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1, 45-58 (1987)
Abstract
According to our proposal the endogenous opioid functions, activated m ainly by
social interactions in early childhood and by stress later in life, serve multiple roles
both in early ontogenesis and in adulthood. First, they m ight insure social cohesion.
Second, they can mediate a special kin d o f homeostatic regulation, and third, they
seem to determine characteristic cognitive functions: prim ary process thinking,
primitive fo rm s o f defense mechanisms and basic conceptual structures guiding
prosocial behavior. We propose that an alternation o f two biological states, one with
and one without the involvem ent o f the endogenous opioid mechanisms, character
izes the norm al course o f life. These two states are supposed to represent different
forms o f homeostatic regulation and different kinds o f cognition. Physical and
psychological health seems to be dependent on the relative part each takes in the life
o f an individual. On the basis o f som e considerations discussed in this paper the
endogenous opioid functions seem to be relevant factors o f hum an cognition. The
conceptual schem e o f psychoanalysis, w orked out on the basis o f empirical data,
could be used to describe the cognitive characteristics which, in our proposal, were
suggested to ensue on the endogenous opioid activity.
INTRODUCTION
Research into the endogenous opioid peptides (E O Ps) in the last few years has
provided findings and theoretical assum ptions which seem to be pertinent to the
psychology of personality. In this p aper a conceptual scheme along with an
interpretation of the relevant findings will be presented.
Requests for reprints should be addressed to 2^uzsanna Kulcs^r, Departm ent of Personality and
Clinical Psychology, Institute of Psychology, Lor^nd Eotvos University, Izabella U. 46, 1064 Budapest,
Hungary.
0890-2070/87/010045-58$07.00
1987 by John W iley & Sons, Ltd.
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Z. Kulcsdr et al.
that the endorphin level increases significantly during long distance running
(A ppenzeller, Standefer, A ppenzeller and A tkinson, 1980; Fraioli, M oretti,
Poolucci, Alicicco, Cresenzi and Fortunio, 1980). Prince (1982) and H enry (1982a)
suppose th at tribal rituals result in euphoria also owing to opiate release. Prince,
for exam ple, suggests th at m uscular activity and trem bling might act as a kind of
endorphin pum p (Prince, 1982, pp. 414).
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the opiate antagonist naloxone dim inished the analgesic effect of placebo
(G revert, A lbert and G oldstein, 1985, p. 129).
O n th e basis o f the above considerations we supposed an increased placebo
responsibity as a function o f sensation seeking, especially thrill and adventure
seeking scores.
We worked with 57 tonsillectomy patients (41 females and 16 males) betw een the
ages 16 and 45. SSS was adm inistered the day before surgery. Post-surgical pain
was evaluated by the patients on a visual analog scale once every 10 min for 2 h
starting from the first occurrence of pain after the effect of the local anaesthesia
wore off. Placebo (5 ml saline solution i.m .) was given in a single blind fashion at a
point when the subject first requested an analgesic. O n a subsequent request, any
time after the first, active m edication was provided. T hree groups of subjects with
distinct pain reaction types w ere identified: (a) placebo responders (criterion: a
minimum of 10 mm pain score reduction within 20 min of placebo adm inistration),
(b) nonresponders, and (c) no-m edication. This latter group consisted of subjects
who did not require analgesic during the tim e of observation. G roups of subjects
with high and low TA S and Dis (disinhibition) scores w ere form ed by m edian split
and the distribution of the four personality groups am ong the three pain reaction
types was determ ined. A dditionally, m ean personality scores in the three pain
reaction type groups w ere com pared by one-way analyses of variance. According to
our results (see Figure 1) high TA S (H T ) scorers w ere over-represented in the
responder and no-m edication groups and low TA S (LT) scorers constituted the
m ajority of the nonresponders (j^ = 11.4; p < 0.01). M oreover, TAS and SSS
total scores differed significantly in the three pain reaction groups (p < 0.01 and
Nonresponders (NR)
Responders (R)
10
8
E
0>
a>
.Q
E
4
.g
E
3C
*
groups
groups
No Medication (NM)
c<u
HTHD = High TAS, High Dis
0)
wm
I'-'-i
3C
groups
Figure 1.
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Z. Kulcsdr et al.
NM
NR
EH)
F=5.701
p < .01
pain reaction types
Figure 2.
p < 0.05 resp.; Figure 2). Placebo responders and no-m edication subjects gave
higher scores as com pared to the nonresponders. The similarity, in term s of
personality scores, of placebo responder and no-m edication groups was substantial.
The only difference betw een them was that subjects in the latter group indicated
significantly less pain during the observations (see Figure 3). As an interpretation
we might suggest that in the case of subjects who did not require m edication, the
endogenous analgesic system (m ore probably but not surely opioid in nature) can
be even m ore easily activated than those of placebo responders, who need a
conditioned stim ulus (placebo) to have their auto-analgesic system work.
100
NM
NR
(O
80
60
40
20
F=21.99
p<.01
pain reaction types
Figure 3.
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To sum up: our results were in line with the expectations. Sensation seeking
proved to be a rath er good predictor of endogenous analgesic effects, at least in a
state of post-operative pain.
It is interesting to note that the personality characteristics suggested in our
analysis to describe the placebo responders vs nonresponders o r, in term s of our
proposed personality dim ension, confronters and defenders, quite closely match
the description given by Lasagna and his co-workers (Lasagna, M osteller, von
Felsinger and B eecher, 1954) concerning these two groups of subjects. Namely,
they described high placebo responders as being sociable with greater instinctual
needs and em otionality and less defensiveness, while nonresponders were
described as being rigid, which may well be an expression of their defense
mechanisms in a stressful situation (Lasagna, et al., 1954, p. 775). T he parallel is
all the m ore notew orthy because in 1954 endogenous analgesic m echanisms had not
been discovered and no predictions could be m ade concerning the behavioural
correlates of their action.
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prom inent effect on separation distress, as com pared to a wide range of other
substances including a variety of agonists and antagonists for cholinergic,
noradrenergic, dopam inergic and serotonergic receptor systems as well as such
m ajor psychopharm aceuticals as benzodiazepines, sedatives, antipsychotics, and
antidepressants (Panksepp er a /., 1985, p. 17).
A n abundance of further evidence shows that the opiates are involved in social
behaviour.
Investigating the autoradiographic m ap of [^H jdiprenorphine binding in the rat
brain, Panksepp and Bishop (1981) found a global brain opioid activation in the
presence of social stimuli, namely in the norm al course o f play (Panksepp et al.,
1985, p. 17).
T he finding th at, after a few days of social isolation, hyperalgesia and reduced
m orphine sensitivity occur in the rat also indicates that social stim ulation has a
facilitatory effect on the endogenous opioid system. A lexander, Combs and
H adaw ay (1978), m oreover, reported th at social isolation increases voluntary
opiate consum ption.
Summarizing the results, Panksepp arrived at the conclusion that social
interaction is reinforced by an endogenous opiate rew ard. T he reduction of
gregariousness after low doses of opiates is also in line with the hypothesis. On the
o th er hand, there are interesting data showing that the opiate antagonist naloxone
disrupts contact com fort. It was found, for exam ple, that young puppies after
naloxone treatm ent w ere eager to interact with hum ans but do n o t settle down for
sustained periods of petting (Panksepp et al., 1980, p. 479). In th e case of chicks a
simple following response to hum ans was not attenuated by naloxone, however,
social proxim ity could not prevent distress vocalization afte r this treatm ent
(Panksepp et al., 1985). L et us cite another, final example. A sim ple m easure of
contact com fort is a tendency of young chickens to rapidly fall asleep in the cupped
hands of a hum an (Panksepp et al., 1980, p. 479). A fter naloxone treatm ent the
sleep latency significantly increased in this situation.
O n the basis of these results, we propose that social connotations become
conditioned to the activation of the endogenous opioid system s in the early
ontogenesis, so that later in life w henever the systems are activated by stress and
pain, social connotations will arise together with the paradoxically occurring
euphoric states.
E O P s and personality
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behavioural activity reaches an extrem ely high level before weaning in rats if tested
in social isolation. H ow ever, this hyperactivity does not appear in the nest, even if
the catecholam ine systems are pharmacologically stim ulated. T he possibility that in
the vicinity of the m other the socially-induced opiates exert a control over
behaviour, is quite obvious.
A simple general pattern of the developm ent of regulatory functions seems to
em erge from the above. Namely, two forms and two levels of hom eostatic
regulation m ight be visualized. A t the first, a crucial role of socially-induced
regulatory effects seems to be characteristic, while at the second, a more
autonom ous hom eostatic regulation is reached. H ofer (1984) pointed out,
how ever, th at social regulation o f biological functions, even of biological rhythms,
is present in adulthood as well, and the idea of relationships as regulators offers a
biological explanation, e.g. for the syndrom e of bereavem ent. It might be
suggested th at psychopathological sym ptoms, for example splitting as a cognitive
characteristic of borderline patients, reflect a m ore intensive participation of
prim ary regulatory effects and thus the opioid mechanisms in homeostatic
regulation. Psychosom atic diseases, characterized by disturbed hom eostatic regula
tion at the biological, and by strong dependency at the psychological level might
also represent states o f prim ary, or socially-induced regulation.
In this approach, m oreover, stress and pain, resulting in a perturbation of
hom eostasis, as Panksepp points out, might be considered as regressive states, but
in this case the stress-induced opioid regulation is self-controlled, instead of being
socially m ediated.
W e w onder if stress seeking or risk taking as a trait occurs in the background of a
perturbed hom eostatic regulation and serves as a self-healing device. O ur
confronters, perhaps, are auto-addicts dependent on their own opioid functions.
This hypothesis seems to be supported by those findings according to which the
biological correlates of sensation seeking are factors of psychiatric vulnerabilty
(H aier, Buchsbaum , M urphy, G ottesm an and Coursey, 1980).
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Z. Kulcsdr et al.
A FINAL NOTE
M ost recent data reported by K ehoe and Blass (1986) according to which short
term social isolation of 10-day-old rats can induce an opioid dependent analgesic
effect, queries the idea of the social activation of the E O F systems in the early life.
The controversy over the results presented by Panksepp and co-workers and by
K ehoe and Blass can not be solved on the basis of the data available at present. It
might be proposed, how ever, that the opioids activated by stress and those induced
by social stim ulation in early ontogenesis are different either in their biochemical
characteristics o r in their site of action. Since the original findings of Panksepp and
his group fit extrem ely well with the theoretical assum ptions concerning human
psychological developm ent, it is tem pting to suggest that there is some biological
substrate, o r som e complex neurophysiological/biochemical mechanism to underlie
the well-defined stages of biological and psychological developm ent.
REFERENCES
Alexander, B. K., Combs, R. B. and Hadway, P. F. (1978). The effect of housing and
gender on morphine self administration in rats. Psychopharmacology, 58: 175-179.
Angyal, A. (1965). Neurosis and Treatment: A Holistic Theory, Wiley, New York.
Appenzeller, O., Standefer, J., Appenzeller, J. and Atkinson, R. R. (1980). Neurology and
endurance training. V. Endorphine, Neurology, 30: 418-419.
Cleckley, H. (1976). The Mask o f Sanity, C. V. Mosby, St Louis.
Faioli, F., Moretti, C., Poolucci, D., Alicicco, E., Cresenzi, F. and Fortunio, G. (1980).
Physical exercise stimulates marked concomitant release of beta-endorphin and adrenocorticotrop hormone (ACTH) in peripherial blood in man, Experientia, 36: 987-989.
Freud, S. (1953). The Interpretation o f Dreams. In: The Standard Edition o f the Complete
Psychological Works o f Sigmund Freud, Vols 4 & 5, Hogarth Press, London. (Originally
published, 1900).
Grevert, P., Albert, L. H. and Goldstein, A. (1983). Partial antagonism of placebo
analgesia by naloxone, Pain, 16: 129-143.
Haier, R. J., Buchsbaum, M. S., Murphy, D. L., Gottesman, I. T. and Coursey, R. D.
(1980). Psychiatric vulnerability, monoamine oxidase and the average evoked potential,
Archives o f General Psychiatry, 37: 340-345.
Henry, J. L. (1982a). Circulating opioids: Possible physiological roles in central nervous
function. Neuroscience and Biobehavioral Reviews, 6: 229-245.
Henry, J. L. (1982b). Possible involvement of endorphine in altered states of conscious
ness, Ethos, 10: 394408.
Hofer, M. A. (1981). Toward a developmental basis for disease predisposition: The effects
of early maternal separation on brain, behavior and cardiovascular system. In: Weiner,
H., Hofer, M. A. and Stunkard, A. J. (Eds) Brain, Behaviour and Bodily Disease, Raven,
New York, pp. 209-228.
Hofer, M. A. (1984). Relationships as regulators: A psychobiologic perspective on
bereavement. Psychosomatic Medicine, 46: 183-197.
Janov, A. (1970). The Primal Scream, Dell Publishing, New York.
Jung, C. G. (1962). Commentary. In: Jung, C. G. and Wilhelm, R. (Eds) The Secret o f the
Golden Flower. A Chinese Book o f Life, Harvest Books, New York, pp. 81-137.
Kehoe, P. and Blass, E. M. (1986). Opioid-mediation of separation distress in 10-day-old
rats: Reversal of stress with maternal stimuli. Developmental Psychobiology, 19:385-398.
Kernberg, O. F. (1981). Objectbeziehungen und Praxis der Psychoanalyse [Object-relations
theory and clinical psychoanalysis], Klett-Cotta, Stuttgart.
57
Klein, M. (1962). Das Seelenleben des Kleinkindes [The psychoanalysis of children], Ernst
Klett Verlag, Stuttgart.
Kris, E. (1952). Psychoanalytic Explorations in Art, International Universities Press, New
York.
Kulcs^r, Z. (1986). Decreased impact of stress: Possible biological and developmental
factors in psychopathy. Paper presented at the Stress and Emotion Conference,
BudapestA'isegr^d, June 1986.
Kulcs^r, Z ., Frecska, E., Simon, M. and Szab6, L. Z. (1985). Pain reaction types,
endogenous analgesic mechanisms and the sensation seeking trait. Paper presented at the
IVth World Congress of Biological Psychiatry, Philadelphia, September 1985 [First title;
Placebo reactivity and the sensation seeking trait].
Lasagna, L., Mosteller, F., von Felsinger, I. M. and Beecher, H. K. (1954). A study of the
placebo analgesia, American Journal o f Medicine, 16: 776-779.
Mabry, P. D. and Campbell, B. A. (1978). Cholinergic-monoaminergic interactions during
ontogenesis. In: Butcher, L. L. (Ed.) Cholinergic-monoaminergic Interactions in the
Brain, Academic Press, New York, pp. 257-270.
Maier, S. F. and Coon, D. J. (1979). Long term analgesic effects of inescapable shock and
learned helplessness. Science, 206: 91-93.
Maier, S. F., Davies, S., Grau, J. W., Jackson, R. L., Morrison, D. H. andMoye, T. (1980).
Opiate antagonists and long-term analgesia reaction induced by inescapable shock in
rats. Journal o f Comparative Physiological Psychology, 94: 1172-1183.
Maier, S. F., Drugan, R. C. and Grau, J. W. (1982). Controlability, coping behaviour and
stress induced analgesia in the rat. Pain, 12: 47-56.
Mathews, P. M., Froelich, C. J., Sibbitt, W. L. and Bankhurst, A. D. (1983). Enhancement
of natural cytotoxicity by beta-endorphin. Journal o f Immunology, 130: 1658-1662.
Noyes, R. (1972). Attitude changes following near death experiences. Psychiatry, 43: 237
272.
Panksepp, J. (1986). The neurochemistry of behavior. Annual Review o f Psychology, 37:
77-107.
Panksepp, J. and Bishop, P. (1981). An autoradiographic map of (^H)diprenorphine
binding in rat brain. Effects of social interaction. Brain Research Bulletin, 7: 405-410.
Panksepp, J., Herman, B. H., Vilberg, T., Bishop, P. and DeEskinazi, F. G. (1980).
Endogenous opioids and social behavior. Neuroscience and Biobehavioral Reviews, 4:
473^87.
Panksepp, J., Siviy, S. M. and Normansell, L. A. (1985). Brain opioids and social
emotions. In: Reite, M. and Fields, T. (Eds) The Psychobiology o f Attachment and
Separation, Academic Press, New York, pp. 3-^9.
Prince, R. (1982). Shamans and endorphins. Ethos, 10: 410-423.
Randall, P. K. and Campbell, B. A. (1980). Ontogeny of behavioral arousal in rats: Effects
of maternal and sibling presence. Journal o f Comparative Physiological Psychology, 90:
453-459.
Rees, W. D. and Lutkins, S. G. (1967). Mortality of bereavement, British Medical Journal,
4: 13-16.
Rodgers, R. J. and Hendrie, C. A. (1984). On the role of endogenous opioid mechanisms in
offense, defense and nociception. In: Mitzek, K. et al. (Eds) Ethopharmacological
Aggression Research, Alan R. Liss, New York, pp. 27-41.
Shaar, C. J., Frederickson, R. C. A., Diniger, N. B. and Jackson, L. (1977). Enkephalin
analogues and naloxone modulate the release of growth hormone and prolactin
evidence for regulation by an endogenous opioid peptide in brain. Life Sciences, 21: 853
860.
Spiegel, K., Kourides, I. A. and Pasternak, G. W. (1982). Prolactin and growth hormone
release by morphine in the rat: Different receptor mechanisms. Science, 217: 745-747.
Watkins, L. R. and Mayer, D. J. (1982). Organization of endogenous opiate and non-opiate
pain control systems. Science, 216: 1185-1192.
Zuckerman, M. (1979). Sensation Seeking: Beyond the Optimal Level o f Arousal, Erlbaum,
Hillsdale, NJ.
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R tsim t
Selon notre th6orie, les fonctions endogfenes opioides, activ6es principalement par les
interactions sociales dans la prime enfance et le stress dans la vie ult6rieure, jouent des r61es
multiple tant dans la prime ontogenese qu^i Iage adulte. Elies peuvent en premier lieu
assurer la cohesion sociale. Deuxifemement, elles peuvent mddiatiser une sorte speciale de
regulation homeostatique et, troisifemement, elles semblent determiner des fonctions
cognitives caract6ristiques; processus de pensee primaire, formes primitives de mecanismes
de defense et structures conceptuelles de base guidant le comportement prosocial. Nous
proposons une alternance de deux etats biologiques Iun avec et Iautre sans Iinclusion des
mecanismes endogenes opioides qui caracterisent le cours normal de la vie. Ces deux etats
sont supposes refieter differentes formes de regulation homeostatique et differentes sortes
de cognitions. La sante physique et psychologique semble etre dependante du poids relatif
qua chaque etat dans la vie dun individu. Cest sur la base de quelques considerations
discutees dans cet article que Ton peut supposer que les fonctions endogfenes opioids sont des
facteurs dimportance de la cognition humaine. Le schema conceptuel de la psychanalyse,
developpe sur la base de donnees empiriques, a pue etre utilise pour decrire les
caracteristiques cognitives qui, selon notre theorie, proviennent de Iactivite endogene
opioide.
ZUSAMMENFASSUNG
Wir vermuten, daU die endogenen opioiden Funktionen welche hauptsachlich durch soziale
Interaktionen in der friihen Kindheit sowie durch Stress im spateren Leven aktiviert werden,
vielfaltige Funktionen in der fruhen Ontogenese und im Erwachsenenalter erfullen. Erstens
mogen sie die soziale Kohasion sichern, zweitens konnen sie eine bestimmte Art der
homoostatischen Regulation vermitteln und drittens bestimmen sie offenbar charakteristische kognitive Funktionen: Primares ProzeBdenken, primitive Formen von Abwehrmechanismen und grundlegende konzeptuelle Strukturen, welche prosoziales Verhalten
steuern. Wir schlagen vor, daB eine Abwechselung zweier biologischer Zustande, einer mit
und einer ohne EinschluB des endogenen opioiden Mechanismus, den normalen Lebenslauf
charakterisiert. Es wird angenommen, daB diese zwei Zustande verschiedene Formen
homdostatischer Regulation und Kognition reprasentieren. Physische und psychische
Gesundheit scheinen abhangig zu sein von dem relativen Anteil, welchen jeder Mechanis
mus im Leben eines Individuums iibernimmt. Aus einigen Griinden, welche in diesem
Papier diskutiert werden, scheinen die endogenen opioiden Funktionen relevante Faktoren
der menschlichen Kognition zu sein. Das konzeptuelle Schema der Psychoanalyse, welches
auf empirischer Grundlage erarbeitet wurde, konnte zur Beschreibung der kognitiven
Charakteristika benutzt werden, welche unserer Sicht zufolge vorgeschlagen wurden, um
der endogenen opioiden Aktivitat Rechnung zu tragen.