Different psychophysiological and clinical symptoms are linked to affective versus sensory vicarious pain experiences.

V. Botan,H. D. Critchley,J. Ward

doi:10.1111/psyp.13826

Abstract

For some people, seeing pain in others triggers a pain-like experience in themselves: these experiences can either be described in sensory terms and localized to specific body parts (sensory-localized, or S/L) or in affective terms and nonlocalized or whole-body experiences (affective-general, or A/G). In two studies, it is shown that these are linked to different clinical and psychophysiological profiles relative to controls. Study 1 shows that the A/G profile is linked to symptoms of Blood-Injection-Injury Phobia whereas the S/L profile shows some tendency toward eating disorders. Study 2 shows that the A/G profile is linked to poor interoceptive accuracy (for heartbeat detection) whereas the S/L profile is linked to higher heart-rate variability (HRV) when observing pain, which is typically regarded as an index of good autonomic emotion regulation. Neither group showed significant differences in overall heart rate, systolic blood pressure (SBP), or skin conductance response (SCR) when observing pain, and no overall differences in state or trait anxiety. Overall, the research points to different underlying mechanisms linked to different manifestations of vicarious pain response. Affective-General pain responders have strong subjective bodily experiences (likely of central origin given the absence of major differences in autonomic responsiveness) coupled with a worse ability to read objective interoceptive signals. Sensory-localized pain responders have differences in their ability to construct a multi-sensory body schema (as evidenced by prior research on the Rubber Hand Illusion) coupled with enhanced cardiovagal (parasympathetic) reactivity often indicative of better stress adaptation.

Highlights

Seeing someone else in pain may elicit a similar sensation in the observer which is known as vicarious pain perception (Fitzgibbon, Giumarra, Georgiou-Karistianis, Enticott, & Bradshaw, 2010; Fitzgibbon et al, 2012)
In neither responder group did we find an overall increase in physiological arousal to observing pain driven by the sympathetic system (relating to blood pressure, skin conductance, or heart rate) nor a lowering of these indices of arousal that might be elicited by the compensatory over-activity of the parasympathetic system (e.g. as postulated for Blood-Injection-Injury Phobia)
The simulation of pain by vicarious pain responders may primarily be driven by differences in brain activity without concomitant individual differences in the overall level of autonomic responses in the body

Summary

Introduction

Seeing someone else in pain may elicit a similar sensation in the observer which is known as vicarious pain perception (Fitzgibbon, Giumarra, Georgiou-Karistianis, Enticott, & Bradshaw, 2010; Fitzgibbon et al, 2012). Vicarious pain experiences have been reported in clinical populations such as patients with a history of traumatic pain or in phantom limb patients (Giummarra & Bradshaw, 2008; Fitzgibbon et al, 2010), and in the healthy general population. Grice-Jackson et al (2017a) identified two sub-groups of vicarious pain responders who report different qualities of their vicarious experience. Using a cluster analysis method, they identified a group of sensory-localised vicarious pain responders (S/L) who report feeling a localised pain sensation on their own body when seeing someone else in pain, and a group of affective-general responders (A/G) who report a generalised pain sensation in their entire body. Subsequent research, using a more conservative clustering method, reported a prevalence of 12.3% for S/L and 9.0% for AG (both being more common in females; Botan et al, 2018a)

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