The current study probes the involvement of the opioid system in placebo effects on social pain, using the opioid antagonist naloxone. 60 participants who recently experienced an unwanted breakup will experience rejection-related stimuli and receive painful heat and pressure stimuli during fMRI scanning. Participants will be randomized to receive either a naloxone or saline nasal spray, and be informed that the spray is either saline, or an effective pain and negative emotion reducing agent.
Background: Loss of close relationships is one of the most aversive life events. An unwanted romantic breakup leads to a 20% risk of developing depression within a month, a dramatic increase in depression risk. The investigators recently identified brain pathways mediating placebo effects on physical heat pain and the social pain associated with an unwanted breakup, including common involvement of dlPFC-PAG pathways and vmPFC. Other recent studies have identified rejection-related opioidergic activity in these circuits that may reflect endogenous regulatory mechanisms. This experiment probes the involvement of the opioid system in placebo effects on social pain, using the opioid antagonist naloxone. Design: Extending the investigator's previous design, participants who recently experienced an unwanted breakup will submit pictures of their ex-partners, places associated with strong memories of the partner, and written descriptions of memories that evoke rejection and social pain. Participants will 1) experience rejection-related stimuli and 2) receive painful heat and pressure stimuli in separate runs during fMRI scanning. FMRI scans after Control and Placebo treatment-nasal spray with suggestions of efficacy for emotion and pain-will be performed in a 2-session within-person counterbalanced design. Participants will be randomized into two groups that receive either (1) 4mg naloxone nasal spray or (2) saline in the nasal spray in both sessions, implementing a 2 x 2 (Placebo/Control x Saline/Naloxone) design.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
TRIPLE
Enrollment
60
Participants will be informed that the spray is an effective pain and negative emotion reducing agent.
Participants will be informed that the spray is saline.
Participants will be informed that the spray is an effective pain and negative emotion reducing agent.
Participants will be informed that the spray is saline.
Dartmouth College
Hanover, New Hampshire, United States
Intervention effects on pain ratings
Pain ratings will be given on a 0-100 scale. 0 being "no pain at all" and 100 being "most pain imaginable in the context of this study."
Time frame: Immediately after pain stimuli
Intervention effects on negative affect ratings
Rejection ratings will be given on a 0-100 scale. 0 being "not rejected at all" and 100 being "very rejected."
Time frame: Immediately after rejection stimuli
Brain: Pain signature response
A priori regions of interest response from the brain (fMRI) patterns to the pain.
Time frame: Immediately after pain stimuli
Brain: Rejection signature response
A priori regions of interest response from the brain (fMRI) patterns to rejection. The investigators will utilize a multivariate brain pattern developed and published in Woo et al., 2014, Nature Communications. This is a rejection-selected pattern of brain activity.
Time frame: Immediately after rejection stimuli
Skin conductance
Skin conductance response (SCR) will be recorded during the task.
Time frame: Immediately after pain/rejection stimuli
Heart rate
Heart rate will be recorded during the task.
Time frame: Immediately after pain/rejection stimuli
Whole-brain maps of intervention effects
Standard resting-state images will be acquired for exploratory analyses. Exploratory brain analysis will include univariate voxel-wise maps comparing participant groups with a threshold of q \< 0.05, False Discovery Rate (FDR) corrected.
Time frame: Immediately after pain/rejection stimuli
Rejection Sensitivity Questionnaire
A measure of sensitivity to actual or perceived rejection with ratings on a 6-point Likert scale ranging from "very unconcerned" - "very concerned." Higher scores indicate more reaction sensitivity.
Time frame: Within 2 weeks before first fMRI scan
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