The effect of acute pain on risky and intertemporal choice

The effect of fast and slow decision-making on equity-efficiency tradeoffs and moral repugnance

Fast-and-slow models of decision-making are commonly invoked to explain economic behaviour. However, past research has focused on human cooperation and generosity and thus largely overlooked situations where there are sharp conflicts between efficiency and equality, or between efficiency and more intuitive moral values (repugnance). Here, we contribute to fill this gap in the literature. We conducted a preregistered experiment (n = 1500 recruited from Prolific) to assess the effects of fast, intuitive decisions, under time pressure versus slow, deliberate decisions, under time delay, on (i) people's distributional preferences and (ii) their attitudes toward repugnant transactions. The results show increased preference for equality and decreased preference for efficiency under time pressure, but no effects on moral repugnance. Exploratory analyses revealed that most of the observed treatment effects in our data were accounted for by women. Our results provide some support for theories that associate controlled cognition with concern for efficiency, and intuitive, emotional responses with inequality aversion.

The modulation of pain in reward processing is reflected by increased P300 and delta oscillation

Pain elicits the desire for a reward to alleviate the unpleasant sensation. This may be a consequence of facilitated neural activities in the reward circuit. However, the temporal modulation of pain on reward processing remains unclear. We addressed this issue by recording electroencephalogram when participants received win or loss feedback in a simple gambling task. Pain treatment was conducted on 33 participants with topical capsaicin cream and on 33 participants with hand cream as a control. Results showed that pain generally increased the P300 amplitude for both types of feedback but did not affect feedback-related negativity (FRN). A significant interaction effect of treatment (painful, non-painful) and outcome (win, loss) was observed on delta oscillation as pain only enhanced the power of win feedback. In addition, the FRN and theta oscillation responded more to loss feedback, but this effect was unaffected by pain. These findings indicate that pain may enhance secondary value representation and evaluation processes of rewards, but does not influence primary distinction of reward or reward expectation. The temporal unfolding of how pain affects reward-related neural activities highlights the prominent impact of pain on high-level cognitive processes associated with reward.

Anti-social behaviour and economic decision-making: Panel experimental evidence in the wake of COVID-19

We systematically examine the acute impact of exposure to a public health crisis on anti-social behaviour and economic decision-making using unique experimental panel data from China, collected just before the outbreak of COVID-19 and immediately after the first wave was overcome. Exploiting plausibly exogenous geographical variation in virus exposure coupled with a dataset of longitudinal experiments, we show that participants who were more intensely exposed to the virus outbreak became more anti-social than those with lower exposure, while other aspects of economic and social preferences remain largely stable. The finding is robust to multiple hypothesis testing and a similar, yet less pronounced pattern emerges when using alternative measures of virus exposure, reflecting societal concern and sentiment, constructed using social media data. The anti-social response is particularly pronounced for individuals who experienced an increase in depression or negative affect, which highlights the important role of psychological health as a potential mechanism through which the virus outbreak affected behaviour.

Public health shocks, learning and diet improvement

Many governments aim to mitigate health risks by attacking nutritional failures. In this article, we exploit a unique natural experiment, the COVID-19 pandemic as an exogenous public health shock, to estimate the learning effects of intensive health information campaigns on nutrient intake during the pandemic. Using data from nearly-one million food purchases in China, our empirical findings strongly support the learning effect in explaining improvements in nutrient intake in the post-COVID-19 period. We conclude that when public health shocks occur, policy makers can boost relevant learning mechanisms by promoting information and education to improve individuals' awareness of preventive health behaviors of a more permanent nature, which can lead to health improvements in a society.

The impact of C-tactile low-threshold mechanoreceptors on affective touch and social interactions in mice

Affective touch is necessary for proper neurodevelopment and sociability. However, it remains unclear how the neurons innervating the skin detect affective and social behaviors. The C low-threshold mechanoreceptors (C-LTMRs), a specific population of somatosensory neurons in mice, appear particularly well suited, physiologically and anatomically, to perceive affective and social touch. However, their contribution to sociability has not been resolved yet. Our observations revealed that C-LTMR functional deficiency induced social isolation and reduced tactile interactions in adulthood. Conversely, transient increase in C-LTMR excitability in adults, using chemogenetics, was rewarding, promoted touch-seeking behaviors, and had prosocial influences on group dynamics. This work provides the first empirical evidence that specific peripheral inputs alone can drive complex social behaviors. It demonstrates the existence of a specialized neuronal circuit, originating in the skin, wired to promote interactions with other individuals.

Face Mask Reduces the Effect of Proposer’s (Un)Trustworthiness on Intertemporal and Risky Choices

Previous literature suggested that individuals increase temporal and risk discounting at the presence of a proposer whose face is perceived as untrustworthy, suggesting the activation of protective choice patterns. By the way, the COVID-19 pandemic has substantially transformed the way we interact with other people, even bringing us into situations where the face of the person making a proposal is not fully visible, because of the mask. With the current study, we aimed at verifying if the effect of proposer’s facial (un)trustworthiness on discounting behavior is modulated by mask wearing. In two different experiments, participants performed traditional delay and probability discounting tasks with masked proposers manipulated across trustworthiness levels. Results highlighted that, even after checking for subject-specific emotion recognition ability with masked faces, the presence of a masked untrustworthy proposer increases both delay and probability discounting parameters, although the effect is not statistically significant and smaller than the one detected at the presence of an untrustworthy proposer without a mask. These results suggest that the ability to perceive the proposer’s (un)trustworthiness is affected by the mask, with a consequent less strong effect of proposer’s (un)trustworthiness on choice behavior on both intertemporal and risky choices. Limits and possible implications are outlined and discussed.

The subsequent interruptive effects of pain on attention

BACKGROUND

Pain is known to interrupt attentional performance selectively. In a previous study we showed that the interruptive effect of thermal pain on attention could persist up to 1500 ms after painful stimulus offset, but whether the pain modality affects this subsequent interruptive effect remains unclear.

METHODS

The present study was conducted to determine the time course of the interruptive effect of electrically induced pain on orienting and executive attention using various intervals between electric stimulation and attentional tasks (0, 250, 500, 750, 1000, 1250, and 1500 ms) and three study groups (pain, non-pain, and control). We performed two separate experiments in which participants performed a spatial cue task (experiment 1) and the Stroop task (experiment 2). Participants in the pain and non-pain groups received brief electric somatosensory stimulation, and those in the control group received no physical stimulus. We compared the performance of the three groups under the interstimulus interval (ISI) conditions.

RESULTS

The impairment of orienting attention prevailed under the first six ISI conditions in the pain and non-pain groups (F_{2, 63} = 5.72, P < 0.01); executive attention was not affected (F_1,66 = 1.64, P = 0.20), confirming the persistence of the interruptive effect after stimulus offset.

CONCLUSIONS

This study demonstrated the interruptive effect of somatic stimulation on subsequent orienting attention performance, with no effect on executive attention. These findings suggest that pain has differential effects on the components of attention, depending on its modality and salience.

Money gained through suffering is less valuable: Pain reduces the sensitivity to outcome magnitude in monetary decision making

Enduring pain would change individuals' behavioral preferences and neural responses in multiple decision-making tasks. Yet few studies have investigated how money's casual association with painful experience would modify people's decisions with it. It is an important and common social situation. The present study investigated how money's association with pain influences the way people make monetary decisions. Participants gambled with money that they earned in four different ways: enduring pain (Pain), randomly assigned (Random), non-painful effort task (Effort), and observing negative images (NO). Results revealed two different patterns. In the Random and Pain conditions, participants were not sensitive to the gambling risk such that they more randomly chose high- and low-risk options; the differences in FNR amplitude triggered by high- and low-risk choices were comparable on the neural level. In contrast, in the Effort and NO conditions, participants showed higher sensitivity to the magnitude and larger differences in FNR amplitudes between high- and low-risk choices. These findings suggested that pain cannot increase the subjective value of monetary gain like other non-painful efforts can do and monetary rewards may not be the optimal way to compensate for the physical suffering or loss in society.

Contextualised strong reciprocity explains selfless cooperation despite selfish intuitions and weak social heuristics

Humans frequently cooperate for collective benefit, even in one-shot social dilemmas. This provides a challenge for theories of cooperation. Two views focus on intuitions but offer conflicting explanations. The Social Heuristics Hypothesis argues that people with selfish preferences rely on cooperative intuitions and predicts that deliberation reduces cooperation. The Self-Control Account emphasizes control over selfish intuitions and is consistent with strong reciprocity-a preference for conditional cooperation in one-shot dilemmas. Here, we reconcile these explanations with each other as well as with strong reciprocity. We study one-shot cooperation across two main dilemma contexts, provision and maintenance, and show that cooperation is higher in provision than maintenance. Using time-limit manipulations, we experimentally study the cognitive processes underlying this robust result. Supporting the Self-Control Account, people are intuitively selfish in maintenance, with deliberation increasing cooperation. In contrast, consistent with the Social Heuristics Hypothesis, deliberation tends to increase the likelihood of free-riding in provision. Contextual differences between maintenance and provision are observed across additional measures: reaction time patterns of cooperation; social dilemma understanding; perceptions of social appropriateness; beliefs about others' cooperation; and cooperation preferences. Despite these dilemma-specific asymmetries, we show that preferences, coupled with beliefs, successfully predict the high levels of cooperation in both maintenance and provision dilemmas. While the effects of intuitions are context-dependent and small, the widespread preference for strong reciprocity is the primary driver of one-shot cooperation. We advance the Contextualised Strong Reciprocity account as a unifying framework and consider its implications for research and policy.

Craving mediates the association between momentary pain and illicit opioid use during treatment for opioid-use disorder: an ecological momentary assessment study

AIM

To assess the role of momentary pain on opioid craving and illicit opioid use among individuals receiving opioid agonist treatment.

DESIGN

Observational study using ecological momentary assessment.

SETTING

The National Institute of Drug Abuse Intramural Research Program in the United States.

PARTICIPANTS

Fifty-six adults who qualified for opioid agonist treatment.

MEASUREMENTS

Participants completed randomly prompted assessments of pain severity, stress, negative mood, opioid craving and illicit opioid use for a mean of 66 days [standard deviation (SD) = 27]. Urine samples were collected two to three times/week throughout.

FINDINGS

Almost 70% of participants reported moderate average pain severity in the past 24 hours at intake and 35% of participants reported chronic pain. There were no significant differences in percent of opioid-positive urine samples (P = 0.73) and average level of opioid craving during the study period (P = 0.91) among opioid agonist treatment only patients versus opioid agonist treatment patients with chronic pain. However, momentary pain severity significantly predicted concurrent opioid craving [B = 0.02, 95% confidence interval (CI) = 0.01, 0.04], over and above stress and negative mood. Momentary opioid craving, in turn, significantly predicted illicit opioid use that was assessed in the next moment [odds ratio (OR) = 1.72, 95% CI = 1.12, 2.64), while controlling for autocorrelation and the effects of pain, negative mood and stress. Momentary opioid craving significantly mediated the prospective association between momentary pain and illicit opioid use (95% CI = 0.003, 0.032). Exploratory analysis revealed that momentary pain severity also significantly moderated the momentary association between stress and opioid craving (B = 0.02, 95% CI = 0.00, 0.04), such that when momentary pain severity increased, the association between the two intensified.

CONCLUSIONS

Among people receiving opioid agonist treatment, momentary pain appears to be indirectly associated with illicit opioid use via momentary opioid craving.

Does pain make people short-sighted? The impacts of physical and psychological pains on intertemporal choice

We conducted three experiments to investigate the effects of physical and psychological pains on intertemporal choices. In Experiments 1 and 2, physical pain was induced by the self-created Shiatsu sheet treading method (SSTM) and the classical cold pressor task (CPT), respectively. In Experiment 3, psychological pain was induced by the video induction method. All types of pain increased preference for smaller immediate rewards. Theoretical implications and practical implications are discussed.

Intraoperative posture and workload assessment in vascular surgery

Quantifying the workload and postural demand on vascular surgeons provides valuable information on the physical and cognitive factors that predispose vascular surgeons to musculoskeletal pain and disorders. The aim of this study was to quantify the postural demand, workload, and discomfort experienced by vascular surgeons and to identify procedural factors that influence surgical workload. Both objective (wearable posture sensors) and subjective (surveys) assessment tools were used to evaluate intraoperative workload during 47 vascular surgery procedures. Results demonstrate unfavorable neck and low back postures as well as high pain scores for those body segments. Additionally, workload from subjective surveys increased significantly as a function of operative duration, and mental workload was high across all procedure types. Neck postural risk exposure and physical demand were among the variables that increased with surgical duration, procedure type, and loupes used by the surgeons. Correlations among postural angles and pain scores showed consistency between the objective assessment and the subjective surveys for neck and trunk. The authors believe that the results of this study highlight the need for developing mitigating measures such as ergonomic interventions for vascular surgery.

Narcissism, the Experience of Pain, and Risky Decision Making

Personality characteristics and situational factors are known to influence performance on behavioral decision making tasks; however, variability exists in the relationship between narcissism and decision making. In addition, recent research suggests that the presence of acute pain can negatively affect decisions, and even the threat of pain can also cause changes in decision making. Narcissists are known to experience social pain differently than non-narcissists, but relatively little is known about how physical pain is experienced. The present study examined the influence of both pain and narcissism on risky decision making task performance. Participants (n = 248) completed assessments of the narcissistic admiration and rivalry concept as well as vulnerable narcissism. They were asked to complete a pain recall task before administration of the Balloon Analog Risk Task (BART), Columbia Card Task (CCT), Game of Dice Task (GDT), and Iowa Gambling Task (IGT). Although individuals who recalled a socially painful experience took less risks on the IGT across trials, no effect of narcissism was seen on any of the tasks. Recalling a physically or socially painful situation did not negatively affect decision making on the BART, CCT, or GDT. Results are discussed in the context of previous research on narcissism, pain, and cognitive task performance.

Effects of acute pain and pain-related fear on risky decision-making and effort during cognitive tests

Introduction: The experience of acute pain and pain-related fear negatively impact cognition and behavior; however, little research has examined their impacts on risky decision-making and effort. The present study investigated the effects of acute pain and pain-related fear on risky decision-making and effort during cognitive tests. Method: Levels of pain-related fear were assessed. Healthy participants (n = 146) experienced acute pain induced via cold pressor task, and then were randomly assigned to one of the four conditions to induce pain-related fear: Pain Threat (n = 36), Pain Threat with Control (n = 39), Cognitive Threat with Control (n = 34), and Control (n = 36). Participants then completed measures of effort (Word Memory Test [WMT], self-reported effort) and risky decision-making (Iowa Gambling Task [IGT], Balloon Analogue Risk Task [BART]). Results: Collapsed across condition, participants did not learn to decide advantageously on the IGT following an acute pain experience. During the early trials (1-40) on the IGT, participants in the Pain Threat condition made riskier decisions. Higher levels of pain during the cold pressor task predicted less risky decisions on the BART, and participants in the Cognitive Threat with Control condition made less risky decisions. Participants in the Pain Threat with Control condition self-reported lower effort on cognitive tests, yet no group-based differences were seen in WMT performance. Greater pain-related fear predicted greater self-reported effort and better WMT performance, but no effects were seen on decision-making task performance. Conclusions: The experience of pain and the threat of additional pain can lead to changes in risky decision-making and effort on cognitive tasks. This threat of additional pain could activate underlying pain-related fear, creating hypervigilance to and avoidance of pain that affects subsequent task performance. Implications for research and clinical evaluation of acute pain and pain-related fear are discussed.

No Effect of Ego Depletion on Risk Taking

We investigated the effect of ego depletion on risk taking. Specifically, we conducted three studies (total n = 1,716) to test the prediction that ego depletion results in decisions that are more strongly in line with prospect theory, i.e., that ego depletion reduces risk taking for gains, increases risk taking for losses, and increases loss aversion. Ego depletion was induced using two of the most common manipulations from previous literature: the letter 'e' task (Studies 1 and 3) and the Stroop task (Study 2). Risk taking was measured using a series of standard, incentivized economic decision-making tasks assessing risk preferences in the gain domain, risk preferences in the loss domain, and loss aversion. None of the studies revealed a significant effect of ego depletion on risk taking. Our findings cast further doubts about the ability of ego-depletion manipulations to affect actual behavior in experimental settings.

Pain here and now: physical pain impairs transcendence of psychological distance

Background

The ability to traverse psychological distance by going beyond the experienced reality of the self, here and now, is fundamental for effective human functioning. Yet, little is known about how physical pain affects transcendence of psychological distance. Using a construal level theory framework of psychological distance, the current research examines the hypothesis that pain impairs people’s ability to traverse any kind of psychological distance whether it be temporal, social, and spatial distance, or the hypothetical.

Methods

Using the cold pressor test, 151 participants participated in an experiment where they were either induced with acute pain (treatment group) or no pain (control group) while completing a battery of questions measuring to what extent their current thoughts were transcending psychological distance.

Results

The results were largely consistent with the hypothesis. Relative to the control group, pain induced participants showed significantly less transcendence of past temporal distance, social distance, spatial distance, and the hypothetical. Furthermore, greater self-reported pain intensity was significantly associated with less transcendence of temporal (past and future), social, and spatial distance.

Conclusion

Physical pain impairs the ability to traverse psychological distance. The research has practical implications for the pain clinic and for pain-afflicted individuals in everyday life.

Effects of experimental pain induction on alcohol urge, intention to consume alcohol, and alcohol demand

Research suggests one determinant of alcohol consumption may be physical pain, but there is no empirical evidence that pain has a causal effect on drinking. Therefore, the primary aim of this study was to test experimental pain as a determinant of several alcohol consumption proxies: self-reported urge to drink, intention to consume alcohol, and alcohol demand. This study also was designed to test negative affect as a mediator of the effects of pain on alcohol use proxies. We hypothesized that participants randomized to experimental pain induction (vs. no pain) would report greater urge, intention, and alcohol demand, and that these effects would be mediated by increased negative affect. Participants were healthy undergraduates who were moderate-heavy drinkers (N = 61). Experimental pain was induced using a novel capsaicin-heat model intended to approximate key features of clinical pain. Results indicated that participants in the pain condition subsequently endorsed greater urge and intention to drink. Furthermore, these effects were mediated by pain-induced negative affect. We observed no effect of pain on alcohol demand. This is the first study to demonstrate a causal effect of acute pain on urge and intention to drink. Given the close association between alcohol consumption, urge and intention to drink, these findings suggest that pain may influence alcohol consumption, which can have implications for individuals with co-occurring pain and alcohol use disorder (AUD). Specifically, individuals with co-occurring pain and AUD may drink to alleviate pain-related negative affect. Therefore, improving pain-coping skills may enhance pain-management abilities, subsequently reducing coping-motivated drinking. (PsycINFO Database Record

The (Null) Effect of Affective Touch on Betrayal Aversion, Altruism, and Risk Taking

Pleasant touch is thought to increase the release of oxytocin. Oxytocin, in turn, has been extensively studied with regards to its effects on trust and prosocial behavior, but results remain inconsistent. The purpose of this study was to investigate the effect of touch on economic decision making. Participants (n = 120) were stroked on their left arm using a soft brush (touch condition) or not at all (control condition; varied within subjects), while they performed a series of decision tasks assessing betrayal aversion (the Betrayal Aversion Elicitation Task), altruism (donating money to a charitable organization), and risk taking (the Balloon Analog Risk Task). We found no significant effect of touch on any of the outcome measures, neither within nor between subjects. Furthermore, effects were not moderated by gender or attachment. However, attachment avoidance had a significant effect on altruism in that those who were high in avoidance donated less money. Our findings contribute to the understanding of affective touch—and, by extension, oxytocin—in social behavior, and decision making by showing that touch does not directly influence performance in tasks involving risk and prosocial decisions. Specifically, our work casts further doubt on the validity of oxytocin research in humans.

How Accurate Appraisal of Behavioral Costs and Benefits Guides Adaptive Pain Coping

Coping with pain is a complex phenomenon encompassing a variety of behavioral responses and a large network of underlying neural circuits. Whether pain coping is adaptive or maladaptive depends on the type of pain (e.g., escapable or inescapable), personal factors (e.g., individual experiences with coping strategies in the past), and situational circumstances. Keeping these factors in mind, costs and benefits of different strategies have to be appraised and will guide behavioral decisions in the face of pain. In this review we present pain coping as an unconscious decision-making process during which accurately evaluated costs and benefits lead to adaptive pain coping behavior. We emphasize the importance of passive coping as an adaptive strategy when dealing with ongoing pain and thus go beyond the common view of passivity as a default state of helplessness. In combination with passive pain coping, we highlight the role of the reward system in reestablishing affective homeostasis and discuss existing evidence on a behavioral and neural level. We further present neural circuits involved in the decision-making process of pain coping when circumstances are ambiguous and, therefore, costs and benefits are difficult to anticipate. Finally, we address the wider implications of this topic by discussing its relevance for chronic pain patients.