SYMPOSIA

Abstracts of the Invited Speakers
eating behavior in spite of negative consequences, loss of control, and frequent relapse.
Human and animal studies have demonstrated that in some brains the consumption of sugar-rich foods or drinks primes the release of
euphoric endorphins and dopamine within the nucleus accumbens, in a manner similar to some drugs of abuse. The neurobiological
pathways of drug and “sugar addiction” involve similar neural receptors, neurotransmitters, and hedonistic regions in the brain. Craving,
tolerance, withdrawal, and sensitization have been documented in both human and animal studies. In addition, there appears to be cross
sensitization between sugar addiction and narcotic dependence in some individuals There also appears to be some common genetic
markers between alcohol dependence, bulimia, and obesity, such as the A1 allele gene and the dopamine 2 receptor gene.
Key words: Binge eating, eating disorder, addiction
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S53-4
[PS-03]
Symposium Title: Painful syndromes in psychiatry and their managements
Pain and personality
Mehmet Ak
Department of Psychiatry, Gulhane School of Medicine, Ankara, Turkey
E-mail: drmehmetak@gmail.com
There is a dynamic two-way interaction between pain and personality and the psychophysiology and anatomy of this relationship are
not elucidated fully. Is there a specific personality type of pain or do some people perceive and express pain more than others? Probably
there is no clear answer to this question. So far chronic pain has been shown to affect personality, as indicated by studies using Cloninger’s
Temperament and Character Inventory. A relationship has been demonstrated between some personality traits and pain. In studies that
reported the prevalence of personality disorders, associations with chronic pain vary between 31% to 81%. The most frequently identified
personality trait is one with paranoid features.
Today I will talk mainly about studies using Cloninger’s model, because Cloninger’s integrative psychobiological approach provides a
flexible framework for both clinical assessment and treatment planning. The most significant and consistent result of these studies was
elevated harm avoidance scores. Harm avoidance scores still remain high even after controlling for the effect of depression and anxiety.
Thus this temperament dimension is possibly an important state and trait feature for development of psychosomatic illnesses. These
findings also confirmed that serotonergic systems are involved in the process of psychosomatic organization. Cloninger described that
people with chronic anxiety, avoid harm that is characterized by more pain, are difficult to calm, tire easily, and display specific signs
based on specific anticipatory anxiety. Harm avoidance refers to an inherited tendency to block the behavior in the answers given to the
blocking, non-rewarding, and punishment signals. High harm avoidance behavior is observed in the form of social withdrawal, becoming
tired easily, staying away from strangers, fear of uncertainty, and being pessimistic that there would be some problems in a situation even
when others do not worry.. These people are timid, passive, insecure, and pessimistic individuals.
Looking at the size of the character, it is seen that low self-directedness scores are the most common finding. The original meaning of
self-directedness is in accordance with choosing goals and values of the individual, optimization of the behavior to maintain a situation,
editing capabilities, and being strong-willed.
Individuals with low self-directedness do not expect to be able to control and positively influence an aversive situation and overcome
obstacles. Self-directedness is closely related to the concept of self-efficacy. Self-efficacy is defined as the personal conviction that one
can successfully show problem-solving behavior in a given situation. There is much evidence which suggests that low self-efficacy plays
an important role in pain control, coping with disability, and treatment outcome. Our clinical experiences show that pain can sometimes
be the symbol of help, sometimes the quest for attention, and other times problems that can not be expressed. Emotions that are not
expressed can mean pain and unexpressed emotions can be the cause of pain for some people that do not heal. In order to understand
and to treat these people, employing a holistic assessment and approach are very important.
Key words: Character, pain, temperament
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S54
S54 Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org