Craving love? Enduring grief activates brain’s reward center Mary-Frances O’Connor, David K....
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Transcript of Craving love? Enduring grief activates brain’s reward center Mary-Frances O’Connor, David K....
Craving love? Enduring grief activates brain’s reward center
Mary-Frances O’Connor, David K. Wellisch, Annette L. Stanton, Naomi I.Eisenberger, Michael R. Irwin, Matthew D. Lieberman.
Neuroimage2008Vol.42, 969 – 972
Presented by: Antony Au
Pathways Reward pathway:
Mesolimbic pathway (dopaminergic) Nucleus accumbens (NA)
Pain pathway: Dorsal anterior cingulate cortex
(dACC) Insula Periaqueductal gray (PAG)
This study revolves around...
Complicated Grief (CG) Chronic / traumatic grief Unresolved Prolonged sense of mourning (i.e. Stuck)
Non-complicated grief (NCG)
Set of criteria considered to be in DSM-V Symptoms of CG distinctly different than
those in major depressive disorder (DSM-IV)
Research Purpose
Investigates whether the CG group has greater activity occurrence in brain’s reward or pain networks than the NCG group through a fMRI study
Participants
11 CG, 12 NCG women Death of mother/sister to breast cancer in
past 5 yrs Excluded those with DSM-IV Axis I disorder
Axis I = clinical disorders Clinical interview
CG/NCG diagnosed in structural clinical interview
Procedure
15 grief-related words and 15 neutral words matched with 15 photos
Photo: Participant’s deceased love one matched with
stranger Grief words:
Chosen from provided autobiographical narrative
Total of 60 composites Viewed through goggles in randomized
order
Results CG vs. NCG NA
activity in response to grief-related than neutral words: CG: more NCG: less
Only NA more significantly active
Results
While both CG and NCG exhibited activity in ACC, insula, PAG:
NCG > CG activity in both: Words: grief-related than neutral Pictures: deceased than stranger
In summary: NCG: more pain, less reward CG: less pain, more reward
Theories out there... Two opposing models of grief:
Detachment model Grief helps acceptance of death NA activity should reduce over time NCG supports this
Reunion Model Grief conflicts the separation of deceased NA activity continue over time CG supports this
...an Addiction?
CG seem to be “stuck” Activation of reward pathway? Compared to NCG: more reward than pain May explain why it is hard to “let go”
Research therapy Selective serotonin reuptake inhibitor
(SSRI) Used because CG symptoms under major
depressive disorder ones Effectiveness for CG?
Dopaminergic drugs
Opinions, opinions, opinions.
Strengths Examination of both reward + pain
pathways
Limitations Lack of male participants Cannot generalize to public No discussion on physical vs. social
pain
For the future:
Other cues to invoke grief Neurocognitive similarities / differences
To what extent is NA associated in emotion regulation
Therapy Behavioural modification Medicine
References
Boelon, P.A., & van den Bout, J. (2005). Complicated grief, depression and anxiety as distinct postloss syndromes: a confirmatory factor analysis study, Am. J. Psychiatry, 162, 2175-2177.
Bowlby, J. (1980). Attachment and loss. Loss, Sadness and Depression, vol.3, Basic Books, New York.
Knuston, B., Adams, C.M., Fong, G.W., & Hommer, D. (2001). Anticipation of increasing monetary reward selectively recruits nucleus accumbens, J. Neurosci., 21, RC159.
Shear, K., Frank, E., Houck, P.R., Reynolds III, C.F. (2005). Treatment of complicated grief: a randomized controlled trial, J. Am. Med. Assoc., 293, 2601-2608.
Zygmont, M., Prigerson, H., Houck, P., Miller, M., Shear, M. J, & Jacobs, S. (1998). A post hoc comparison of paroxetine and nortriptyline for symptoms of traumatic grief, J. Clin. Psychiatry, 59, 241-245.
Thanks for listening (:Questions?