Sticks and Stones: Brain Releases Natural Painkillers During Social Rejection

"Sticks and stones may break my bones, but words will never hurt me," goes the playground rhyme that's supposed to help children endure taunts from classmates. But a new study suggests that there's more going on inside our brains when someone snubs us -- and that the brain may have its own way of easing social pain.

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The findings, recently published in Molecular Psychiatry by a University of Michigan Medical School team, show that the brain's natural painkiller system responds to social rejection -- not just physical injury.

What's more, people who score high on a personality trait called resilience -- the ability to adjust to environmental change -- had the highest amount of natural painkiller activation.

The team, based at U-M's Molecular and Behavioral Neuroscience Institute, used an innovative approach to make its findings. They combined advanced brain scanning that can track chemical release in the brain with a model of social rejection based on online dating. The work was funded by the U-M Depression Center, the Michigan Institute for Clinical and Health Research, the Brain & Behavior Research Foundation, the Phil F Jenkins Foundation, and the National Institutes of Health.

They focused on the mu-opioid receptor system in the brain -- the same system that the team has studied for years in relation to response to physical pain. Over more than a decade, U-M work has shown that when a person feels physical pain, their brains release chemicals called opioids into the space between neurons, dampening pain signals.

David T. Hsu, Ph.D., the lead author of the new paper, says the new research on social rejection grew out of recent studies by others, which suggests that the brain pathways that are activated during physical pain and social pain are similar.

"This is the first study to peer into the human brain to show that the opioid system is activated during social rejection," says Hsu, a research assistant professor of psychiatry. "In general, opioids have been known to be released during social distress and isolation in animals, but where this occurs in the human brain has not been shown until now."

The study involved 18 adults who were asked to view photos and fictitious personal profiles of hundreds of other adults. Each selected some who they might be most interested in romantically -- a setup similar to online dating.

But then, when the participants were lying in a brain imaging machine called a PET scanner, they were informed that the individuals they found attractive and interesting were not interested in them.

Brain scans made during these moments showed opioid release, measured by looking at the availability of mu-opioid receptors on brain cells. The effect was largest in the brain regions called the ventral striatum, amygdala, midline thalamus, and periaqueductal gray -- areas that are also known to be involved in physical pain.

The researchers had actually made sure the participants understood ahead of time that the "dating" profiles were not real, and neither was the "rejection." But nonetheless, the simulated social rejection was enough to cause both an emotional and opioid response.

Suffering slings and arrows differently

Hsu notes that the underlying personality of the participants appeared to play a role in how much of a response their opioid systems made.

"Individuals who scored high for the resiliency trait on a personality questionnaire tended to be capable of more opioid release during social rejection, especially in the amygdala," a region of the brain involved in emotional processing, Hsu says. "This suggests that opioid release in this structure during social rejection may be protective or adaptive."

The more opioid release during social rejection in another brain area called the pregenual cingulate cortex, the less the participants reported being put in a bad mood by the news that they'd been snubbed.

The researchers also examined what happens when the participants were told that someone they'd expressed interest in had expressed interest in them -- social acceptance. In this case, some brain regions also had more opioid release. "The opioid system is known to play a role in both reducing pain and promoting pleasure, and our study shows that it also does this in the social environment," says Hsu.

The new research holds more importance than just pure discovery, note the authors, who also include senior author Jon-KarZubieta, M.D., Ph.D., a longtime opioid researcher. Specifically, they are pursuing further research on how those who are vulnerable to, or currently suffering from depression or social anxiety have an abnormal opioid response to social rejection and/or acceptance. "It is possible that those with depression or social anxiety are less capable of releasing opioids during times of social distress, and therefore do not recover as quickly or fully from a negative social experience. Similarly, these individuals may also have less opioid release during positive social interactions, and therefore may not gain as much from social support," Hsu theorizes.

Hsu also notes that perhaps new opioid medications without addictive potential may be an effective treatment for depression and social anxiety. Although such medications are not yet available, he adds, "increasing evidence for the neural overlap of physical and social pain suggests a significant opportunity to bridge research in the treatment of chronic pain with the treatment of psychiatric disorders."

If nothing else, perhaps knowing that our response to a social snub isn't "all in our heads" can help some people understand their responses and cope better, Hsu says. "The knowledge that there are chemicals in our brains working to help us feel better after being rejected is comforting."

Increased Life Expectancy Among Family Caregivers: Johns Hopkins-led Study

Those who assist a chronically ill or disabled family member enjoy an 18 percent survival advantage compared to statistically matched noncaregivers, suggests results of a Johns Hopkinsled
analysis of data previously gathered on more than 3,000 family caregivers. This contradicts longstanding
conventional wisdom.

In a report, published in the current online version of the American Journal of Epidemiology, researchers found that providing care for a chronically ill or disabled family member not only fails to increase health risk, but also is associated with a ninemonth extension in life expectancy over the sixyear period of the study.

According to the Commission on LongTerm Care, family caregivers — the backbone of America's longterm
care system — provide an estimated $450 billion in care and immeasurable support every year. An aging America means more demand for caregivers who help care for the elderly, but a looming shortage of caregivers could endanger many of the most vulnerable.

"Taking care of a chronically ill person in your family is often associated with stress, and caregiving has been previously linked to increased mortality rates," says first author, David L. Roth, Ph.D., director of the Johns Hopkins University Center on Aging and Health. "Our study provides important new information on the issue of whether informal family caregiving responsibilities are associated with higher or lower mortality rates as suggested by multiple conflicting previous studies."

Roth and his colleagues conducted an analysis of information gathered originally in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. That study, sponsored by the National Institutes of Health (NIH), looked at information from over 30,000 people, aged 45 years or older, to assess the excess stroke risk among AfricanAmericans living in the nation's Southeastern "stroke belt." Dr. Roth's team studied whether 3,503 family caregivers from the REGARDS study showed differences in rates of death from all causes over a sixyear period compared with a matched sample of 3,503 noncaregivers.

The groups were matched using a measure based on 15 common variables that included demographics, health history and health behaviors. According to Roth, theirs is the first study of its kind to show mortality effects for caregivers using this "propensity score matching" approach. "Although our findings are not entirely new, the statistical methods we used were unique and innovative and our large national database, which included a large number of AfricanAmerican caregivers, is what really sets our research apart," he said.

Roth added that analyses of subgroups of caregivers were consistent with the findings for the overall group of caregivers. "We did not find any subgroup of caregivers in the REGARDS sample that appeared to be vulnerable to increased mortality risks. This includes our analyses of all spouse caregivers and of the spouse caregivers who report experiencing some caregiving strain," stated Roth.

"In many cases, caregivers report receiving benefits of enhanced selfesteem, recognition and gratitude from their care recipients. Thus, when caregiving is done willingly, at manageable levels, and with individuals who are capable of expressing gratitude, it is reasonable to expect that health benefits might accrue in those situations," added Roth.

Roth cautioned that his team's analysis had its limitations, and could not rule out the possibility that some subgroups of caregivers might be more vulnerable to increased risk of death. The limitations were mostly due to a lack of information on the functional status of the care recipients and the specifics of the care being provided.

"If highly stressful situations can be avoided or managed effectively, caregiving may actually offer some health benefits for both the care recipients and the caregivers, including reduced risk of death for those providing care," Roth said. "Negative public health and media portrayals of the risk of family caregiving may do a disservice by portraying caregiving as dangerous, and could potentially deter family members from taking on what can be a very satisfying and healthy family role. Public discussions of caregiving should more accurately balance the potential risks and gains of this universal family role."

Roth says future research should examine specific group of caregivers. "We need to research adult children who are providing regular care to a disabled parent, because this group is rapidly growing in size in our population, but largely understudied, at least in comparison to spouses," said Roth.

Source-Eurekalert

Is sitting the new ‘smoking’ even for children?

 Written by  DevdeepAhuja

Sitting in front of your laptop, driving long distances, relaxing in front of a television – the modern lifestyle is geared to promote sitting. "Up until very recently, if you exercised for 60 minutes or more a day, you were considered physically active, case closed," Bur now a consistent body of emerging research suggests it is entirely possible to meet current physical activity guidelines while still being incredibly sedentary, and that sitting increases your risk of death and disease, even if you are getting plenty of physical activity. But is it the same for children as well. We assume children to be running around, playing in the ground and being active most of the time. But the fact is the rise of playstation and other gaming consoles have had children stuck in front of tube for long periods of time. So what impact does sitting have on children? Do the children who remain in seated postures for longer duration tend to have greater musculoskeletal problems?

Brink and Louw (2013) undertook a systematic review to evaluate whether there is an association between sitting and upper quadrant musculoskeletal problems (UQMP) for children and what elements of sitting might be related to UMPQ. The reviewer undertook a search of six electronic databases (BioMed Central, CINAHL, PROQUEST, PUBMED, SCIENCE DIRECT and SCOPUS) for papers published between January 2007 and December 2011. Combinations of the following keywords were used: pain, neck and/or shoulder pain, musculoskeletal pain, upper limb pain, upper extremity pain, posture, sitting posture, children, adolescents, learner and student.

Prospective or cross sectional English languages studies reporting on the sitting of male and female children between the ages of six and 12 years and adolescents between the ages of 13 and 18 years were included in the review. The included studies measured UQMP in terms of the onset, area, frequency, intensity or duration of pain as an outcome measure.

The methodological quality was assessed by one reviewer and audited by another reviewer and differences were settled through discussion. This method of quality assessment seems to be fraught with challenges as not all papers were quality assessed by second reviewer. If there are discrepancies between the papers audited, there is a great likelihood of further discrepancies in the papers which were quality assessed only by one author. This is likely to reduce the confidence in findings. The authors also did not describe a cut off point to describe ‘high quality’ and ‘low quality’ papers.

Ten papers were eligible for the review. Four papers reported significant positive associations between sitting and UQMP in children and adolescents. Five elements of sitting were identified as relating to UQMP. Those were sitting duration; activities while sitting; activities while sitting and sitting duration; dynamism; and postural angles.

Thus the authors concluded that sitting and UQMP are related in children and adolescents. So as much as you need to get up and start some form of physical activity, it is also important to get children and adolescents get into the habit of physical activity to stay fit and keep UQMP at bay.

Reference: Brink Y, Louw Q. A systematic review of the relationship between sitting and upper quadrant musculoskeletal pain in children and adolescents. Manual Therapy 18 (2013) 281e288