title: Anger management style and endogenous opioid function: is gender a moderator?
abstract: This study explored possible gender moderation of previously reported associations between elevated trait anger-out and reduced endogenous opioid analgesia. One hundred forty-five healthy participants underwent acute electrocutaneous pain stimulation after placebo and oral opioid blockade in separate sessions. Blockade effects were derived reflecting changes in pain responses induced by opioid blockade. Hierarchical regressions revealed that elevated anger-out was associated with smaller pain threshold blockade effects (less opioid analgesia) in females, with opposite findings in males (interaction p < .001). Similar marginally significant interactions were noted for blockade effects derived for nociceptive flexion reflex threshold, pain tolerance, and pain ratings (p < .10). Anger-in was also associated negatively with pain threshold blockade effects in females but not males (interaction p < .05). Across genders, elevated anger-in was related to smaller pain tolerance blockade effects (p < .01). Overlap with negative affect did not account for these opioid effects. The anger-in/opioid association was partially due to overlap with anger-out, but the converse was not true. These findings provide additional evidence of an association between trait anger-out and endogenous opioid analgesia, but further suggest that gender may moderate these effects. In contrast to past work, anger-in was related to reduced opioid analgesia, although overlap with anger-out may contribute to this finding.
authors.affiliation: Department of Anesthesiology, Vanderbilt University Medical Center, 701 Medical Arts Building, 1211 Twenty-First Avenue South, Nashville, TN 37212, USA. Stephen.Bruehl@vanderbilt.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Bruehl
authors.forename: Mustafa
authors.initials: M
authors.lastname: al'Absi
authors.forename: Christopher R
authors.initials: CR
authors.lastname: France
authors.forename: Janis
authors.initials: J
authors.lastname: France
authors.forename: Angie
authors.initials: A
authors.lastname: Harju
authors.forename: John W
authors.initials: JW
authors.lastname: Burns
authors.forename: Ok Y
authors.initials: OY
authors.lastname: Chung
mesh_terms: D000328:Adult; D000786:Anger / Q000502:physiology*; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D009271:Naltrexone / Q000494:pharmacology*; D009292:Narcotic Antagonists / Q000494:pharmacology*; D009619:Nociceptors / Q000187:drug effects / Q000502:physiology; D018847:Opioid Peptides / Q000502:physiology*; D017288:Pain Threshold / Q000187:drug effects* / Q000502:physiology; D012737:Sex Factors; D012867:Skin / Q000294:innervation; D013223:Statistics as Topic
chemical_list: D009292:Narcotic Antagonists; D018847:Opioid Peptides; D009271:Naltrexone