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The functional neuroanatomy of mental pain in depression
Abstract
This study aimed at determining the functional neuroanatomy of mental pain, a hitherto neglected symptom in the study of depression, which according to DSM-IV is stronglylinked with suicide. Mental pain (measured with the Orbach & Mikulincer Mental Pain Scale), suicidal ideation (measured using the Hamilton Rating Scale for Depression), hopelessness (measured using Beck's Hopelessness Scale), and regional cerebral blood flow as measured with single photon emission computed tomography were assessed in 39 depressed individuals. Levels of mental pain were significantly and positively associated with suicidal ideation and levels of hopelessness. When compared with patients with low levels of mental pain, those with high levels of mental pain showed relatively increased perfusion in the right dorsolateral prefrontal cortex, occipital cortex and inferior frontal gyrus and in the left inferior temporal gyrus, and relatively decreased perfusion at the medulla. The findings indicate that mental pain in depressed patients is associated with an increased risk of suicide and that high levels of mental pain are associated with changes in perfusion in brain areas that are involved in the regulation of emotions. Further study is warranted to understand whether this association reflects increased emotional processing or decreased cognitive control over mental pain in depressed individuals.
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In the citing paper
“It was chosen because psychological pain measured by this instrument is dissociable from the negative emotions related to depressive and anxiety disorders and is specifically associated with suicidality.8,11”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [11]
In the citing paper
“Psychological pain describes a widely accepted transdiagnostic dimension9 with specific neurobiological bases10,11 and validated measurement tools.8,12”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [11]
In the citing paper
“In this study, mental pain was associated with change in brain areas involved in emotional processing [18].”
From High depression symptomatology and mental pain characterize suicidal psychiatric patients (2022) · cites this paper as [18]
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“Mental pain or “psychache”, as named after Shneidman (1976), is thought to act as a powerful releaser of suicidal impulse aimed at escaping from pain and suffering (van Heeringen et al., 2010).”
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“First, this brain area has been associated with mental pain in functional imaging studies (Meerwijk et al., 2013; van Heeringen et al., 2010).”
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“Similar findings have emerged from studies using the Orbach and Mikulincer Mental Pain Scale (22, 34, 35) and using Holden’s 2001 revision (36) of Shneidman’s Psychache Scale (37).”
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“We found that the rCBF in the left inferior temporal gyrus was also normalized after treatment. van Heeringen et al. (2010) reported that perfusion in this region was relatively increased in patients with high- rather than low levels of mental pain.”
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“This phenomenological overlap with depression has been conceptualized as mental pain (114), which functionally localizes predominantly to the dl-PFC but also the dm-PFC.”
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“Psychological pain was first described by Shneidman (1996) as “psychache,” then by Orbach et al. (2003) as “mental pain,” then by Mee et al. (2006) as “psychological pain,” and later by other authors as “emotional pain” or “psychic pain” (van Heeringen et al., 2010).”
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“Recently, the evidence of non-invasive functional brain imaging of psychache has gradually accumulated many results of neuroimaging studies have reported the significant associations between psychache and the cerebral perfusion changes of emotion regulation center and the complexity of left frontal lobe (37, 38).”
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“, hopelessness (47), psychological pain (48), impaired executive function (49), and lack of pleasure (50, 51)].”
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“The OMMP was shown to possess a high degree of validity in psychiatric inpatients (Orbach, Mikulincer, Gilboa-Schechtman, & Sirota, 2003; van Heeringen et al., 2010) and in university students and the general population (Orbach, Mikulincer, Sirota, & Gilboa-Schechtman, 2003).”
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“…ample research has 46 found that people with depression report high levels of psychological pain and that hopelessness 47 covaries with psychological pain (van Heeringen et al., 2010; Mee et al., 2011; Li et al., 2014; 48 Xie et al., 2014; Cáceda et al., 2014; Troister, D’Agata & Holden, 2015).”
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I Predict, Therefore I Cannot Be
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van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.004
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.011
Cheng, Y., Chen, S., Zhao, W., Wang, T., Zhang, G., Wang, Z., & Zhang, Y. (2021) · Research Square · doi:10.21203/rs.3.rs-501650/v1
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.007
I Think, Therefore I Do Not Want to Be
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.006
Taheri, A. A., Parvizifard, A. A., Reisi, S., Jafari, M., Heshmati, K., Foroughi, A., & Eivazi, M. (2021) · Research Square · doi:10.21203/rs.3.rs-853154/v1
(2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.013
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.015
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.001
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.005
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.012
Definicija i procjena duševne boli / Definition and the Assessment of Psychological Pain
Čekić, E. (2021) · Pregled: časopis za društvena pitanja / Periodical for social issues · doi:10.48052/19865244.2021.2.87
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.014
Metadata
- Authors
- van Heeringen, K., Van den Abbeele, D., Vervaet, M., Soenen, L., & Audenaert, K.
- Affiliations
- Ghent University Hospital (BE)
- Venue
- Psychiatry Research: Neuroimaging
- Publisher
- Elsevier BV
- Published
- 2010-02
- Volume
- 181
- Issue
- 2
- Pages
- 141-144
- ISSN
- 0925-4927 (ISSN-L)
- OpenAlex
- W2151215130
- Cited by
- 113
- References
- 16
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 8 · 2020: 6 · 2019: 7 · 2018: 20 · 2017: 7 · 2016: 10 · 2015: 5 · 2014: 9 · 2013: 6 · 2012: 6
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research Neuroimaging (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- psychological suffering, depression, suicidal ideation, hopelessness, regional cerebral blood flow, dorsolateral prefrontal cortex, inferior frontal gyrus, inferior temporal gyrus, medulla, emotion regulation, suicide risk
- MeSH terms
- Adolescent, Adult, Aged, Brain Mapping, Cysteine, Depression, Female, Humans, Functional Laterality, Male, Middle Aged, Pain, Psychiatric Status Rating Scales, Organotechnetium Compounds, Tomography, Emission-Computed, Single-Photon, Young Adult
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