***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED Two experiments assessed how interpersonal transactions influence responses to  cold pressor pain in women versus men . In Experiment 1 , 91 young adults ( 57 women , 34 men ) were r and omly assigned to either a no transaction ( NT ) condition in which they coped alone with the cold pressor test or a transaction opportunity ( TO ) condition in which they also had the option of interacting with an empathetic , reflecting experimenter . Compared to men , women had lower pain tolerance and reported more pain and catastrophizing , although there were no gender differences in support seeking or other ways of coping . Within the TO condition , women were no more likely than men to initiate a transaction , but female speakers were more pain-focused than male speakers , and speaking with the empathetic interaction partner had generally negative effects on pain perception and coping . In Experiment 2 , 126 young adults ( 76 women , 50 men ) were r and omly assigned to NT , TO , or experimenter-directed ( 1 ) Distraction ( DT ) , ( 2 ) Reinterpretation ( RT ) , or ( 3 ) Encouragement ( ET ) conditions . Although men had similar levels of pain tolerance across the 5 transaction conditions , women in NT and TO conditions exhibited reduced tolerance compared with those in the DT , RT , and ET conditions . Pain tolerance times among women in DT , RT , and ET conditions were equal to or exceeded those of men in these conditions . Together , findings suggest the nature of interpersonal transactions exerts a greater influence on women 's responses to noxious stimulation than those of men . PERSPECTIVE This study adds to literature indicating that women exhibit reduced tolerance for experimentally induced pain compared with men . These results suggest that the nature of interpersonal transactions also affects women 's responses to noxious stimulation , more than those of men OBJECTIVE The aim of this study was to test the hypothesis that greater global and situational relationship satisfaction would reduce the negative impact of threatening information on acute pain . DESIGN An experimental design was used to manipulate threat and elicit acute pain via a cold pressor task . SETTING The study was completed in a research laboratory at a large urban university in the Midwestern USA . SUBJECTS Participants were 134 couples , in which at least one individual was an undergraduate student . METHODS After administration of a global relationship satisfaction measure , couples were r and omly assigned to either receive high or low threatening information about the painful task . Following the threat manipulation , couples discussed the upcoming task and rated their satisfaction with the interaction ( i.e. , situational relationship satisfaction ) . The design ated pain participant then completed the painful task alone . RESULTS The threat manipulation altered couples ' perceived threat of pain . Situational relationship satisfaction moderated the effect of threat on pain trajectories such that situational relationship satisfaction predicted less pain intensity at an earlier point in the task for the low threat condition than the high threat condition . Greater global relationship satisfaction predicted greater likelihood of task completion among those in the low threat condition , whereas it was unrelated to task completion in the high threat condition . Greater global relationship satisfaction also predicted lower pain intensity throughout the task . CONCLUSIONS These findings demonstrate that the interpersonal context is independently related to acute pain and may also alter the effect of threatening information on acute pain Social contact promotes enhanced health and well-being , likely as a function of the social regulation of emotional responding in the face of various life stressors . For this functional magnetic resonance imaging ( fMRI ) study , 16 married women were subjected to the threat of electric shock while holding their husb and 's h and , the h and of an anonymous male experimenter , or no h and at all . Results indicated a pervasive attenuation of activation in the neural systems supporting emotional and behavioral threat responses when the women held their husb and 's h and . A more limited attenuation of activation in these systems occurred when they held the h and of a stranger . Most strikingly , the effects of spousal h and -holding on neural threat responses varied as a function of marital quality , with higher marital quality predicting less threat-related neural activation in the right anterior insula , superior frontal gyrus , and hypothalamus during spousal , but not stranger , h and -holding We tested whether the presence of a stranger  reduces cardiovascular responses during stressful tasks if the evaluation potential of the stranger is minimized and whether cardiovascular responses are affected by the quality of support in a friendship . Undergraduate women performed stressful tasks in one of three conditions :  Alone , with a same-sex Stranger , or with a same-sex best Friend .  The stranger and friend could not hear participants ' responses . Alone women had the greatest increases in SBP and HR while women in the Stranger and Friend conditions did not differ in their responses . In the Friend condition , HR responses were smallest in women who were highly satisfied with the support that they generally received from their friend . We conclude that the presence of a nonevaluative friend or stranger can reduce cardiovascular responses and that the quality of supportive ties modulates the impact of those ties on responses to stress The endogenous opioid system is involved in stress responses , in the regulation of the experience of pain , and in the action of analgesic opiate drugs . We examined the function of the opioid system and μ-opioid receptors in the brains of healthy human subjects undergoing sustained pain .  Sustained pain induced the regional release of endogenous opioids interacting with μ-opioid receptors in a number of cortical and subcortical brain regions . The activation of the μ-opioid receptor system was associated with reductions in the sensory and affective ratings of the pain experience , with distinct neuroanatomical involvements . These data demonstrate the central role of the μ-opioid receptors and their endogenous lig and s in the regulation of sensory and affective components of the pain experience Abstract Although emotion regulation modulates the pain experience , inconsistencies have been identified regarding the impact of specific regulation strategies on pain . Our goal was to examine the effects of emotion suppression and cognitive re appraisal on automatic ( ie , nonverbal ) and cognitively mediated ( ie , verbal ) pain expressions . Non clinical participants were r and omized into either a suppression ( n = 58 ) , re appraisal ( n = 51 ) , or monitoring control ( n = 42 ) condition . Upon arrival to the laboratory , participants completed the Emotion Regulation Question naire , to quantify self-reported suppression and re appraisal tendencies . Subsequently , they completed a thermal pain threshold and tolerance task . They were then provided with instructions to use , depending on their experimental condition , suppression , re appraisal , or monitoring strategies . Afterward , they were exposed to experimentally induced pain .  Self-report measures of pain , anxiety , and tension were administered , and facial expressions , heart rate , and galvanic skin response were recorded . The Facial Action Coding System was used to quantify general and pain-related facial activity ( ie , we defined facial actions that occurred during at least 5 % of pain stimulation periods as “ pain-related actions ” ) . Re appraisal and suppression induction led to reductions in nonverbal and verbal indices of pain . Moreover , self-reported tendencies to use suppression and re appraisal ( as measured by the Emotion Regulation Question naire ) did not interact with experimental condition in the determination of participants ' responses . Results suggest that consciously applying emotion regulation strategies during a painful task can moderate both cognitively mediated ( eg , verbal ) and automatic ( eg , facial activity ) expressions of pain Pain is an unpleasant sensory and emotional experience usually triggered by stimulation of peripheral nerves and often associated with actual or potential tissue damage . It is well known that pain perception for patients and normal subjects can be modulated by psychological factors , such as attention , stress , and arousal . Our underst and ing of how this modulation occurs at a neuroanatomical level is poor . Here we neuroanatomically defined a key area in the network of brain regions active in response to pain that is modulated by attention to the painful stimulus . High-resolution functional magnetic resonance imaging was used to define brain activation to painful heat stimulation applied to the h and of nine normal subjects within the periaqueductal gray region . Subjects were asked to either focus on or distract themselves from the painful stimuli , which were cued using colored lights . During the distraction condition , subjects rated the pain intensity as significantly lower compared with when they attended to the stimulus . Activation in the periaqueductal gray was significantly increased during the distraction condition , and the total increase in activation was predictive of changes in perceived intensity . This provides direct evidence supporting the notion that the periaqueductal gray is a site for higher cortical control of pain modulation in humans Chronic pain patients show substantial psychological distress , including depressed mood , anxiety , and anger . Nevertheless , the causal role of negative mood in the course of chronic pain conditions remains unclear . This study prospect ively investigated the relationship between daily pain , negative mood , and social support in 109 people with reflex sympathetic dystrophy syndrome . Participants completed 28 daily diaries that included questions about pain , mood , and perceived support .  Time-lagged within-subject analyses indicated that pain led to increases in depressed , anxious , and angry mood . Depressed mood , but not anxiety or anger , contributed to increases in pain . Perceived support had both main and buffering ( interaction ) effects on negative mood and a main effect on pain BACKGROUND The presence of social support has been associated with decreased stress responsiveness . Recent animal studies suggest that the neuropeptide oxytocin is implicated both in prosocial behavior and in the central nervous control of neuroendocrine responses to stress . This study was design ed to determine the effects of social support and oxytocin on cortisol , mood , and anxiety responses to psychosocial stress in humans . METHODS In a placebo-controlled , double-blind study , 37 healthy men were exposed to the Trier Social Stress Test . All participants were r and omly assigned to receive intranasal oxytocin ( 24 IU ) or placebo 50 min before stress , and either social support from their best friend during the preparation period or no social support . RESULTS Salivary free cortisol levels were suppressed by social support in response to stress . Comparisons of pre- and poststress anxiety levels revealed an anxiolytic effect of oxytocin . More importantly , the combination of oxytocin and social support exhibited the lowest cortisol concentrations as well as increased calmness and decreased anxiety during stress . CONCLUSIONS Oxytocin seems to enhance the buffering effect of social support on stress responsiveness . These results concur with data from animal research suggesting an important role of oxytocin as an underlying biological mechanism for stress-protective effects of positive social interactions Objective The purpose of this experimental study was to supplement and exp and on clinical research demonstrating that the provision of social support is associated with lower levels of acute pain . Methods Undergraduates ( 52 men and 49 women ) performed the cold pressor task either alone or accompanied by a friend or stranger who provided active support , passive support , or interaction .  Pain perception was measured on a 10-point scale . Results Participants in the active support and passive support conditions reported less pain than participants in the alone and interaction conditions , regardless of whether they were paired with a friend or stranger . Conclusions These data suggest that the presence of an individual who provides passive or active support reduces experimental pain OBJECTIVE To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain , psychological disability , physical disability , pain-coping , and pain behavior in patients with osteoarthritis ( OA ) of the knees . METHODS Eighty-eight OA patients with persistent knee pain were r and omly assigned to 1 of 3 conditions : 1 ) spouse-assisted pain-coping skills training , ( spouse-assisted CST ) , 2 ) a conventional CST intervention with no spouse involvement ( CST ) , or 3 ) an arthritis education-spousal support ( AE-SS ) control condition . All treatment was carried out in 10 weekly , 2-hour group sessions . RESULTS Data analysis revealed that at the completion of treatment , patients in the spouse-assisted CST condition had significantly lower levels of pain , psychological disability , and pain behavior , and higher scores on measures of coping attempts , marital adjustment , and self-efficacy than patients in the AE-SS control condition . Compared to patients in the AE-SS control condition , patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies . CONCLUSION These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients OBJECTIVE To evaluate the long-term effects of a spouse-assisted coping skills intervention in patients with osteoarthritis ( OA ) of the knees , and to evaluate how pre- to posttreatment changes in marital adjustment and self-efficacy relate to long-term improvements in pain , psychological disability , physical disability , pain coping , and pain behavior . METHODS A followup study was conducted with 88 OA patients who had been r and omly assigned to 1 of 3 treatment conditions : 1 ) spouse-assisted coping skills training ( spouse-assisted CST ) , 2 ) a conventional CST intervention with no spouse involvement , and 3 ) an arthritis education-spousal support ( AE-SS ) control condition .  To evaluate long-term outcome , comprehensive measures of self-efficacy , marital adjustment , pain , psychological disability , physical disability , pain coping , and pain behavior were collected from these individuals at 6 and 12 months posttreatment . RESULTS Data analysis revealed that , at 6-month followup , patients in the spouse-assisted CST condition scored higher on measures of coping and self-efficacy than those in the AE-SS control group . At 6-month followup , patients who received CST without spouse involvement showed a significantly higher frequency of coping attempts and reported higher levels of marital adjustment than those in the AE-SS control group . At 12-month followup , patients in the spouse-assisted CST condition had significantly higher overall self-efficacy 
    Output:
    
Discussion : This review presents evidence that the stress-buffering effect is more often able to account for the relationship between social support and pain experience .
Moreover , findings suggest the critical significance of stress appraisal and attenuated stress systems in linking social support to aspects of reduced pain experience .