Drinking against pain? Physiological and psychological mechanisms involved in alcohol effects on pain perception

• Applicant: Professor Dr. Stefan Lautenbacher, since 8/2020
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology ; General, Cognitive and Mathematical Psychology
• Term: from 2015 to 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 270293385

Self-medication by alcohol is a common phenomenon in patients with chronic pain. In line with this finding, pain-dampening effects of alcohol have been shown also in experimental research. However, it is still unclear by which mechanisms alcohol exerts effects on pain sensitivity. Therefore, the aim of this project is to identify physiological and psychological mechanisms of alcohol on pain sensitivity in patients with chronic pain as well as in pain-free persons. The project is divided into two project lines. In the first line, which focusses on physiological mechanisms, we plan to investigate whether alcohol applied in a subclinical dosage influences endogenous pain modulation (conditioned pain modulation (CPM), temporal summation). CPM (formerly called DNIC-like) means that the sensitivity to noxious stimuli is inhibited by concurrent application of a second noxious stimulus at a remote body site; temporal summation means the enhancement of pain sensitivity by repetitive application of noxious stimuli in short time intervals. Both of these processes are in dysfunctional form discussed as pathophysiological mechanisms of pain chronification. The second line of the project addresses psychological mechanisms: Emotional processing and impulse control both play an important role in pain sensitivity and might be modulated by alcohol consumption. It is well established that emotion processing (e.g. anger, anxiety) is markedly changed under the influence of alcohol; yet it is still unclear to what extent such emotional processes are involved in effects of alcohol on pain sensitivity. Attenuation of impulse control by alcohol leads to disinhibition of responsive behavior, which might also apply to the facial expression of pain as an important component of pain behavior; similar effects have already been shown for the expression of anger. Such effects would be of importance for emotional communication, but also for pain sensitivity itself, as an enhanced facial expression of pain might lead to intensification of pain via facial feedback mechanisms. The effects on alcohol on these physiological and psychological factors will be investigated in pain-free persons and patients suffering from functional chronic back pain (frequent self-medication by alcohol, great importance of psycho-physiological factors), as we would expect changes in the described mechanisms particularly in such patients as precursors or consequences of pain chronification.

• DFG Programme: Research Grants
• Co-Investigator: Professor Dr. Jörg Wolstein
• Ehemalige Antragstellerin: Dr. Claudia Horn-Hofmann, until 8/2020