Impaired empathy and increased anger following social exclusion in non-intoxicated opioid users

Abstract

Rationale Social functioning is modulated by the endogenous opioid system. In opioid use disorder, social functioning appears disrupted, but little research has delineated the nature of these deficits and their relationship to acute opioid use. Objectives The current study aimed to assess both emotional and cognitive empathy, along with subjective and physiological responses to social exclusion in opioid users who were either acutely intoxicated or non-intoxicated from using opioids. Methods Individuals on an opioid substitution medication (OSM) were divided into 'intoxicated users' (had taken their OSM the same day as testing, n = 20) and 'non-intoxicated users' (had taken their OSM > 12 h ago, n = 20) and compared with opioidnaïve controls (n = 24). Empathy was assessed using the multifaceted empathy test and self-report questionnaire. Participants also underwent a period of social exclusion (Cyberball Game) and completed measures of mood and physiological responses (salivary cortisol and heart rate). Results Non-intoxicated users had significantly lower emotional empathy (the ability to experience others' emotions), as well as greater anger after social exclusion when compared with the intoxicated users and controls. Anger did not change with social exclusion in the intoxicated user group and cortisol levels were lower overall. Conclusions Reduced ability to spontaneously share the emotions of others was reported in non-intoxicated users, particularly regarding positive emotions. There was some support for the idea of hyperalgesia to social pain, but this was restricted to an enhanced anger response in non-intoxicated users. Equivalent rates of empathy between the intoxicated users and controls could indicate some remediating effects of acute opioids.

Exploring the relationship between social exclusion and smartphone addiction: The mediating roles of loneliness and self-control

“…For the first path of this indirect effect, the results of this study were consistent with the prior studies. Some scholars have indicated that social exclusion is not only a direct predictor of self-control ( Crescioni and Baumeister, 2009 ; Burson et al, 2012 ; Xiaojun et al, 2017 ), but can also contribute to negative affects and experiences such as loneliness, depression, and anger ( Fung et al, 2016 ; Feng et al, 2019 ; Carlyle et al, 2020 ; Arslan, 2021 ), which will indirectly decrease self-control ( Chester et al, 2016 ). This might be because social exclusion threatens individuals’ basic psychological requirements ( Williams, 2009 ; Baumeister, 2011 ), which will motivate people to do something actively to compensate for their psychological distress or find some substitutes to console themselves.…”

Chronic non‐medical prescription opioid use and empathy for pain: Does pain make the difference?

“…Furthermore, our NMPOU sample was less affected by confounding factors, which are commonly accompanied by individuals with current or former heroin use (e.g., pre‐existing brain injuries due to hypoxia following overdose‐induced coma, or viral infections such as hepatitis C [HCV] and human immune‐deficiency virus [HIV] caused by intravenous injection; Byrd et al., 2013; Darke, 2011; Mintzer & Johnson, 2007; Yarlott et al., 2017). This might further explain the different empathy results of the MET between our NMPOU group and a recent study reporting impaired affective empathy in nonintoxicated opioid substituted patients with former heroin use (Carlyle et al., 2020). Fifth, we controlled for trait empathy by using the IRI showing no group differences and no correlation with empathy for pain.…”

Mortality and negative outcomes of opioid use and opioid use disorder: a 6‐year follow‐up study

“…Similarly, a review from Iran found a high prevalence of domestic violence in those with drug use disorders [28]. The association of opioid use with violence appears to be complicated, involving biological as well as social and characterological factors [29, 30].…”