Pain relief provided by an outgroup member enhances analgesia

The Effect of Everyday-Life Social Contact on Pain

Pain is a biopsychosocial phenomenon, resulting from the interplay between physiological and psychological processes and social factors. Given that humans constantly interact with others, the effect of social factors is particularly relevant. Documenting the significance of the social modulation of pain, an increasing number of studies have investigated the effect of social contact on subjective pain intensity and pain-related physiological changes. While evidence suggests that social contact can alleviate pain, contradictory findings indicate an increase in pain intensity and a deterioration of pain coping strategies. This evidence primarily stems from studies examining the effect of social contact on pain within highly controlled laboratory conditions. Moreover, pain assessments often rely on one-time subjective reports of average pain intensity across a predefined period. Ecological momentary assessments (EMAs) can circumvent these problems, as they can capture diverse aspects of behavior and experiences multiple times a day, in real time, with high resolution, and within naturalistic and ecologically valid settings. These multiple measures allow for the examination of fluctuations of pain symptoms throughout the day in relation to affective, cognitive, behavioral, and social factors. In this opinion paper, we review the current state and future relevance of EMA-based social pain research in daily life. Specifically, we examine whether everyday-life social support reduces or enhances pain. The first part of the paper provides a comprehensive overview of the use of EMA in pain research and summarizes the main findings. The review of the relatively limited number of existing EMA studies shows that the association between pain and social contact in everyday life depends on numerous factors, including pain syndromes, temporal dynamics, the nature of social interactions, and characteristics of the interaction partners. In line with laboratory research, there is evidence that everyday-life social contact can alleviate, but also intensify pain, depending on the type of social support. Everyday-life emotional support seems to reduce pain, while extensive solicitous support was found to have opposite effects. Moreover, positive short-term effects of social support can be overshadowed by other symptoms such as fatigue. Overall, gathering and integrating experiences from a patient's social environment can offer valuable insights. These insights can help interpret dynamics in pain intensity and accompanying symptoms such as depression or fatigue. We conclude that factors determining the reducing versus enhancing effects of social contact on pain need to be investigated more thoroughly. We advocate EMA as the assessment method of the future and highlight open questions that should be addressed in future EMA studies on pain and the potential of ecological momentary interventions for pain treatment.

The social transmission of empathy relies on observational reinforcement learning

Theories of moral development propose that empathy is transmitted across individuals. However, the mechanisms through which empathy is socially transmitted remain unclear. Here, we combine computational learning models and functional MRI to investigate whether, and if so, how empathic and non-empathic responses observed in others affect the empathy of female observers. The results of three independent studies showed that watching empathic or non-empathic responses generates a learning signal that respectively increases or decreases empathy ratings of the observer. A fourth study revealed that the learning-related transmission of empathy is stronger when observing human rather than computer demonstrators. Finally, we show that the social transmission of empathy alters empathy-related responses in the anterior insula, i.e., the same region that correlated with empathy baseline ratings, as well as its functional connectivity with the temporoparietal junction. Together, our findings provide a computational and neural mechanism for the social transmission of empathy that accounts for changes in individual empathic responses in empathic and non-empathic social environments.

Learning from Ingroup Experiences Changes Intergroup Impressions

Humans form impressions toward individuals of their own social groups (ingroup members) and of different social groups (outgroup members). Outgroup-focused theories predict that intergroup impressions are mainly shaped by experiences with outgroup individuals, while ingroup-focused theories predict that ingroup experiences play a dominant role. Here we test predictions from these two psychological theories by estimating how intergroup impressions are dynamically shaped when people learn from both ingroup and outgroup experiences. While undergoing fMRI, male participants had identical experiences with different ingroup or outgroup members and rated their social closeness and impressions toward the ingroup and the outgroup. Behavioral results showed an initial ingroup bias in impression ratings which was significantly reduced over the course of learning, with larger effects in individuals with stronger ingroup identification. Computational learning models revealed that these changes in intergroup impressions were predicted by the weight given to ingroup prediction errors. Neurally, the individual weight for ingroup prediction errors was related to the coupling between the left inferior parietal lobule and the left anterior insula, which, in turn, predicted learning-related changes in intergroup impressions. Our findings provide computational and neural evidence for ingroup-focused theories, highlighting the importance of ingroup experiences in shaping social impressions in intergroup settings.SIGNIFICANCE STATEMENT Living in multicultural societies, humans interact with individuals of their own social groups (ingroup members) and of different social groups (outgroup members). However, little is known about how people learn from the mixture of ingroup and outgroup interactions, the most natural experiences in current societies. Here, participants had identical, intermixed experiences with different ingroup and outgroup individuals and rated their closeness and impressions toward the ingroup and the outgroup. Combining computational models and fMRI, we find that the weight given to ingroup experiences (ingroup prediction errors) is the main source of intergroup impression change, captured by changes in connectivity between the parietal lobe and insula. These findings highlight the importance of ingroup experiences in shaping intergroup impressions in complex social environments.

The influence of social signals on the self-experience of pain: A neuroimaging review

Researchers in cognitive neuroscience have investigated extensively how psychological factors shape the processing and perception of pain using behavioral, physiological, and neuroimaging methods. However, social influences of pain, an essential part of biopsychosocial pain models, have received relatively little attention. This is particularly true for the neurobiological mechanisms underlying social modulations on pain. Therefore, this review discusses the findings of recent neuroimaging studies measuring the effects of social manipulations on pain perception (e.g., verbal and non-verbal social signals, social interaction style, conformity, social support, and sociocultural mediators). Finally, a schematic summary of the different social modulatory themes is presented.

Adaptive Empathy: A Model for Learning Empathic Responses in Response to Feedback

Empathy is usually deployed in social interactions. Nevertheless, common measures and examinations of empathy study this construct in isolation from the person in distress. In this article we seek to extend the field of examination to include both empathizer and target to determine whether and how empathic responses are affected by feedback and learned through interaction. Building on computational approaches in feedback-based adaptations (e.g., no feedback, model-free and model-based learning), we propose a framework for understanding how empathic responses are learned on the basis of feedback. In this framework, adaptive empathy, defined as the ability to adapt one's empathic responses, is a central aspect of empathic skills and can provide a new dimension to the evaluation and investigation of empathy. By extending existing neural models of empathy, we suggest that adaptive empathy may be mediated by interactions between the neural circuits associated with valuation, shared distress, observation-execution, and mentalizing. Finally, we propose that adaptive empathy should be considered a prominent facet of empathic capabilities with the potential to explain empathic behavior in health and psychopathology.

The skin conductance response indicating pain relief is independent of self or social influence on pain

Pain relief is defined as the ease of pain and is thus highly relevant for clinical applications and everyday life. Given that pain relief is based on the cessation of an aversive pain experience, it is reasonable to assume that pain relief learning would also be shaped by factors that alter subjective and physiological pain responses, such as social presence or a feeling of control. To date, it remains unclear whether and how factors that shape autonomic pain responses might affect pain relief learning. Here, we investigated how pain relief learning is shaped by two important factors known to modulate pain responses, i.e. social influence and controllability of pain. Skin conductance responses (SCRs) were recorded while participants learned to associate a formerly neutral stimulus with pain relief under three different pain conditions. In the social‐influence condition (N = 34), the pain stimulation could be influenced by another person’s decisions. In the self‐influence condition (N = 31), the participants themselves could influence the pain stimulation. Finally, in the no‐influence condition (N = 32), pain stimulation was simply delivered without any influence. According to our results, the SCRs elicited by the stimulus that was associated with pain relief were significantly smaller compared to the SCRs elicited by a neutral control stimulus, indicating pain relief learning. However, there was no significant difference in the pain relief learning effect across the groups. These results suggest that physiological pain relief learning in humans is not significantly influenced by social influence and pain controllability.

The contents of this page will be shown on the eTOC on the online version only. It will not be published as part of the article PDF. Subjective and physiological pain responses can be altered by social support or pain controllability. Pain relief strongly depends on the perceived pain, but we found that it is less influenceable. Neither social nor self‐influence changed the magnitude of physiological pain‐relief responses. We conclude that pain relief is a basic mechanism not easily influenced by circumstantial manipulations.

A neurocognitive model of ideological thinking

Ideological behavior has traditionally been viewed as a product of social forces. Nonetheless, an emerging science suggests that ideological worldviews can also be understood in terms of neural and cognitive principles. The article proposes a neurocognitive model of ideological thinking, arguing that ideological worldviews may be manifestations of individuals' perceptual and cognitive systems. This model makes two claims. First, there are neurocognitive antecedents to ideological thinking: the brain's low-level neurocognitive dispositions influence its receptivity to ideological doctrines. Second, there are neurocognitive consequences to ideological engagement: strong exposure and adherence to ideological doctrines can shape perceptual and cognitive systems. This article details the neurocognitive model of ideological thinking and synthesizes the empirical evidence in support of its claims. The model postulates that there are bidirectional processes between the brain and the ideological environment, and so it can address the roles of situational and motivational factors in ideologically motivated action. This endeavor highlights that an interdisciplinary neurocognitive approach to ideologies can facilitate biologically informed accounts of the ideological brain and thus reveal who is most susceptible to extreme and authoritarian ideologies. By investigating the relationships between low-level perceptual processes and high-level ideological attitudes, we can develop a better grasp of our collective history as well as the mechanisms that may structure our political futures.

Clinician-Patient Movement Synchrony Mediates Social Group Effects on Interpersonal Trust and Perceived Pain

Pain is an unfortunate consequence of many medical procedures, which in some patients becomes chronic and debilitating. Among the factors affecting medical pain, clinician-patient (C-P) similarity and nonverbal communication are particularly important for pain diagnosis and treatment. Participants (N = 66) were randomly assigned to clinician and patient roles and were grouped into C-P dyads. Clinicians administered painful stimuli to patients as an analogue of a painful medical procedure. We manipulated the perceived C-P similarity of each dyad using groups ostensibly based on shared beliefs and values, and each patient was tested twice: Once with a same group clinician (concordant, CC) and once with a clinician from the other group (discordant, DC). Movement synchrony was calculated as a marker of nonverbal communication. We tested whether movement synchrony mediated the effects of group concordance on patients' pain and trust in the clinician. Movement synchrony was higher in CC than DC dyads. Higher movement synchrony predicted reduced pain and increased trust in the clinician. Movement synchrony also formally mediated the group concordance effects on pain and trust. These findings increase our understanding of the role of nonverbal C-P communication on pain and related outcomes. Interpersonal synchrony may be associated with better pain outcomes, independent of the specific treatment provided. PERSPECTIVE: This article demonstrates that movement synchrony in C-P interactions is an unobtrusive measure related to their relationship quality, trust toward the clinician, and pain. These findings suggest that interpersonal synchrony may be associated with better patient outcomes, independent of the specific treatment provided.

The mere physical presence of another person reduces human autonomic responses to aversive sounds

Social animals show reduced physiological responses to aversive events if a conspecific is physically present. Although humans are innately social, it is unclear whether the mere physical presence of another person is sufficient to reduce human autonomic responses to aversive events. In our study, participants experienced aversive and neutral sounds alone (alone treatment) or with an unknown person that was physically present without providing active support. The present person was a member of the participants' ethnical group (ingroup treatment) or a different ethnical group (outgroup treatment), inspired by studies that have found an impact of similarity on social modulation effects. We measured skin conductance responses (SCRs) and collected subjective similarity and affect ratings. The mere presence of an ingroup or outgroup person significantly reduced SCRs to the aversive sounds compared with the alone condition, in particular in participants with high situational anxiety. Moreover, the effect was stronger if participants perceived the ingroup or outgroup person as dissimilar to themselves. Our results indicate that the mere presence of another person was sufficient to diminish autonomic responses to aversive events in humans, and thus verify the translational validity of basic social modulation effects across different species.

The effects of psychosocial stress on intergroup resource allocation

Stress changes our social behavior. Traditionally, stress has been associated with “fight-or-flight” – the tendency to attack an aggressor, or escape the stressor. But stress may also promote the opposite pattern, i.e., “tend-and-befriend” – increased prosociality toward others. It is currently unclear which situational or physiological factors promote one or the other. Here, we hypothesized that stress stimulates both tendencies, but that fight-or-flight is primarily directed against a potentially hostile outgroup, moderated by rapid-acting catecholamines, while tend-and-befriend is mainly shown towards a supportive ingroup, regulated by cortisol. To test this hypothesis, we measured stress-related neurohormonal modulators and sex hormones in male and female participants who were exposed to a psychosocial stressor, and subsequently played an intergroup social dilemma game in which they could reveal prosocial motives towards an ingroup (ingroup-love) and hostility towards an outgroup (outgroup-hate). We found no significant effects of stress on social preferences, but stress-related heart-rate increases predicted outgroup-hostile behavior. Furthermore, when controlling for testosterone, cortisol was associated with increased ingroup-love. Other-regarding behavior was overall higher in male than female participants. Our mixed results are of interest to scholars of the effects of stress on prosocial and aggressive behavior, but call for refinement in future replications.

Brain activity sustaining the modulation of pain by empathetic comments

Empathetic verbal feedback from others has been shown to alleviate the intensity of experimental pain. To investigate the brain changes associated with this effect, we conducted 3T-fMRI measurements in 30 healthy subjects who received painful thermal stimuli on their left hand while overhearing empathetic, neutral or unempathetic comments, supposedly made by experimenters, via headsets. Only the empathetic comments significantly reduced pain intensity ratings. A whole-brain BOLD analysis revealed that both Empathetic and Unempathetic conditions significantly increased the activation of the right anterior insular and posterior parietal cortices to pain stimuli, while activations in the posterior cingulate cortex and precuneus (PCC/Prec) were significantly stronger during Empathetic compared to Unempathetic condition. BOLD activity increased in the DLPFC in the Empathetic condition and decreased in the PCC/Prec and vmPFC in the Unempathetic condition. In the Empathetic condition only, functional connectivity increased significantly between the vmPFC and the insular cortex. These results suggest that modulation of pain perception by empathetic feedback involves a set of high-order brain regions associated with autobiographical memories and self-awareness, and relies on interactions between such supra-modal structures and key nodes of the pain system.