Re: differential mechanism

Final installment (yeah)

From your post:
Anxiety and fear appear to have differerent effects on pain perception where fear reduces pain and anxiety enhances it. This raises the question about endogenous opiod involvement. Dissociation, for instance, appears to involve excessive opiate release (e.g. Bohus et al. 1999).
The us of opioid antgonists seems to interfere with exposure treatment, but seems to enhance the effects of DBT (Bohus) and there are some preliminary findings that it increases the treatment effects of EMDR. The latter remains to be replicated in a double blind study.

I have tended to view fear and anxiety as interchangeable, whereas others distinguish between them (e.g., Barlow). I will have to review the arguments for why they are different. For our purposes, I will accept the validity of the fear/anxiety discrimination and the idea that fear reduces pain perception (presumably through recruitment of the endorphines) while anxiety enhances pain perception.

I was aware of the literature showing opioid antogonists seem to interfere with exposure. I guess this would imply the exposure therapy reduces fear, not anxiety. I wasn't aware of the data suggesting that opioid antagonists enhance DBT. Following the same logic, then, we would infer that DBT reduces anxiety but not fear. What would your predictions be about the effects of opioid antagonists on EMDR?

I find this to be intriguing and would like to read more. Could you provide the full citation for the Bohus DBT study?

Replies:

Re: differential mechanism, by Ulrich Lanius, 11/05/01 Re: differential mechanism, by Cahill, 11/06/01 Re: differential mechanism, by Ulrich Lanius, 11/07/01 Re: differential mechanism, by Cahill, 11/07/01

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