Observing painful events in others leads to a temporally extended general response facilitation in the self

In your skin? Somatosensory cortex is purposely recruited to situate but not simulate vicarious touch

Previous studies of vicarious touch suggest that we automatically simulate observed touch experiences in our own body representation including primary and secondary somatosensory cortex (SCx). However, whether these early sensory areas are activated in a reflexive manner and the extent with which such SCx activations represent touch qualities, like texture, remains unclear. We measured event-related potentials (ERPs) of SCx's hierarchical processing stages, which map onto successive somatosensory ERP components, to investigate the timing of vicarious touch effects. In the first experiment, participants (n = 43) merely observed touch or no-touch to a hand; in the second, participants saw different touch textures (soft foam and hard rubber) either touching a hand (other-directed) or they were instructed that the touch was self-directed and to feel the touch. Each touch sequence was followed by a go/no-go task. We probed SCx activity and isolated SCx vicarious touch activations from visual carry over effects. We found that vicarious touch conditions (touch versus no-touch and soft versus hard) did not modulate early sensory ERP components (i.e. P50, N80); but we found effects on behavioural responses to the subsequent go/no-go stimulus consistent with post-perceptual effects. When comparing other- with self-directed touch conditions, we found that early and mid-latency components (i.e. P50, N80, P100, N140) were modulated consistent with early SCx activations. Importantly, these early sensory activations were not modulated by touch texture. Therefore, SCx is purposely recruited when participants are instructed to attend to touch; but such activation only situates, rather than fully simulates, the seen tactile experience in SCx.

Empathic pain observation does not influence automatic imitation in an online setting

Previous research has shown that empathic pain observation can lead to motor facilitation in the form of faster reaction times. However, it is unclear whether participants are focusing on the others' pain or simply focusing on their own discomfort/distress (from watching the videos) during the task. This is an important issue as self- vs other-oriented focusing plays a key role in empathic processing. To address this issue, we combined empathic pain observation with the automatic imitation task (AIT). Previous work has shown that AIT effects are smaller after experiencing pain, which has been interpreted as the result of the experience of pain leading to a self-oriented focus. If empathic pain observation similarly leads to a self-oriented focus, then we should expect similar AIT results after pain observation (smaller AIT effects); however, if it instead leads to an other-oriented focus, then we should see the opposite (larger AIT effects). Although we found initial evidence for the latter hypothesis (Experiment 1), subsequent failed replications suggests that we do not have sufficient evidence to claim that pain observation influences automatic imitation one way or the other (Experiment 2 and 3). We discuss some possible reasons for finding null results in these experiments and suggest future avenues of research to better elucidate this topic.

Effect of doctor-patient news-induced moral judgments on pain empathy for doctors and patients in China

Objective

Pain empathy's preferential nature tends to trigger prejudice and intergroup conflicts. Given the current degree of proliferation of doctor-patient conflict news in China, this study aims to determine whether readers of doctor-patient news-initiated moral judgments prefer pain empathy for doctors or patients.

Materials and methods

This study utilized localized doctor-patient news with high or low moral performance (based on morality ratings of patients' behaviors) as moral-judgment-eliciting materials, and painful pictures as pain empathy-eliciting materials. The event-related potential (ERP) technique was utilized to assess moral judgment's effect on the cognitive empathy component and to investigate electroencephalogram signals' accuracy in classifying four brain response patterns when facing doctor or patient is experiencing or not experiencing pain.

Results

Under low moral text material, participants exhibited smaller mean wave amplitude of positive 300 (P3) and late positive potential (LPP) to painful pictures than non-painful pictures when facing patients; under high moral text material, participants exhibited larger mean wave amplitude of P3 and LPP to painful pictures than non-painful pictures when facing doctors. Electroencephalogram (EEG) signals' classification accuracy was significant in 0-1,000 ms in both high and low moral judgments, but the classification accuracy was higher in low moral judgments in some cognitive empathy stages (0.51, 0.53-0.55, 0.66-0.79, and 0.88-1 s).

Conclusion

Under low moral judgment, individuals pay less attention to the patient's (perpetrator's) pain; under high moral judgment, individuals empathize with the doctor (the person praised), showing that news-induced moral judgment can sway readers' empathy for different social groups. In cognitive empathy, individuals' brain representations are more discriminatory under low than high moral judgments when confronted with pain by doctors and patients, which provides insight into objectively recognizing group bias.

Increasing self-other bodily overlap increases sensorimotor resonance to others' pain

Empathy for another person’s pain and feeling pain oneself seem to be accompanied by similar or shared neural responses. Such shared responses could be achieved by mapping the bodily states of others onto our own bodily representations. We investigated whether sensorimotor neural responses to the pain of others are increased when experimentally reducing perceived bodily distinction between the self and the other. Healthy adult participants watched video clips of the hands of ethnic ingroup or outgroup members being painfully penetrated by a needle syringe or touched by a cotton swab. Manipulating the video presentation to create a visuospatial overlap between the observer’s and the target’s hand increased the perceived bodily self-attribution of the target’s hand. For both ingroup and outgroup targets, this resulted in increased neural responses to the painful injections (compared with nonpainful contacts), as indexed by desynchronizations of central mu and beta scalp rhythms recorded using electroencephalography. Furthermore, these empathy-related neural activations were stronger in participants who reported stronger bodily self-attribution of the other person’s hand. Our findings provide further evidence that empathy for pain engages sensorimotor resonance mechanisms. They also indicate that reducing bodily self-other distinction may increase such resonance for ingroup as well as outgroup targets.

Exploring the relationship between social power and the ERP components of empathy for pain

Social power (the ability to control or influence another's thoughts, feelings, or behaviors) and empathy (the ability to both share and understand the thoughts and feelings of others) are fundamental to social life. Here, we explore the relationship between social power and the ERP components associated with empathy for pain. Participants were induced into states of high and low social power via a double blind version of the episodic recall task (e.g., "recall a time you felt powerful"). Afterward, they completed a pain categorization task, viewing pictures of hands that were in pain or not in pain, from a first-person or third-person visual perspective. Whereas both high and low social power states were associated with enhanced N2 amplitudes when observing another in pain, only the high social power state was associated with an enhancement of the P3. Based on this pattern of data, we tentatively suggest that, whereas social power does not seem to impact the initial emotional response to observing another's pain (as indexed by the N2), low social power might induce changes in the cognitive evaluation of another's pain relative to high social power (as indexed by the P3). We discuss our findings in relation to the broader literature on power and empathy.

Investigating the effects of pain observation on approach and withdrawal actions

Previous research has shown that observing another individual receiving a painful stimulus leads to motor facilitation as indexed by faster reaction times. The current study explores whether the type of action that is executed modulates this facilitation effect. Specifically, we examined whether approach-like and withdraw-like movements are differentially influenced by pain observation. In experiment 1, participants performed key presses (approach) and releases (withdraw) after observing another person in pain (vs. no pain). In experiment 2, participants used a joystick to make forward (approach) and backward (withdraw) movements after observing another person in pain (vs. no pain). Across both experiments, we did not find evidence for differential effects of pain observation on approach-like and withdraw-like movements. We do, however, report a robust response-general effect of pain observation on motor behaviour (i.e., faster reaction times after pain observation vs. no pain, regardless of movement type). We discuss these results in relation to the wider emotion, attention, and social neuroscience of empathy literatures.

To move or not to move: motor cortical output is enhanced during pain observation regardless of motor preparation state

Previous transcranial magnetic stimulation (TMS) studies have reported a decrease in motor cortical output during pain observation. In contrast, recent behavioral studies have shown that response times are faster after pain observation. This suggests that there is a mismatch between motor activity "during" versus "after" pain observation. We propose that these opposing effects of pain observation on motor activity may be explained by task constraints, as participants in TMS studies are instructed to keep still and relax their hands, whereas participants in behavioral studies maintain a state of readiness to respond. Task and methodological differences make it difficult to compare the results from TMS and behavioral paradigms examining the motor consequences of pain observation. As such, the aim of the current study is to directly test whether task instructions affect motor activity in TMS and behavioral measures of motor activity in the context of pain observation, within a single experiment. Participants watched videos of hands in painful versus nonpainful scenarios while TMS-induced motor evoked potentials were recorded. In the "active" block, participants responded to a cue that appeared immediately after each video; in the "passive" block, they relaxed their hand. Contrary to expectations, participants showed enhanced motor cortical output during pain observation (vs. no-pain) in "both" blocks. We discuss these results in relation to the wider literature on the social neuroscience of empathy.NEW & NOTEWORTHY The current study provides novel results showing an increase motor cortical output, measured via transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs), during empathic pain observation regardless of motor preparation state. Interestingly, this finding runs counter to the empathy for pain literature, which often finds a decrease in motor cortical output during empathic pain observation. We discuss potential explanations for this discrepancy and relate these results to the wider empathy for pain literature.

The Role of Sensorimotor Processes in Pain Empathy

Pain is a salient, aversive sensation which motivates avoidance, but also has a strong social signaling function. Numerous studies have shown that regions of the nervous system active in association with first-hand pain are also active in response to the pain of others. When witnessing somatic pain, such as seeing bodies in painful situations, significant activations occur not only in areas related to the processing of negative emotions, but also in neuronal structures engaged in somatosensation and the control of skeletal muscles. These empathy-related sensorimotor activations are selectively reviewed in this article, with a focus on studies using electrophysiological methods and paradigms investigating responses to somatic pain. Convergent evidence from these studies shows that these activations (1) occur at multiple levels of the nervous system, from the spinal cord up to the cerebral cortex, (2) are best conceptualized as activations of a defensive system, in line with the role of pain to protect body from injury, and (3) contribute to establishing a matching of psychological states between the sufferer and the observer, which ultimately supports empathic understanding and motivate prosocial action. Future research should thus focus on how these sensorimotor responses are related to higher-order empathic responses, including affective sharing and emotion regulation, and how this motivates approach-related prosocial behaviors aimed at alleviating the pain and suffering of others.

Exploring the effects of visual perspective on the ERP components of empathy for pain

Previous neurophysiological research suggests that there are event-related potential (ERP) components associated with empathy for pain: an early affective component (N2) and two late cognitive components (P3/LPP). The current study investigated whether and how the visual perspective from which a painful event is observed affects these ERP components. Participants viewed images of hands in pain vs. not in pain from a first-person or third-person perspective. We found that visual perspective influences both the early and late components. In the early component (N2), there was a larger mean amplitude during observation of pain vs no-pain exclusively when images were shown from a first-person perspective. We suggest that this effect may be driven by misattributing the on-screen hand to oneself. For the late component (P3), we found a larger effect of pain on mean amplitudes in response to third-person relative to first-person images. We speculate that the P3 may reflect a later process that enables effective recognition of others' pain in the absence of misattribution. We discuss our results in relation to self- vs other-related processing by questioning whether these ERP components are truly indexing empathy (an other-directed process) or a simple misattribution of another's pain as one's own (a self-directed process).

Please empathize! Instructions to empathise strengthen response facilitation after pain observation

Recent research has shown that observing others in pain leads to a general facilitation of reaction times. The current study sheds further light on the relationship between pain observation and reaction time by exploring how bottom-up processes, in the form of perceived pain intensity, and top-down processes, in the form of explicit instructions to empathise, influence response facilitation after pain observation. Participants watched videos of a hand getting pierced by a needle or touched by a Q-tip. To manipulate bottom-up information, participants saw videos depicting either deep or shallow insertion of the needle. To investigate potential top-down modulation, half the participants were explicitly requested to empathise with the person in the video, while the other half were told to simply watch and attend to the video. Results from two experiments corroborate previous results showing response facilitation after pain observation. Critically, experiment 2 provides robust evidence that explicit instructions to empathise with a person in pain strengthen response facilitation. We discuss these results considering social cognitive neuroscience and experimental psychology studies of empathy and pain observation.

Changes in spontaneous overt motor execution immediately after observing others' painful action: two pilot studies

Research has demonstrated that motor control is directly influenced by observation of others’ action, stimulating the mirror neuron system. In addition, there is evidence that both emotion and empathy after observing a painful stimulus affects motor cortical excitability and reaction times. Aim of the present two pilot studies is a) to test for significant influence of observing other’s painful bending of the trunk on execution of the same activity in a self-directed bending action (study 1) and to compare these results with a bending action according to a strict bending protocol (study 2). In addition to study 1, differences between Low Back Pain (LBP) patients versus healthy subjects are tested. Video footage of a (1) neutral, (2) painful, and (3) happy bending action was presented in random order. Changes in flexion–relaxation phenomenon (FRP) of back muscles were studied directly after watching the videos with surface EMG, in study 1 during a self-directed bending action in LBP patients and healthy subjects, in study 2 according to a strict bending protocol. FRP ratios were calculated by a custom-made analysis scheme tested for sufficient reliability prior to both studies. Evoked emotions were measured with an Emotional Questionnaire after each video. A Mixed Model ANOVA was used to test for the effect video and the difference between LBP and healthy subjects on the FRP-rs. Differences in evoked emotion will be tested with a Wilcoxon Signed Rank Test. In study 1, 24 healthy controls and 16 LBP patients FRP-rs were significantly influenced after observing a painful video in all subjects versus a happy and neutral video (p = 0.00). No differences were present between LBP and healthy controls. All subjects experienced more fear after observation of the painful video (p 0.05). In study 2, 6 healthy subjects followed the strict FRP bending protocol for three times after observing each video. No significant changes occurred in FRPs per video compared to FRPs of six healthy subjects carrying out the spontaneous bending activity. Observing a painful action in another person changes motor performance and increases fear in both people with and without back pain, during self-directed trunk flexion, but not during a protocolled trunk flexion.