Pain and suicidality: Insights from reward and addiction neuroscience
Section snippets
Neurobiology of pain
Illness is the doctor to whom we pay most heed; to kindness, to knowledge, we make promise only; pain we obey.
Marcel Proust. Remembrance of Things Past (1922)
The neurobiology of pain has been reviewed in detail elsewhere (Costigan et al., 2009, von Hehn et al., 2012) and some elements are briefly presented here. Acute painful sensation signals real or perceived tissue damage from environmental hazards. Chronic pain usually arises from neuropathic (damage to the peripheral or central nervous
The opponent process
There is no love which is not pain
There is no love which does not bruise
There is no love which does not wither
Louis Aragon. There is no happy love (1946)
A great truth is a truth whose opposite is also a truth.
Thomas Mann. Essay on Freud (1929)
The valence-based approach/avoidance dichotomy does not seem to be universal, however, as some painful (Nixon et al., 2008) and/or aversive (Sapolsky, 1998, Selye, 1976) stimuli may be perceived as desirable (i.e., rewarding and reinforcing) across various
Therapeutic considerations
But he who is joined with all the living has hope, for a living dog is better than a dead lion. For the living know that they will die, but the dead know nothing, and they have no more reward, for the memory of them is forgotten. Their love and their hate and their envy have already perished, and forever they have no more share in all that is done under the sun.
Ecclesiastes. The English Standard Version Bible (1971)
Suicide- and pain neuropsychopathologies are indisputably enormous entities with
Summary and conclusions
Any knowledge that doesn’t lead to new questions quickly dies out: it fails to maintain the temperature required for sustaining life.
Wislawa Szymborska. Nobel Lecture (1996)
Suicide is a question occupying human mind since the dawn of history and its ethical, philosophical, logical or even clinical legitimacy is certainly far from been addressed by the present paper. A compilation of balanced views on this conundrum is presented in the middle column of Table 4.
Pain patients are vulnerable for
Acknowledgments
The authors gratefully acknowledge Ms. Adriana Johnson for her help with the preparation of the manuscript and support from the Mayday Fund/Herlands Fund for Pain Systems Neuroscience Research (DB).
This study was supported with resources and the use of facilities at the Providence VA Medical Center. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.
References (465)
- et al.
Lithium attenuates methamphetamine-induced hyperlocomotion and behavioral sensitization via modulation of prefrontal monoamine release
Neuropharmacology
(2012) - et al.
The role of the habenular complex in the elevation of dorsal raphe nucleus serotonin and the changes in the behavioral responses produced by uncontrollable stress
Brain Res.
(2001) - et al.
Clarifying the role of emotion dysregulation in the interpersonal-psychological theory of suicidal behavior in an undergraduate sample
J. Psychiatr. Res.
(2011) - et al.
Examining the role of emotion in suicidality: negative urgency as an amplifier of the relationship between components of the interpersonal-psychological theory of suicidal behavior and lifetime number of suicide attempts
J. Affect. Disord.
(2011) - et al.
Pain and the brain: specificity and plasticity of the brain in clinical chronic pain
Pain
(2011) - et al.
Elevated CSF CRF in suicide victims
Biol. Psychiatry
(1989) - et al.
Catecholamine influences on prefrontal cortical function: relevance to treatment of attention deficit/hyperactivity disorder and related disorders
Pharmacol. Biochem. Behav.
(2011) - et al.
Predicting value of pain and analgesia: nucleus accumbens response to noxious stimuli changes in the presence of chronic pain
Neuron
(2010) Pharmacokinetics and temperature
J. Pharm. Sci.
(1974)- et al.
Dissociable neural representations of future reward magnitude and delay during temporal discounting
Neuroimage
(2009)
Lithium attenuates pain-related behavior in a rat model of neuropathic pain: possible involvement of opioid system
Pharmacol. Biochem. Behav.
Signal valence in the nucleus accumbens to pain onset and offset
Eur. J. Pain
Cerebral interactions of pain and reward and their relevance for chronic pain
Neurosci. Lett.
Incubation of cue-induced cigarette craving during abstinence in human smokers
Biol. Psychiatry
Impulsivity and suicidality: the mediating role of painful and provocative experiences
J. Affect. Disord.
Pleasures of the brain
Brain Cogn.
Motivation concepts in behavioral neuroscience
Physiol. Behav.
Neuroscience of affect: brain mechanisms of pleasure and displeasure
Curr. Opin. Neurobiol.
Parsing reward
Trends Neurosci.
Reward-aversion circuitry in analgesia and pain: implications for psychiatric disorders
Eur. J. Pain
Pain and analgesia: the value of salience circuits
Prog. Neurobiol.
Neurobiology of relapse to heroin and cocaine seeking: an update and clinical implications
Eur. J. Pharmacol.
In vivo neurochemical effects of tail pinch
J. Neurosci. Methods
Blockade of CRF1 receptors in the central nucleus of the amygdala attenuates the dysphoria associated with nicotine withdrawal in rats
Pharmacol. Biochem. Behav.
Biological substrates of reward and aversion: a nucleus accumbens activity hypothesis
Neuropharmacology
Self-stimulation of an ‘aversive’ brain structure: the mesencephalic central gray area
Brain Res.
Blockade of kappa opioid receptors attenuates the development of depressive-like behaviors induced by cocaine withdrawal in rats
Neuropharmacology
A longitudinal study of pain and pain catastrophizing in a cohort of National Guard troops at risk for PTSD
Pain
Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence
Pain
Reward deficiency syndrome: genetic aspects of behavioral disorders
Prog. Brain Res.
Major increases in opioid analgesic abuse in the United States: concerns and strategies
Drug Alcohol Depend.
Effects of day-to-day affect regulation on the pain experience of patients with rheumatoid arthritis
Pain
The prevalence of pain complaints in a general population
Pain
Stress, genes and the biology of suicidal behavior
Psychiatr. Clin. N. Am.
Dopamine and monogamy
Brain Res.
Understanding fear of pain in chronic pain: interoceptive fear conditioning as a novel approach
Eur. J. Pain
Structural and functional neuroimaging studies of the suicidal brain
Prog. Neuropsychopharmacol. Biol. Psychiatry
Dopamine and drug addiction: the nucleus accumbens shell connection
Neuropharmacology
Suicide attempts in veterans with bipolar disorder during treatment with lithium, divalproex, and atypical antipsychotics
J. Affect. Disord.
Chronic pain leads to concomitant noradrenergic impairment and mood disorders
Biol. Psychiatry
A comparative analysis of completed suicide using high resolution brain SPECT imaging
J. Neuropsychiatry Clin. Neurosci.
Sex and emotion in the acquired capability for suicide
Arch. Suicide Res.
Human brain imaging studies of chronic pain: translational opportunities
On the Art of Poetry.
Rhetoric.
Understanding Physics
Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art
Depress. Anxiety
Brain mediators of predictive cue effects on perceived pain
J. Neurosci.
Behavior simultaneously maintained by both presentation and termination of noxious stimuli
J. Exp. Anal. Behav.
Braking dopamine systems: a new GABA master structure for mesolimbic and nigrostriatal functions
J. Neurosci.
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The authors equally contributed to this work.