Top-down attention modulation on the perception of others' vocal pain: An event-related potential study

The Empathy for Pain Stimuli System (EPSS): Development and preliminary validation

We present the Empathy for Pain Stimuli System (EPSS): a large-scale database of stimuli for studying people's empathy for pain. The EPSS comprises five sub-databases. First, the Empathy for Limb Pain Picture Database (EPSS-Limb) provides 68 painful and 68 non-painful limb pictures, exhibiting people's limbs in painful and non-painful situations, respectively. Second, the Empathy for Face Pain Picture Database (EPSS-Face) provides 80 painful and 80 non-painful pictures of people's faces being penetrated by a syringe or touched by a Q-tip. Third, the Empathy for Voice Pain Database (EPSS-Voice) provides 30 painful and 30 non-painful voices exhibiting either short vocal cries of pain or neutral interjections. Fourth, the Empathy for Action Pain Video Database (EPSS-Action_Video) provides 239 painful and 239 non-painful videos of whole-body actions. Finally, the Empathy for Action Pain Picture Database (EPSS-Action_Picture) provides 239 painful and 239 non-painful pictures of whole-body actions. To validate the stimuli in the EPSS, participants evaluated the stimuli using four different scales, rating pain intensity, affective valence, arousal, and dominance. The EPSS is available to download for free at https://osf.io/muyah/?view_only=33ecf6c574cc4e2bbbaee775b299c6c1 .

The effect of top-down attention on empathy fatigue

Prolonged exposure to others' suffering can lead to empathy fatigue, especially when individuals struggle to effectively regulate their empathic capacity. Shifting active attention away from emotional components toward cognitive components of others' suffering is an effective strategy for mitigating empathy fatigue. This research investigated how top-down attentional manipulation modulates empathy fatigue in both auditory (Study 1) and visual (Study 2) modalities. Participants completed two tasks in both studies: (i) the attention to cognitive empathy task (A-C task) and (ii) the attention to emotional empathy task (A-E task). Each task included three blocks (Time Block 1, Time Block 2, and Time Block 3) designed to induce empathy fatigue. Study 1 revealed that the A-C task reduced empathy fatigue and N1 amplitudes than the A-E task in Time Block 3, indicating that attention to cognitive empathy might decrease auditory empathy fatigue. Study 2 indicates that the A-C task caused a longer N2 latency than the A-E task, signifying a decelerated emotional empathic response when attention was on cognitive empathy in the visual modality. Overall, prioritizing cognitive empathy seems to conserve mental resources and reduce empathy fatigue. This research documented the relationship between top-down attention and empathy fatigue and the possible neural mechanism.

Neural mechanisms of priming effects of spicy food pictures induced analgesia

In this study, the effects of the priming of spicy food pictures on pain perception were evaluated in female participants using standardized methods of pain. Results from behavior tests revealed that the priming of spicy food pictures significantly reduced pain perception, particularly at high-pain intensities. Electrophysiological analysis showed that the analgesic effects of spicy food pictures were linked to decreased pain-related event-related potentials, such as N2 and P2 amplitudes, and suppressed θ-oscillations in the sensorimotor cortex. Both N2 amplitudes and θ-oscillations activities were found to be correlated with participants' pain perception. These results suggest that spicy-arousal stimuli may act as an "antagonist" to the increase in N2 amplitudes and θ-oscillations power induced by pain and influence the neuronal networks involved in integrating spontaneous nociceptive resources, which supports the dissociation theory of pain sensation and affection. These findings highlight the potential use of spicy-arousal stimuli as an analgesic and emphasize the importance of considering both the intensity of the stimuli and the individual's emotional state in the assessment and treatment of pain.

Attention and emotion shape self-voice prioritization in speech processing

Both self-voice and emotional speech are salient signals that are prioritized in perception. Surprisingly, self-voice perception has been investigated to a lesser extent than the self-face. Therefore, it remains to be clarified whether self-voice prioritization is boosted by emotion, and whether self-relevance and emotion interact differently when attention is focused on who is speaking vs. what is being said. Thirty participants listened to 210 prerecorded words spoken in one's own or an unfamiliar voice and differing in emotional valence in two tasks, manipulating the attention focus on either speaker identity or speech emotion. Event-related potentials (ERP) of the electroencephalogram (EEG) informed on the temporal dynamics of self-relevance, emotion, and attention effects. Words spoken in one's own voice elicited a larger N1 and Late Positive Potential (LPP), but smaller N400. Identity and emotion interactively modulated the P2 (self-positivity bias) and LPP (self-negativity bias). Attention to speaker identity modulated more strongly ERP responses within 600 ms post-word onset (N1, P2, N400), whereas attention to speech emotion altered the late component (LPP). However, attention did not modulate the interaction of self-relevance and emotion. These findings suggest that the self-voice is prioritized for neural processing at early sensory stages, and that both emotion and attention shape self-voice prioritization in speech processing. They also confirm involuntary processing of salient signals (self-relevance and emotion) even in situations in which attention is deliberately directed away from those cues. These findings have important implications for a better understanding of symptoms thought to arise from aberrant self-voice monitoring such as auditory verbal hallucinations.

Skin Color and Attractiveness Modulate Empathy for Pain: An Event-Related Potential Study

Although racial in-group bias in empathy for pain has been reported, empathic responses to others’ pain may be influenced by other characteristics besides race. To explore whether skin color and attractiveness modulate empathy for pain, we recorded 24 participants’ reactions to painful faces from racial in-group members with different skin color (fair, wheatish, or dark) and attractiveness (more or less attractive) using event-related potentials (ERPs). Results showed that, for more attractive painful faces, dark skin faces were judged as less painful and elicited smaller N2 amplitudes than fair- and wheatish-skinned faces. However, for less attractive faces, there were no significant differences among the three skin colors. Our findings suggest that empathy for pain toward racial in-group members may be influenced by skin color and attractiveness.

Social Exclusion Down-Regulates Pain Empathy at the Late Stage of Empathic Responses: Electrophysiological Evidence

Social exclusion has a significant impact on cognition, emotion, and behavior. Some behavioral studies investigated how social exclusion affects pain empathy. Conclusions were inconsistent, and there is a lack of clarity in identifying which component of pain empathy is more likely to be affected. To investigate these issues, we used a Cyberball task to manipulate feelings of social exclusion. Two groups (social exclusion and social inclusion) participated in the same pain empathy task while we recorded event-related potentials (ERP) when participants viewed static images of body parts in painful and neutral situations. The results showed early N2 differentiation between painful and neutral pictures in the central regions in both groups. The pattern at the late controlled processing stage was different. Parietal P3 amplitudes for painful pictures were significantly smaller than those for neutral pictures in the social exclusion group; they did not differ in the social inclusion group. We observed a parietal late positive potential (LPP) differentiation between painful and neutral pictures in both groups. LPP amplitudes were significantly smaller in the social exclusion group than those in the social inclusion group for painful stimuli. Our results indicate that social exclusion does not affect empathic responses during the early emotional sharing stage. However, it down-regulates empathic responses at the late cognitive controlled stage, and this modulation is attenuated gradually. The current study provides neuroscientific evidence of how social exclusion dynamically influences pain empathy.

Pain Modulates Responses to Emotional Stimuli

Pain and emotion are common subjective experiences that play vital roles in daily life. Pain has been clinically confirmed to increase depressive mood. However, little is known about how pain modulates cognitive emotional judgment processing. A better understanding of this may help explain the effect of pain on the development of depressive moods. We recruited 30 adult participants to test their responses to pictures of scenes (Experiment 1) and faces (Experiment 2) that represented happy, neutral, and sad emotions, while experiencing painful (induced via topical capsaicin cream) and control (hand cream) treatments. Results showed that participants in the painful condition showed lower accuracy to emotional scene stimuli and longer reaction times to both emotional scene and face stimuli, relative to the control condition. In addition, the difference values of the reaction times between the painful and control conditions were larger for sad scenes than for happy or neutral scenes. These results suggest that pain alters attentional processing of emotional stimuli, especially with regards to sad scene stimuli, which may explain how painful stimuli affect the development of depressive moods.

Altered neuronal habituation to hearing others' pain in adults with autistic traits

This study tested the hypothesis that autistic traits influence the neuronal habituation that underlies the processing of others' pain. Based on their autism-spectrum quotient (AQ), two groups of participants were classified according to their autistic traits: High-AQ and Low-AQ groups. Their event-related potentials in response to trains of three identical audio recordings, exhibiting either painful or neutral feelings of others, were compared during three experimental tasks. (1) In a Pain Judgment Task, participants were instructed to focus on pain-related cues in the presented audio recordings. (2) In a Gender Judgment Task, participants were instructed to focus on non-pain-related cues in the presented audio recordings. (3) In a Passive Listening Task, participants were instructed to passively listen. In the High-AQ group, an altered empathic pattern of habituation, indexed by frontal-central P2 responses of the second repeated painful audio recordings, was found during the Passive Listening Task. Nevertheless, both High-AQ and Low-AQ groups exhibited similar patterns of habituation to hearing others' voices, both neutral and painful, in the Pain Judgment and Gender Judgment Tasks. These results suggest altered empathic neuronal habituation in the passive processing of others' vocal pain by individuals with autistic traits.

The linkage between first-hand pain sensitivity and empathy for others' pain: Attention matters

Many studies suggested shared psychological and neural representations for first-hand physical pain and empathy for others' pain, both of which depend strongly upon top-down controlled mechanisms such as attention. This study aimed to assess the interindividual variation in first-hand physical pain and empathy for pain, and whether their relationship is dependent upon attention. We recruited participants exhibiting high and low sensitivity to first-hand pain (HPS and LPS), and adopted pain empathy paradigms involving attention directed toward or withdrawn from pain of another. Relative to the LPS group, participants in the HPS group estimated greater pain intensity experienced by others, felt greater unpleasantness when viewing others in pain, and exhibited greater sensitivity in discriminating others' pain. Electroencephalographic data showed that when attention was directed toward others' pain, only participants in the HPS group exhibited significant pain empathic effects on the N1 component of event-related potentials and on the α-oscillation response. These empathic neural responses mediated the linkage between first-hand pain sensitivity and empathic behavioral responses. Nevertheless, empathic responses were comparable between two groups when attention was withdrawn from others' pain. These results demonstrate a shared sensitivity to first-hand pain and empathy for pain provided that attention is directed toward pain.

Differences between empathy for face and body pain: Cognitive and neural responses

Empathy for pain is a hotspot in the field of empathy research because of its specific cognitive and neural mechanism. Currently, studies of empathy for pain can be classified into two categories based on the body regions receiving the painful stimulus, i.e., empathy for face pain and empathy for body pain, which conveys painful information based on individuals’ faces or body parts, respectively. Although the existing evidence revealed differences between these two kinds of pain empathy regarding the underlying cognitive and neural mechanisms, the current studies tend to confuse these findings. Therefore, we summarized the differences between empathy for face and body pain, mainly regarding the behavioral reactivity tendency, brain activations, and electrophysiological (EEG) signals. These differences probably stem from the fact that the human face contains more emotional information, while other body parts contain more perceptual information. Thus, future studies should identify the distinctions between empathy for face and body pain, to explore further how empathy for face pain is affected by the facial information of others and focus on empathy for face pain in individuals with psychopathological disorders. Furthermore, the specific reasons for these distinctions and their underlying neuromechanisms deserve to be further reviewed.

The interaction between pain and attractiveness perception in others

When considering the “beauty-is-good” stereotype, facial attractiveness should facilitate empathy for pain. On the other hand, having in mind the “threat value of pain” hypothesis, pain cues would be more salient, and thus, its processing would not suffer influence by facial attractiveness. The event-related potential (ERP) allows investigating if one of these theories could predict individuals’ responses regarding the perception of pain or attractiveness in others’ faces. We tracked 35 participants’ reactions to pictures depicting more and less attractive faces displayed in a painful and non-painful condition. Each participant completed the following two tasks when presented the images of faces: (1) the Pain Judgment Task, in which participants should rate the pain levels, and (2) the Attractiveness Judgment Task, in which participants should rate the attractiveness. Results showed that participants exhibited differences rating more and less attractive faces in the non-painful pictures, but not in the painful pictures. These results were observed in P3 and LPC amplitudes in the Pain Judgment Task, as well as in N170 and P2 amplitudes in the Attractive Judgment Task. Our results suggested that both explicit and implicit empathic pain processing inhibited the processing of attractiveness perception. These findings supported the “threat value of pain” hypothesis. Besides, in the Attractive Judgment Task, the N170 and P2 amplitudes for more attractive painful pictures were larger than those for more attractive non-painful pictures. In contrast, no significant difference was found between the amplitudes for painful and non-painful, less attractive pictures. Our findings suggest that explicit facial attractiveness processing for more attractive face images potentiates the implicit empathy for pain processing, therefore partly supporting the “beautiful-is-good” stereotype.