This paper provides a critical evaluation of the basis of Zajonc’s (1984) argument from a neurobiological and psychotherapeutic point of view.     

The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning

Anxiety about pain is increasingly recognized as one factor contributing to increased pain perception and pain behavior [McCracken, L. M., Faber S. D., & Janeck A. S. (1998) Pain-related anxiety predicts nonspecific physical complaints in persons with chronic pain. Behavior Research and Therapy, 36, 621-630; McCracken L., & Gross R. (1995). The pain anxiety symptoms scale (PASS) and the assessment of emotional responses to pain. Innovations in clinical practice: a source book, 14, 309-321]. To assess this emotional reaction to pain in chronic pain patients, McCracken, Zayfert and Gross [McCracken, L., Zayfert, C., & Gross, R. (1992). The Pain Anxiety Symptom Scale: development and validation of a scale to measure fear of pain. Pain, 50, 67-73] developed the Pain Anxiety Symptom Scale (PASS) composed of four subscales: Cognitive Anxiety, Fearful Appraisal, Escape Avoidance and Physiological Anxiety. The present study extended previous work by examining the relationship among pain anxiety dimensions, use of active and passive coping strategies and arthritis self-efficacy as predictors of functional status in 154 rheumatoid arthritis (RA) patients. Functional status was assessed using the Five-Factor Model of the Arthritis Impact Scale, 2nd ed., (AIMS2): Physical Functioning, Affective Experience, Symptoms, Social Interaction and Role Function. Hierarchical multiple regression analysis on each of the AIMS2 criterion variables showed that pain anxiety, pain and symptom self-efficacy, health status and coping strategies were able to explain between 9 and 38% of the variance in the five AIMS2 variables. The present results support the hypothesized role of pain anxiety along with previously established contributions of self-efficacy and coping strategies, in affecting physical, social, emotional and role functioning in chronic RA patients.     

Emotion Control Values and Responding to an Anger Provocation inAsian-American and European-American Individuals

The present research examined whether Asian-American (AA) versus European-American (EA) women differed in experiential, expressive, or autonomic physiological responding to a laboratory anger provocation and assessed the mediating role of values about emotional control. Results indicate that AA participants reported and behaviorally displayed less anger than EA participants, while there were no group differences in physiological responses. Observed differences in emotional responses were partially mediated by emotion control values, suggesting a potential mechanism for effects of cultural background on anger responding.