Viewing pictures of a romantic partner reduces experimental pain: involvement of neural reward systems

Psychophysiological and interpersonal effects of parallel group crafting: a multimodal study using EEG and ECG

In occupational therapy, crafts and groups are used as therapeutic tools, but their electrophysiological effects have not been well described. This study aimed to investigate the effects of group crafting on the physiological synchrony (PS) of dyadic heartbeats and on the autonomic activity and electroencephalogram (EEG) of individuals. In this cross-sectional study, individuals' EEG and dyadic electrocardiogram (ECG) were measured during the task in a variety of conditions. The three conditions were alone, parallel, nonparallel. Autonomic activity from the subjects' ECG, PS from the dyadic ECG, and current source density from exact Low Resolution Brain Electromagnetic Tomography (eLORETA) from subjects' EEG were analyzed. Measurements from 30 healthy young adults showed that the parallel condition significantly increased subjects' parasympathetic activity and dyadic PS. Parallel condition and frontal midline theta influenced parasympathetic activity, whereas parasympathetic activity was not associated with PS. Dyadic lag value were correlated with frontal delta, beta, and gamma activity. The results suggest that crafting in parallel groups increases parasympathetic activity and PS through different mechanisms, despite the absence of direct interaction. They also explain the electrophysiological evidence for the use of crafts and groups in psychiatric occupational therapy, such as increased relaxation and PS.

Verbal Support From a Stranger Reduces the Development of Mechanical Hypersensitivity: Behavioral and Neurophysiological Evidence

Hand-holding reduces experimentally induced acute pain and buffers against the development of mechanical secondary hypersensitivity, an indirect proxy of central sensitization. Here, we tested if verbal support from a stranger, a common occurrence in clinical contexts, exerts the same effects. In this preregistered study, 44 healthy female participants were assigned to an alone or support group whereby a supportive female stranger encouraged them through the painful procedure leading to secondary mechanical hypersensitivity. Mechanical hypersensitivity was measured via self-reports and by the size of the anteroposterior and mediolateral spread of mechanical hypersensitivity. We investigated the moderating role of attachment style on self-reports and the effects of support on skin conductance level, salivary cortisol, and pinprick-evoked potentials. We also tested whether theta/beta ratio in the resting-state electroencephalogram predicted mechanical hypersensitivity. Self-reported ratings and the late part of the pinprick-evoked potentials were reduced in the support group, but the spread of mechanical hypersensitivity was not. Attachment anxiety and avoidance moderated the self-reported intensity such that individuals with higher attachment anxiety and avoidance scores reported lower intensity ratings in the support group. No significant effect of the verbal support was observed on skin conductance level and salivary cortisol. The theta/beta ratio did not predict the extent of hypersensitivity. Our data indicate that, in women, verbal support during intense pain leading to hypersensitivity is effective on some behavioral outcomes, but altogether the lack of group differences in cortisol, self-reported stress, and skin conductance does not provide strong support for the stress-buffering hypothesis. PERSPECTIVE: Verbal support by a stranger during a painful procedure leading to secondary mechanical hypersensitivity attenuated the development of some measures of mechanical hypersensitivity and associated neural responses in healthy female participants. No evidence was found for the role of stress. DATA AVAILABILITY: The authors will make all data available upon request.

Refuting Six Misconceptions about Romantic Love

Scientific research on romantic love has been relatively sparse but is becoming more prevalent, as it should. Unfortunately, several misconceptions about romantic love are becoming entrenched in the popular media and/or the scientific community, which hampers progress. Therefore, I refute six misconceptions about romantic love in this article. I explain why (1) romantic love is not necessarily dyadic, social, or interpersonal, (2) love is not an emotion, (3) romantic love does not just have positive effects, (4) romantic love is not uncontrollable, (5) there is no dedicated love brain region, neurotransmitter, or hormone, and (6) pharmacological manipulation of romantic love is not near. To increase progress in our scientific understanding of romantic love, I recommend that we study the intrapersonal aspects of romantic love including the intensity of love, that we focus our research questions and designs using a component process model of romantic love, and that we distinguish hypotheses and suggestions from empirical findings when citing previous work.

The extended neural architecture of human attachment: An fMRI coordinate-based meta-analysis of affiliative studies

Functional imaging studies and clinical evidence indicate that cortical areas relevant to social cognition are closely integrated with evolutionarily conserved basal forebrain structures and neighboring regions, enabling human attachment and affiliative emotions. The neural circuitry of human affiliation is continually being unraveled as functional magnetic resonance imaging (fMRI) becomes increasingly prevalent, with studies examining human brain responses to various attachment figures. However, previous fMRI meta-analyses on affiliative stimuli have encountered challenges, such as low statistical power and the absence of robustness measures. To address these issues, we conducted an exhaustive coordinate-based meta-analysis of 79 fMRI studies, focusing on personalized affiliative stimuli, including one's infants, family, romantic partners, and friends. We employed complementary coordinate-based analyses (Activation Likelihood Estimation and Signed Differential Mapping) and conducted a robustness analysis of the results. Findings revealed cluster convergence in cortical and subcortical structures related to reward and motivation, salience detection, social bonding, and cognition. Our study thoroughly explores the neural correlates underpinning affiliative responses, effectively overcoming the limitations noted in previous meta-analyses. It provides an extensive view of the neural substrates associated with affiliative stimuli, illuminating the intricate interaction between cortical and subcortical regions. Our findings significantly contribute to understanding the neurobiology of human affiliation, expanding the known human attachment circuitry beyond the traditional basal forebrain regions observed in other mammals to include uniquely human isocortical structures.

Chronic pain patients low in social connectedness report higher pain and need deeper pressure for pain relief

The experience of rejection and disconnection reliably amplifies pain. Yet, little is known about the impact of enduring feelings of closeness, or social connectedness, on experiences of chronic pain. The current secondary analysis tested the hypothesis that greater social connectedness would predict lower chronic pain ratings, mediated by lower depression and anxiety. In addition, based on the social-affective effects of deeper pressure, and our previous finding that deeper pressure from a weighted blanket reduced chronic pain ratings, we examined whether deeper pressure from a weighted blanket would induce greater pain relief in socially disconnected chronic pain patients. We assessed social connectedness, anxiety, and depression at baseline and pain levels before and after a remote, 7-day randomized-controlled trial of a heavy or light (control) weighted blanket in a predominately White (86%) and female (80%) sample of 95 chronic pain patients. Results revealed that lower social connectedness was associated with higher chronic pain ratings, which was mediated by anxiety, but not depression. Pressure level (light vs. deep) moderated associations between social connectedness and pain reductions, such that deeper pressure was necessary for pain relief in the most socially disconnected participants. Our findings suggest a close relationship between social connectedness and chronic pain through a mechanistic pathway of anxiety. Furthermore, our findings demonstrate that sensory-affective interventions such as a weighted blanket may be a beneficial tool for chronic pain sufferers who are prone to social disconnection, potentially by activating embodied representations of safety and social support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Infant pain vs. pain with parental suppression: Immediate and enduring impact on brain, pain and affect

BACKGROUND

In the short term, parental presence while a human infant is in pain buffers the immediate pain responses, although emerging evidence suggests repeated social buffering of pain may have untoward long-term effects.

METHODS/FINDING

To explore the short- and long-term impacts of social buffering of pain, we first measured the infant rat pup's [postnatal day (PN) 8, or 12] response to mild tail shock with the mother present compared to shock alone or no shock. Shock with the mother reduced pain-related behavioral activation and USVs of pups at both ages and reduced Fos expression in the periaqueductal gray, hypothalamic paraventricular nucleus, and the amygdala at PN12 only. At PN12, shock with the mother compared to shock alone differentially regulated expression of several hundred genes related to G-protein-coupled receptors (GPCRs) and neural development, whereas PN8 pups showed a less robust and less coherent expression pattern. In a second set of experiments, pups were exposed to daily repeated Shock-mother pairings (or controls) at PN5-9 or PN10-14 (during and after pain sensitive period, respectively) and long-term outcome assessed in adults. Shock+mother pairing at PN5-9 reduced adult carrageenan-induced thermal hyperalgesia and reduced Fos expression, but PN10-14 pairings had minimal impact. The effect of infant treatment on adult affective behavior showed a complex treatment by age dependent effect. Adult social behavior was decreased following Shock+mother pairings at both PN5-9 and PN10-14, whereas shock alone had no effect. Adult fear responses to a predator odor were decreased only by PN10-14 treatment and the infant Shock alone and Shock+mother did not differ.

CONCLUSIONS/SIGNIFICANCE

Overall, integrating these results into our understanding of long-term programming by repeated infant pain experiences, the data suggest that pain experienced within a social context impacts infant neurobehavioral responses and initiates an altered developmental trajectory of pain and affect processing that diverges from experiencing pain alone.

Familiarity From Facial Appearance Leads to Hypoalgesia

Social context has been shown to influence pain perception. This study aimed to broaden this literature by investigating whether relevant social stimuli, such as faces with different levels of intrinsic (based on physical resemblance to known individuals) and episodic (acquired through a previous experience) familiarity, may lead to hypoalgesia. We hypothesized that familiarity, whether intrinsic or acquired through experience, would increase pain threshold and decrease pain intensity. Sixty-seven participants underwent pain induction (the cold pressor test) viewing previously seen faces (Episodic Group) or new faces (Non-episodic Group) that differed in the level of intrinsic familiarity (high vs low). Pain threshold was measured in seconds, while pain intensity was measured on a rating scale of 0 to 10. The results did not show an effect of episodic familiarity. However, compared to low, high intrinsic familiar faces had an attenuating effect on pain intensity, even after controlling for pain expectation. These results suggest that physical features conveying a higher feeling of familiarity induce a top-down hypoalgesic modulation, in line with the idea that familiarity may signal safety and that the presence of familiar others reduce perceived threat-related distress. This study provides further evidence on the social modulation of pain and contributes to the literature on first impressions' influence on social behavior. PERSPECTIVE: Consistent with the idea that familiar others signal safety and reduce the sense of threat, facial features conveying familiarity induce a top-down hypoalgesic modulation. This knowledge may contribute to understanding differences in pain perception in experimental and clinical contexts.

Positive imagery in depressive suicidal patients: A randomized controlled trial of the effect of viewing loved ones' photos on mood states and suicidal ideation

According to research, it has been suggested that individuals who are affected by depression could potentially engage in the creation and experience emotional advantages relating to positive events directed towards the past or future, with the condition that they are provided with suitable mental imagery techniques. The main aim of this study was to assess the impact of utilizing positive imagery, specifically through the utilization of photographs featuring loved ones, on mood states and suicidal ideation among individuals diagnosed with depression and exhibiting suicidal tendencies. This randomized, double-blind, controlled crossover trial was conducted among 78 hospitalized depressive patients at three psychiatric services between April and August 2019. The patients participated in four individual picture-viewing sessions on four consecutive days. The four categories of pictures were included: loved ones, neutral faces of strangers, natural landscapes, and optical illusions. Directly prior to and immediately following the observation of the visual stimuli (photographs), the Brunel Mood Scale (BRUMS) and the Beck Scale for Suicide Ideation (BSSI) were completed by the patients. Repeated measures ANOVAs conducted in this study revealed a significant main effect of time on ratings of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). Additionally, statistically significant interactions were identified between picture category and time in relation to the variables of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). The analysis did not reveal a significant main effect of time on ratings of anger, confusion, and suicidal ideation (P values > 0.05). Likewise, the interaction between picture category and time did not yield significant results for the variables of anger, confusion, and suicidal ideation (P values > 0.05). The positive imagery procedure using the presentation of loved ones' photos showed beneficial effects on the mood states of depressed patients. The findings of this study suggest that incorporating a greater emphasis on positive imagery within the context of clinical depression may offer potential advantages. This highlights the potential for novel opportunities in the treatment of depression.

Trial registration

The study has been registered in the Iranian Registry of Clinical Trials (registration number: IRCT20180808040744N1; first registration date: December 22, 2018; website: https://en.irct.ir/trial/33186).

Realizing consumers' existential dreams via product marketing and mixed reality: a perspective based on affective neuroscience theories

In an era of swift societal changes and escalating consumerism, this paper presents an exploration of an innovative approach that integrates product marketing strategies, mixed reality (MR) technology, and affective neuroscience theories to actualize consumers' existential dreams. MR, with its unique capacity to blend the virtual and real worlds, can enhance the consumer experience by creating immersive, personalized environments that resonate with consumers' existential aspirations. Insights from affective neuroscience, specifically the brain's processing of emotions, guide the development of emotionally engaging marketing strategies, which strengthen the connection between consumers, products, and brands. These integrated strategies not only present a novel blueprint for companies to deepen consumer engagement but also promise more fulfilling and meaningful consumer experiences. Moreover, this approach contributes to societal well-being and prosperity, marking a significant stride in the field of marketing.

Pain perception and physiological responses are modulated by active support from a romantic partner

As social animals, humans are strongly affected by social bonds and interpersonal interactions. Proximity and social support from significant others may buffer the negative outcomes of a painful experience. Several studies have investigated the role of romantic partners' support in pain modulation, mostly focusing on tactile support and showing its effectiveness in reducing pain perception. Nevertheless, no study so far has investigated the role of supportive speaking on pain modulation, nor has compared the effects of a tactile and vocal support within the same couples. The present study directly compared for the first time the efficacy of mere presence (Passive Support) and different forms of active (Touch, Voice, Touch + Voice) support from a romantic partner during a painful experience in a naturalistic setting. We assessed pain modulation in 37 romantic couples via both subjective (self-reported ratings) and physiological (skin conductance) measurements. We found that all three types of active support were equally more effective than passive support in reducing the painful experience at both subjective and physiological levels; interestingly, our results suggest that supportive speaking can reduce pain perception with respect to passive support to a similar extent as tactile support does. Overall, this study highlights the relevance of an active support in reducing pain perception, with active types of support being more effective than passive support, regardless of its specific modality.

Social Buffering Effects during Craft Activities in Parallel Group Session Revealed by EEG Analysis and Parasympathetic Activity

INTRODUCTION

The therapeutic structure of occupational therapy (OT) includes groups. Although the presence of others is expected to be relaxing due to the social buffering effect and the tend and befriend theory, it has not been sufficiently validated in accordance with the therapeutic structure of OT. The aim of this study was to investigate the electrophysiological evidence for the effectiveness of parallel groups and states of concentration on craft activities used in OT.

METHODS

Thirty healthy young adults were used as controls to measure EEG and autonomic activity during craft activities in three conditions: alone, parallel, and nonparallel. EEG was analyzed using exact low-resolution electromagnetic tomography, and autonomic activity was analyzed using Lorenz plot analysis.

RESULTS

Parasympathetic activity was significantly higher in the parallel condition than in the alone condition. A significant negative correlation was found between current source density and parasympathetic activity in the region centered on the right insular cortex in the α1 band, and functional connectivity in regions including the anterior cingulate cortex and insular cortex was associated with autonomic activity.

CONCLUSION

Craft activities that occurred during frontal midline theta rhythm also increased parasympathetic activity. The results suggest that the parallel groups used in OT and the intensive state of craft activities induce a social buffering effect that increases parasympathetic activity despite the absence of physical contact or social support. This provides evidence for the effectiveness of the therapeutic structure of occupational activities and groups in OT.

Brain imaging signatures of neuropathic facial pain derived by artificial intelligence

Advances in neuroimaging have permitted the non-invasive examination of the human brain in pain. However, a persisting challenge is in the objective differentiation of neuropathic facial pain subtypes, as diagnosis is based on patients' symptom descriptions. We use artificial intelligence (AI) models with neuroimaging data to distinguish subtypes of neuropathic facial pain and differentiate them from healthy controls. We conducted a retrospective analysis of diffusion tensor and T1-weighted imaging data using random forest and logistic regression AI models on 371 adults with trigeminal pain (265 classical trigeminal neuralgia (CTN), 106 trigeminal neuropathic pain (TNP)) and 108 healthy controls (HC). These models distinguished CTN from HC with up to 95% accuracy, and TNP from HC with up to 91% accuracy. Both classifiers identified gray and white matter-based predictive metrics (gray matter thickness, surface area, and volume; white matter diffusivity metrics) that significantly differed across groups. Classification of TNP and CTN did not show significant accuracy (51%) but highlighted two structures that differed between pain groups-the insula and orbitofrontal cortex. Our work demonstrates that AI models with brain imaging data alone can differentiate neuropathic facial pain subtypes from healthy data and identify regional structural indicates of pain.

In safe hands: Attachment figures' safety properties and the link with attachment style

According to the Learning Theory of Attachment, naturalistic learning experiences about others' responsiveness during distress are an underlying mechanism in the development of attachment. Previous studies have demonstrated attachment figures' unique safety-inducing effects in highly controlled conditioning procedures. Yet, neither have studies examined the presumed influence of safety learning on state attachment, nor have they examined how attachment figures' safety-inducing effects relate to attachment styles. To address these gaps, a differential fear conditioning paradigm was used in which pictures of participants' attachment figure and two control stimuli served as safety cues (CS-). US-expectancy and distress ratings were measured as indicators of fear responding. Results indicate that attachment figures evoked enhanced safety responding compared to control safety cues at the start of acquisition, which was maintained throughout acquisition and when presented together with a danger cue. Attachment figures' safety-inducing effects were reduced in individuals with higher attachment avoidance, although attachment style did not affect the rate of new safety learning. Finally, safe experiences with the attachment figure in the fear conditioning procedure resulted in diminished anxious state attachment. Adding to previous work, these findings underscore the importance of learning processes for attachment development and attachment figures' provision of safety.

Theory of brain complexity and marital behaviors: The application of complexity science and neuroscience to explain the complexities of marital behaviors

The extant theories on the quality and stability of marital relationships have some difficulties in explaining some of the complexities of marital behaviors. The present article is an initial attempt to explain the complexities of marital behaviors based on the science of complexity and neuroscience. This article proposes a new theoretical framework relying on this simple argument that marital behaviors, as one of the most complex human behaviors, are the product of one's brain's complex adaptive system (CAS). Hence, to understand the complexities of marital behaviors, a movement toward familiarity with the brain's CAS involved in marital behaviors needs to be started. The article presents the theory of brain complexity and marital behaviors (BCM) and outlines its assumptions, concepts, and propositions. Then, BCM is compared with the extant theories on happy and stable marriage, and finally, it was concluded by discussing the testability and the potential application of the theory. This article might inspire interdisciplinary studies of marital relationships, complex systems, and neuroscience and may have considerable practical implications.

A partner's smile is not per se a safety signal: Psychophysiological response patterns to instructed threat and safety

Recent studies on fear conditioning and pain perception suggest that pictures of loved ones (e.g., a romantic partner) may serve as a prepared safety cue that is less likely to signal aversive events. Challenging this view, we examined whether pictures of smiling or angry loved ones are better safety or threat cues. To this end, 47 healthy participants were verbally instructed that specific facial expressions (e.g., happy faces) cue threat of electric shocks and others cue safety (e.g., angry faces). When facial images served as threat cues, they elicited distinct psychophysiological defensive responses (e.g., increased threat ratings, startle reflex, and skin conductance responses) compared to viewing safety cues. Interestingly, instructed threat effects occurred regardless of the person who cued shock threat (partner vs. unknown) and their facial expression (happy vs. angry). Taken together, these results demonstrate the flexible nature of facial information (i.e., facial expression and facial identity) to be easily learned as signals for threat or safety, even when showing loved ones.

Toward consistent reporting of sample characteristics in studies investigating the biological mechanisms of romantic love

In this non-systematic review, we consider the sample reporting practices of 42 studies up to and including 2021 investigating the biological mechanisms of romantic love (i.e., 31 neuroimaging studies, nine endocrinological studies, one genetics study, and one combined neuroimaging and genetics study). We searched scientific databases using key terms and drew on our and other authors' knowledge to identify studies that investigated the mechanisms associated with romantic love using neuroimaging, endocrinological, and genetic methods. Only studies with a group or entire sample experiencing romantic love were included. The aim was to collate all relevant studies and determine the comparability of studies and ability to assess the generalizability of findings. We summarize how these studies report sex/gender, age, romantic love, relationship duration/time in love, and sample descriptors. We then outline the case for promoting comparability and the ability to determine generalizability in future studies. The findings indicate a limited ability to compare studies' samples or make an assessment of the generalizability of findings. Existing studies are not representative of the general population in a particular country or globally. We conclude by presenting ideas about how best to report sex, age, romantic love characteristics, relationship status, time in love, relationship duration, relationship satisfaction, type of unrequited love, sexual activity, cultural characteristics, socio-economic status, student status, and method-relevant descriptors. If our ideas are adopted, in part or in whole, we expect the comparability of studies to increase. Adopting our ideas will also make it easier to make an assessment of the generalizability of findings.

Social reappraisal of emotions is linked with the social presence effect in the default mode network

Introduction

Social reappraisal, during which one person deliberately tries to regulate another's emotions, is a powerful cognitive form of social emotion regulation, crucial for both daily life and psychotherapy. The neural underpinnings of social reappraisal include activity in the default mode network (DMN), but it is unclear how social processes influence the DMN and thereby social reappraisal functioning. We tested whether the mere presence of a supportive social regulator had an effect on the DMN during rest, and whether this effect in the DMN was linked with social reappraisal-related neural activations and effectiveness during negative emotions.

Methods

A two-part fMRI experiment was performed, with a psychotherapist as the social regulator, involving two resting state (social, non-social) and two task-related (social reappraisal, social no-reappraisal) conditions.

Results

The psychotherapist's presence enhanced intrinsic functional connectivity of the dorsal anterior cingulate (dACC) within the anterior medial DMN, with the effect positively related to participants' trust in psychotherapists. Secondly, the social presence-induced change in the dACC was related with (a) the social reappraisal-related activation in the bilateral dorsomedial/dorsolateral prefrontal cortex and the right temporoparietal junction and (b) social reappraisal success, with the latter relationship moderated by trust in psychotherapists.

Conclusion

Results demonstrate that a psychotherapist's supportive presence can change anterior medial DMN's intrinsic connectivity even in the absence of stimuli and that this DMN change during rest is linked with social reappraisal functioning during negative emotions. Data suggest that trust-dependent social presence effects on DMN states are relevant for social reappraisal-an idea important for daily-life and psychotherapy-related emotion regulation.

Emotion regulation and the salience network: a hypothetical integrative model of fibromyalgia

Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances and other symptoms, and has a substantial socioeconomic impact. Current biomedical and psychosocial treatments are unsatisfactory for many patients, and treatment progress has been hindered by the lack of a clear understanding of the pathogenesis of fibromyalgia. We present here a model of fibromyalgia that integrates current psychosocial and neurophysiological observations. We propose that an imbalance in emotion regulation, reflected by an overactive 'threat' system and underactive 'soothing' system, might keep the 'salience network' (also known as the midcingulo-insular network) in continuous alert mode, and this hyperactivation, in conjunction with other mechanisms, contributes to fibromyalgia. This proposed integrative model, which we term the Fibromyalgia: Imbalance of Threat and Soothing Systems (FITSS) model, should be viewed as a working hypothesis with limited supporting evidence available. We hope, however, that this model will shed new light on existing psychosocial and biological observations, and inspire future research to address the many gaps in our knowledge about fibromyalgia, ultimately stimulating the development of novel therapeutic interventions.

Spillover effects of retirement: Does health vulnerability matter?

The current literature investigating the impact of retirement and the associated spousal spillover effects overlooks the unintended effects of retirement on spouses in vulnerable health, namely spouses with long-term health conditions (LTHCs). In this paper, we fill this gap in the literature and investigate the impact of an individual's retirement on their partner's health outcomes when their partner has LTHCs. Given the inherent identification challenges associated with entry into retirement, we use the pension-qualifying age in Australia as an instrument. Based on data from the Household Income and Labour Dynamics in Australia survey, we find that the husband's retirement has a positive impact on the wife's quality-adjusted life years (QALY) and other physical and mental health outcomes. We also identify redistribution of domestic workload as a key transmission mechanism of the spousal spillover effects. Women with LTHCs will see their QALY and health improve only if their husband devotes more time to domestic tasks after retirement.

Inter-subject variability of pleasant pain relief using a data-driven approach in healthy volunteers

Background

The offset of a painful and unpleasant sensation can elicit pleasure. This phenomenon, namely pleasant pain relief (PPR), is attracting growing interest in research. While the cold pressor test (CPT) has been frequently used to study the inhibition of pain by the administration of another painful stimulation (inhibitory conditioned pain modulation; ICPM), a preliminary study from our research team has shown that CPT can also elicit a robust and long-lasting PPR. However, its effects on pain relief and inhibition vary greatly between subjects. Although substantial research has been carried out on inter-individual variability in the case of ICPM, the same cannot be said of PPR. Therefore, the current study sought to identify clusters of healthy volunteers with similar dynamic pain responses during the CPT, using a data-driven approach, and to investigate the inter-subject variability for PPR and ICPM.

Methods

One hundred and twenty-two healthy volunteers were recruited. A sequential ICPM paradigm was carried out with CPT (water at 10°C) and a Peltier Thermode to evaluate pain intensity and unpleasantness. Moreover, PPR was measured for four minutes at CPT offset. Statistical analyses were performed using group-based trajectory modelling.

Results

Four trajectories (groups) were identified for CPT pain intensity and unpleasantness ratings with varying levels of tonic pain and pain sensitization (e.g., temporal summation). PPR scores were correlated with both pain ratings trajectories (p &lt; 0.001). On the other hand, no differences were found between groups regarding ICPM efficacy (percentage pain inhibition).

Discussion

This study has provided a first step into the investigation of PPR and ICPM interindividual variability. Using a data-driven approach, it was shown that PPR at CPT offset differs between clusters of participants identified based on dynamic pain intensity and unpleasantness responses from CPT. Thus, it was brought to light that both the levels of tonic pain and pain sensitization underlie individual differences in PPR. The lack of correlation between CPT pain trajectories and ICPM efficacy may be explained by the hypotheses that eliciting ICPM requires only a certain threshold of stimulation which doesn’t need to be noxious. In the future, studies on the inter-subject variability of PPR in large samples of chronic pain patients are warranted.

Stress and reward: A multimodal assessment of childhood sexual abuse

Background

Childhood adversity has been found to impact stress and brain reward systems but it is unclear whether interactions between these systems might explain resilient vs. non-resilient trajectories following childhood sexual abuse (CSA). To address this gap, we adopted a multimodal approach in which cortisol reactivity to an acute stressor was assessed in conjunction with behavioral and neural measures of reward responsiveness in females with major depressive disorder (MDD) or no psychiatric disorders (i.e., resilient) who experienced CSA compared to females with and without MDD who did not experience abuse.

Methods

Latent Class Mixed Modelling (LCMM) identified classes of adults (n = 62; MAge = 26.48, SD = 5.68) characterized by distinct cortisol trajectories in response to a combined social evaluative cold pressor task. Classes were examined for their history of CSA and resilience as well as behavioral and neural measures of reward responsiveness using 128-channel electroencephalography (event-related potentials and source localization analysis).

Results

LCMM analysis identified two distinct classes of individuals with increased (Responders) or blunted (Non-Responders) cortisol reactivity to an acute stressor. Unlike Responders, Non-Responders did not modulate reward responses throughout the stress manipulation. No differences emerged between Responders and Non-Responders in terms of CSA or resilience. However, exploratory results showed that blunted cortisol response and non-modulation of reward responses emerged for those who experienced CSA at a younger age.

Conclusions

Co-occurring blunted stress and reward reactivity emerged irrespective of adults' experience of CSA or resilience. However, preliminary findings showed that CSA ending during peripubertal development was associated with blunted cortisol and reward responsiveness. Future research needs to replicate findings in larger samples and could investigate if increasing reward responsiveness during critical times of neurodevelopment could normalize stress reactivity to future stressors and thus promote resilience.

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.

Attachment Security Priming Delayed Negative Information-Related Attentional Disengagement Among Anxiously Attached Individuals: Evidence From Behavioral and Functional MRI Experiments

Although attachment security has been found to attenuate people’s experience of unpleasant information, how it modulates the attentional process toward such information remains unknown. The present study examined this issue by employing the dot-probe task in functional MRI. After completing the Experiences in Close Relationships-Revised questionnaire (ECR-R), 39 participants were asked to complete the dot-probe task in two conditions: the attachment security priming condition and neutral priming condition. The behavioral results revealed that individuals with high level of attachment anxiety exhibited larger attention disengagement from negative traits in the security priming condition than in the control condition. Correspondingly, the brain regions involved in attention regulation and shifting, such as the posterior cingulate and bilateral parietal area, were less activated among high anxiously attached individuals in the security priming condition. These results suggest a role of attachment security priming in regulating the emotional response in anxiously attached individuals during the attentional stage.

Electrophysiological Correlates of Romantic Love: A Review of EEG and ERP Studies with Beloved-Related Stimuli

Science is starting to unravel the neural basis of romantic love. The goal of this literature review was to identify and interpret the electrophysiological correlates of romantic love. Electroencephalography (EEG) and event-related potential (ERP) studies with a design that elicits romantic love feelings were included. The methods of previous EEG studies are too heterogeneous to draw conclusions. Multiple ERP studies, however, have shown that beloved stimuli elicit an enhanced late positive potential (LPP/P3/P300), which is not due to familiarity, positive valence, or objective beauty. This effect occurs in Western and Eastern cultures and for pictorial and verbal information, and results from bottom-up rather than top-down factors. Studies have also shown that beloved stimuli elicit an early posterior negativity (EPN), which also does not seem to be due to familiarity or positive valence. Data on earlier ERP components (P1, N1, P2, N170/VPP, N2) is scarce and mixed. Of course, the enhanced LPP and EPN are not specific to romantic love. Instead, they suggest that the beloved captures early attention, within 200–300 ms after stimulus onset that is relatively resource-independent, and subsequently receives sustained motivated attention. Future research would benefit from employing cognitive tasks and testing participants who are in love regardless of relationship status.

The Transition from In-Person to Virtual Museum Programming for Individuals Living with Chronic Pain – A Formative Evaluation

Museum engagement may be an effective approach for decreasing social disconnection and pain among individuals living with chronic pain. In October 2019, we launched a randomized controlled trial to assess the feasibility of museum engagement for individuals living with chronic pain; the study was halted in March, 2020 due to Covid-19-related safety concerns. This paper describes the process of transitioning from in-person to virtual museum programing in order to continue the study. Virtual museum programing is a feasible option for individuals living with chronic pain that is amenable to research and which may improve accessibility, inclusivity, and scalability relative to in-person programing.

Neurobiology of Loneliness, Isolation, and Loss: Integrating Human and Animal Perspectives

In social species such as humans, non-human primates, and even many rodent species, social interaction and the maintenance of social bonds are necessary for mental and physical health and wellbeing. In humans, perceived isolation, or loneliness, is not only characterized by physical isolation from peers or loved ones, but also involves negative perceptions about social interactions and connectedness that reinforce the feelings of isolation and anxiety. As a complex behavioral state, it is no surprise that loneliness and isolation are associated with dysfunction within the ventral striatum and the limbic system - brain regions that regulate motivation and stress responsiveness, respectively. Accompanying these neural changes are physiological symptoms such as increased plasma and urinary cortisol levels and an increase in stress responsivity. Although studies using animal models are not perfectly analogous to the uniquely human state of loneliness, studies on the effects of social isolation in animals have observed similar physiological symptoms such as increased corticosterone, the rodent analog to human cortisol, and also display altered motivation, increased stress responsiveness, and dysregulation of the mesocortical dopamine and limbic systems. This review will discuss behavioral and neuropsychological components of loneliness in humans, social isolation in rodent models, and the neurochemical regulators of these behavioral phenotypes with a neuroanatomical focus on the corticostriatal and limbic systems. We will also discuss social loss as a unique form of social isolation, and the consequences of bond disruption on stress-related behavior and neurophysiology.

ISIEA: An image database of social inclusion and exclusion in young Asian adults

Human beings have a fundamental need to belong. Evaluating and dealing with social exclusion and social inclusion events, which represent negative and positive social interactions, respectively, are closely linked to our physical and mental health. In addition to traditional paradigms that simulate scenarios of social interaction, images are utilized as effective visual stimuli for research on socio-emotional processing and regulation. Since the current mainstream emotional image database lacks social stimuli based on a specific social context, we introduced an open-access image database of social inclusion/exclusion in young Asian adults (ISIEA). This database contains a set of 164 images depicting social interaction scenarios under three categories of social contexts (social exclusion, social neutral, and social inclusion). All images were normatively rated on valence, arousal, inclusion score, and vicarious feeling by 150 participants in Study 1. We additionally examined the relationships between image ratings and the potential factors influencing ratings. The importance of facial expression and social context in the image rating of ISIEA was examined in Study 2. We believe that this database allows researchers to select appropriate materials for socially related studies and to flexibly conduct experimental control.

Are positive psychology interventions efficacious in chronic pain treatment? A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

Although positive psychology interventions are increasingly popular in chronic pain treatment their efficacy is still unclear. The objective is to summarize evidence on the effect of positive psychology interventions (PPIs) on pain, physical functioning, and emotional functioning in adults with chronic pain.

METHODS

Four electronic databases and additional references were searched for randomized controlled trials published between 1990 and 2020. Findings from included studies were qualitatively and quantitatively synthesized, and study quality was assessed for risk of bias. A random effects meta-analysis model was applied for outcomes with more than four findings.

RESULTS

Of 16 included randomized controlled trials, almost half delivered positive psychology interventions as self-help online interventions, and half conducted guided face-to-face interventions which lasted mostly eight weeks. Results from meta-analysis showed beneficial effects of positive psychology interventions compared to the control group on pain intensity and emotional functioning (i.e., less depressive symptoms, pain catastrophizing, negative affect; more positive affect) post-intervention. At 3-month follow-up, beneficial effects were maintained for depressive symptoms and positive and negative affect, but not for pain catastrophizing. However, the evidence on the long-term efficacy of PPIs and the efficacy of PPIs on physical functioning remains limited.

CONCLUSION

This review supports the notion that positive psychology interventions are beneficial to chronic pain treatment, although further, high quality research is needed to support this conclusion.

Developing a framework for arts in health programs targeting individuals with chronic pain: a mixed-methods study of practitioners

OBJECTIVES

Chronic pain is a leading cause of morbidity and disability across the world. Cultural engagement may be a valuable tool in addressing the social disconnection that often accompanies chronic pain. This study sought to develop a framework for arts in health programs targeting individuals with chronic pain.

STUDY DESIGN

Sequential explanatory mixed-methods study.

METHODS

Web-based, cross-sectional survey sent to arts and cultural professionals to assess their experience with arts in health programming. Semi-structured interviews conducted with a sample of survey respondents to explore their perspectives on targeted arts in health programming for individuals with chronic pain.

RESULTS

Between October 2019 and January 2020, 208 surveys were completed by arts and cultural professionals. One hundred and twenty (58%) of the respondents indicated that they currently run an arts in health or museums in health program. Among these 120 respondents, 52 (43%) targeted older adults, 50 (42%) targeted individuals with mental health concerns, and 18 (15%) targeted individuals living with pain. Improving well-being (101 [84%]) and reducing social isolation (90 [75%]) were the most common intended program outcomes, while improving pain was the least common outcome (26 [22%]). Fifteen survey respondents were interviewed. Interviewees identified four interdependent themes regarding best practices for arts in health programs pertaining to (1) program content and structure, (2) program facilitation, (3) partnerships, and (4) programs for individuals with chronic pain.

CONCLUSIONS

The cultural sector can support chronic pain prevention and treatment efforts through the development of specialized programs. This study provides a framework for developing arts in health programs that support individuals living with chronic pain.

Pain modulation by your partner: An experimental investigation from a social-affective perspective

Background

Social context such as the relationship between a person experiencing pain and a caregiver has been shown to affect the experience of pain, yet, results are not consistent. Possibly, differential effects of interpersonal relationships are modulated by affective states expressed by social partners. Viewing partner pictures in experimental designs is not only associated with lowered perceived pain intensity, but also affects neural responses. However, the role of affective modulation is not clear. The present study aimed to systematically examine the pain modulating effects of stimuli varying in affect and social content including personal relevance using subjective report and psychophysiological measures of facial and autonomic activity.

Methods

Twenty-nine women underwent a tonic heat pain paradigm with simultaneous picture viewing to investigate the influence of their partners’ faces with a neutral facial expression compared to strangers’ happy, angry and neutral facial expressions on pain intensity and accompanying psychophysiological parameters (facial activity: corrugator muscle activity, autonomic activity: skin conductance level, heart rate). In addition to perceived partner support and relationship characteristics, the contribution of the affective value (valence, arousal) of the partner faces to the observed pain modulation was examined.

Results

Partner and happy faces reduced self-reported pain intensity and corrugator activity, the latter being lowest when viewing partner faces as compared to all other picture categories. As corrugator activity is indexing stimulus unpleasantness and a core feature of the facial pain expression, this physiological pattern matches well with the subjective ratings. Neutral objects, neutral and angry faces had no effect on pain self-report, although angry faces were rated as highly negative. Partner faces also led to increased skin conductance, being an index of motivational activation, and heart rate deceleration, possibly reflecting increased sensory intake. Partner-related pain modulation was primarily related to perceived arousal of the partner’s picture, i.e., the intensity of the activation of approach motivation, and pain-related catastrophizing.

Discussion

Our results are partially consistent with emotional pain control models, especially regarding the modulatory influence of valence. Within the context of socially adaptive behavior, they particularly underline the social signal value of emotion and attachment figures. Clinically, our results imply that just looking at pictures of one’s partner when undergoing acute painful procedures can have a robust hypoalgesic effect.

Neural mechanisms of self-affirmation's stress buffering effects

Self-affirmation can buffer stress responses across different contexts, yet the neural mechanisms for these effects are unknown. Self-affirmation has been shown to increase activity in reward-related neural regions, including the ventral striatum and ventromedial prefrontal cortex (VMPFC). Given that reward-related prefrontal cortical regions such as the VMPFC are involved in reducing neurobiological and behavioral responses to stress, we hypothesized that self-affirmation would activate VMPFC and also reduce neural responses to stress in key neural threat system regions such as the dorsal anterior cingulate cortex (dACC) and anterior insula (AI). We explored this hypothesis using self-affirmation and evaluative stress tasks following a within-subjects design in the fMRI scanner. Consistent with prior work, self-affirmation blocks led to lower self-reported stress and improved performance. With respect to neural activity, compared to control blocks, self-affirmation blocks led to greater VMPFC activity, and subsequently less left AI (but not dACC) activity during stress task blocks. Functional connectivity analyses revealed greater connectivity between the VMPFC and left and right AI during self-affirmation compared to control. These findings begin to articulate the neural circuits involved in self-affirmation's effects during exposure to stressors, and more broadly specify neural reward-based responses to stressful situations.

Touch and social support influence interpersonal synchrony and pain

Interpersonal touch and social support can influence physical health, mental well-being and pain. However, the mechanisms by which supportive touch promotes analgesia are not well understood. In Study 1, we tested how three kinds of social support from a romantic partner (passive presence, gentle stroking and handholding) affect pain ratings and skin conductance responses (SCRs). Overall, support reduced pain ratings in women, but not men, relative to baseline. Support decreased pain-related SCRs in both women and men. Though there were no significant differences across the three support conditions, effects were largest during handholding. Handholding also reduced SCRs in the supportive partner. Additionally, synchronicity in couples’ SCR was correlated with reductions in self-reported pain, and individual differences in synchrony were correlated with the partner’s trait empathy. In Study 2, we re-analyzed an existing dataset to explore fMRI activity related to individual differences in handholding analgesia effects in women. Increased activity in a distributed set of brain regions, including valuation-encoding frontostriatal areas, was correlated with lower pain ratings. These results may suggest that social support can reduce pain by changing the value of nociceptive signals. This reduction may be moderated by interpersonal synchrony and relationship dynamics.

Acetaminophen does not affect cardiac and brain responses to social rejection but seems to attenuate behavioral adaptation in a social judgment task

The present study examined the effect of Acetaminophen on the painful experience of social rejection by examining brain, cardiac and behavioral measures reflecting different aspects of social feedback processing. Healthy students (N = 72), after ingesting either Acetaminophen or a placebo, performed a social judgment paradigm (SJP), in which they could be expectedly or unexpectedly rejected or accepted. During the task, cardiac and brain responses to different types of feedback were measured, as well as expectancies relating to the given feedback. Enhanced cardiac deceleration was found after unexpected social rejection as compared to all other conditions. Larger mean P3 amplitude was found after expected positive and negative feedback stimuli as compared to unexpected stimuli. While cardiac deceleration and P3 were not affected by Acetaminophen, behavioral responses were. While in the control group the percentage of acceptance predictions decreased over the experiment (learning from negative feedback), the Acetaminophen group did not adjust their positive prediction bias over time. The unexpected effect of Acetaminophen on prediction behavior suggests that Acetaminophen might indeed play a role in social pain perception. The normally observed social pain-based learning effect seems to disappear when participants ingest Acetaminophen, which can be interpreted as a reduced pain perception after Acetaminophen.

Neural basis of affective touch and pain: A novel model suggests possible targets for pain amelioration

Pain is one of the most common health problems and has a severe impact on quality of life. Yet, a suitable and efficient treatment is still not available for all patient populations suffering from pain. Interestingly, recent research shows that low threshold mechanosensory C‐tactile (CT) fibres have a modulatory influence on pain. CT‐fibres are activated by slow gentle stroking of the hairy skin, providing a pleasant sensation. Consequently, slow gentle stroking is known as affective touch. Currently, a clear overview of the way affective touch modulates pain, at a neural level, is missing. This review aims to present such an overview. To explain the interaction between affective touch and pain, first the neural basis of the affective touch system and the neural processing of pain will be described. To clarify these systems, a schematic illustration will be provided in every section. Hereafter, a novel model of interactions between affective touch and pain systems will be introduced. Finally, since affective touch might be suitable as a new treatment for chronic pain, possible clinical implications will be discussed.

Romantic love affects emotional processing of love-unrelated stimuli: An EEG/ERP study using a love induction task

The aim of the present study was to investigate (a) the neural correlates of a love induction task (LIT) including listening to love-related songs and thinking about the romantic relationship, and (b) the effects of romantic love on the emotional processing of love-unrelated stimuli during a passive viewing task. The EEG was recorded in two groups of university students: people in love (Love Group, LG, N = 22, 19 F) and people not in love (Control Group, CG, N = 20, 15 F). The LIT induced higher pleasantness and arousal in the LG than in the CG, as well as higher alpha activity in occipital-right electrodes, suggesting active mental imagery and internal focused attention. During the picture viewing task, the LG displayed larger N1 amplitudes than the CG in response to unpleasant pictures, and lower amplitudes of the late positive potential to both pleasant and unpleasant pictures at frontal sites. Overall, these results suggest an early attentional modulation of the neural responses to unpleasant, mood-incongruent cues, followed by an implicit emotional down-regulation of arousing stimuli, which might have important implications for everyday attitudes and behaviors.

Proximate and Ultimate Perspectives on Romantic Love

Romantic love is a phenomenon of immense interest to the general public as well as to scholars in several disciplines. It is known to be present in almost all human societies and has been studied from a number of perspectives. In this integrative review, we bring together what is known about romantic love using Tinbergen’s “four questions” framework originating from evolutionary biology. Under the first question, related to mechanisms, we show that it is caused by social, psychological mate choice, genetic, neural, and endocrine mechanisms. The mechanisms regulating psychopathology, cognitive biases, and animal models provide further insights into the mechanisms that regulate romantic love. Under the second question, related to development, we show that romantic love exists across the human lifespan in both sexes. We summarize what is known about its development and the internal and external factors that influence it. We consider cross-cultural perspectives and raise the issue of evolutionary mismatch. Under the third question, related to function, we discuss the fitness-relevant benefits and costs of romantic love with reference to mate choice, courtship, sex, and pair-bonding. We outline three possible selective pressures and contend that romantic love is a suite of adaptions and by-products. Under the fourth question, related to phylogeny, we summarize theories of romantic love’s evolutionary history and show that romantic love probably evolved in concert with pair-bonds in our recent ancestors. We describe the mammalian antecedents to romantic love and the contribution of genes and culture to the expression of modern romantic love. We advance four potential scenarios for the evolution of romantic love. We conclude by summarizing what Tinbergen’s four questions tell us, highlighting outstanding questions as avenues of potential future research, and suggesting a novel ethologically informed working definition to accommodate the multi-faceted understanding of romantic love advanced in this review.

Verbal threat learning does not spare loved ones

Significant others provide individuals with a sense of safety and security. However, the mechanisms that underlie attachment-induced safety are hardly understood. Recent research has shown beneficial effects when viewing pictures of the romantic partner, leading to reduced pain experience and defensive responding. Building upon this, we examined the inhibitory capacity of loved face pictures on fear learning in an instructed threat paradigm. Pictures of loved familiar or unknown individuals served as signals for either threat of electric shocks or safety, while a broad set of psychophysiological measures was recorded. We assumed that a long-term learning history of beneficial relations interferes with social threat learning. Nevertheless, results yielded a typical pattern of physiological defense activation towards threat cues, regardless of whether threat was signaled by an unknown or a loved face. These findings call into question the notion that pictures of loved individuals are shielded against becoming threat cues, with implications for attachment and trauma research.

High Rejection Sensitivity in Patients With Somatoform Pain Disorder

Objective: Rejection sensitivity (RS) is often associated with mental disorders but as yet has not been investigated in patients with somatoform pain disorder (SPD). The aim of the study was to explore the degree of RS in patients with SPD compared to healthy controls. In addition, we examined factors associated with RS and the moderator effect of SPD. Methods: A total of 65 patients with SPD (confirmed by Structured Clinical Interview, SCID-I) and 65 age- and gender-matched healthy controls participated. Rejection Sensitivity Questionnaire (RSQ), Patient Health Questionnaire (PHQ-9, PHQ-15), Relationship Scale (ReSQ), Essen Trauma Inventory (ETI) and the Childhood Trauma Questionnaire (CTQ) were applied. Multiple linear regression analysis was performed. Results: The level of RS was significantly higher in patients with SPD compared to healthy controls (M = 10.30, SD = 5.64; M = 6.13, SD = 2.50; p < 0.001; d = 0.95). Higher levels of depressive symptoms (p < 0.001), childhood adversities (p < 0.001) and the insecure attachment style (p = 0.007) were related to higher levels of RS. No significant moderation effect was detected. Conclusions: Patients with SPD are highly sensitive to social rejection. In addition, insecure attachment styles as well as depressive symptoms and childhood adversities are strongly associated with RS. Further studies are needed to figure out how RS is connected to SPD over lifetime.

The social ecology of childhood and early life adversity

An increasing prevalence of early childhood adversity has reached epidemic proportions, creating a public health crisis. Rather than focusing only on adverse childhood experiences (ACEs) as the main lens for understanding early childhood experiences, detailed assessments of a child's social ecology are required to assess "early life adversity." These should also include the role of positive experiences, social relationships, and resilience-promoting factors. Comprehensive assessments of a child's physical and social ecology not only require parent/caregiver surveys and clinical observations, but also include measurements of the child's physiology using biomarkers. We identify cortisol as a stress biomarker and posit that hair cortisol concentrations represent a summative and chronological record of children's exposure to adverse experiences and other contextual stressors. Future research should use a social-ecological approach to investigate the robust interactions among adverse conditions, protective factors, genetic and epigenetic influences, environmental exposures, and social policy, within the context of a child's developmental stages. These contribute to their physical health, psychiatric conditions, cognitive/executive, social, and psychological functions, lifestyle choices, and socioeconomic outcomes. Such studies must inform preventive measures, therapeutic interventions, advocacy efforts, social policy changes, and public awareness campaigns to address early life adversities and their enduring effects on human potential. IMPACT: Current research does not support the practice of using ACEs as the main lens for understanding early childhood experiences. The social ecology of early childhood provides a contextual framework for evaluating the long-term health consequences of early life adversity. Comprehensive assessments reinforced with physiological measures and/or selected biomarkers, such as hair cortisol concentrations to assess early life stress, may provide critical insights into the relationships between early adversity, stress axis regulation, and subsequent health outcomes.

The neurobiological reward system in Prolonged Grief Disorder (PGD): A systematic review

Prolonged Grief Disorder (PGD) is a debilitating condition affecting between 7% and 10% of bereaved individuals. Past imaging and psychological studies have proposed links between PGD's characteristic symptoms - in particular, profound yearning - and the neural reward system. We conducted a systematic review to investigate this connection. On December 19, 2019, we searched six bibliographic databases for data on the neurobiology of grief and disordered grief. We excluded studies of the hypothalamic-pituitary-adrenal (HPA) axis, animal studies, and reviews. After abstract and full-text screening, twenty-four studies were included in the final review. We found diverse evidence for the activation of several reward-related regions of the brain in PGD. The data reviewed suggest that compared to normative grief, PGD involves a differential pattern of activity in the amygdala and orbitofrontal cortex (OFC); likely differential activity in the posterior cingulate cortex (PCC), rostral or subgenual anterior cingulate cortex (ACC), and basal ganglia overall, including the nucleus accumbens (NAc); and possible differential activity in the insula. It also appears that oxytocin signaling is altered in PGD, though the exact mechanism is unclear. Our findings appear to be consistent with, though not confirmative of, conceptualizing PGD as a disorder of reward, and identify directions for future research.

The effect of cognitive behavioral techniques using virtual reality on birth pain: a randomized controlled trial

OBJECTIVE

This study was conducted to investigate the effects of cognitive behavioral techniques using virtual reality on birth pain.

DESING

This study was planned as a double blind randomized controlled experimental study.

SETTING AND PARTICIPANTS

It was conducted with 273 pregnant women who were randomized between July 2016 and June 2019 at maternity hospital located in eastern Anatolia, Turkey.

METHODS

The study included 5 groups. (A: videos of newborn photographs with classical music, B: the video of the newborn photograph album, C: an introductory film of Turkey, D: only classical music, E: routine hospital care). The data were collected by using the "Personal Information Form", "Visual Analogue Scale", "Verbal Rating Scale" and "Virtual Reality".

FINDINGS

Groups show homogeneity in terms of demographic and obstetric variables. It was found that mean Visual Analogue Scale posttest mean score of the group A was 4.98 ± 1.69; group B 4.96 ± 1.72; group C 5.96 ± 2.05; group D 5.60 ± 1.63 and group E 6.38 ± 1.86. Mean Verbal Rating Scale posttest score was found that group A was 2.64 ± 0.73, group B 2.70 ± 0.87, group C 3.18 ± 1.14, group D was 2.80 ± 0.86 and group E was 3.96 ± 1.01. It was obtained that the groups' mean Visual Analogue Scale and Verbal Rating Scale posttest mean scores was statistically significant (p<0.05).

CONCLUSION

In this study, all cognitive techniques applied with virtual reality reduced labor pain during the active phase of labor. Especially the video of newborn photographs with classical music and newborn photograph album have been found more effective than other interventions evaluated in reducing labor pain.

IMPLICATIONS FOR PRACTICE

Midwives can use these techniques to reduce birth pain.

Two sides on the fibromyalgia coin: physical pain and social pain (invalidation)

Although fibromyalgia (FM) has been traditionally defined by the extent of physical pain sites alongside other non-pain symptoms, recent evidence has highlighted the importance of social dimension in definition of pain perception. Social pain or invalidation, which denotes painful feeling following social conflicts or misunderstanding about illness legitimacy, is an important but ignored issue in the FM lexicon. While physical and social pain seem to be different and separate entities, we hypothesize that they are completely intertwined with indistinct borders in FM. Accumulating emergent neuroscience and behavioral evidence highlights the overlapping of physical and social pain in different painful conditions. However, this overlapping seems to reach its maximum in FM. This review sheds more light on the tight interconnectivity between physical and social pain in FM from the perspective of intuitional commonalities, clinical aspects, and shared neural pathways. The conceptualization of FM as an integrative physical-social pain paradigm will move us closer to necessitating the incorporation of social pain in future models of FM diagnosis and management. Key Points • Considering of social pain as one key concept is relatively mute in FM literature. • Overlapping of physical and social pain seems to be unique in FM due to its nature. • Acknowledging social pain in the FM lexicon could shift the paradigm of diagnosis and management of FM patients.

Your presence soothes me: a neural process model of aversive emotion regulation via social buffering

The reduction of aversive emotions by a conspecific's presence-called social buffering-is a universal phenomenon in the mammalian world and a powerful form of human social emotion regulation. Animal and human studies on neural pathways underlying social buffering typically examined physiological reactions or regional brain activations. However, direct links between emotional and social stimuli, distinct neural processes and behavioural outcomes are still missing. Using data of 27 female participants, the current study delineated a large-scale process model of social buffering's neural underpinnings, connecting changes in neural activity to emotional behaviour by means of voxel-wise multilevel mediation analysis. Our results confirmed that three processes underlie human social buffering: (i) social support-related reduction of activity in the orbitofrontal cortex, ventromedial and dorsolateral prefrontal cortices, anterior and mid-cingulate; (ii) downregulation of aversive emotion-induced brain activity in the superficial cortex-like amygdala and mediodorsal thalamus; and (iii) downregulation of reported aversive feelings. Results of the current study provide evidence for a distinct neural process model of aversive emotion regulation in humans by social buffering.