Abstract
Minimizing pain and maximizing pleasure are conflicting motivations when pain and reward co-occur. Decisions to prioritize reward consumption or pain avoidance are assumed to lead to pain inhibition or facilitation, respectively. Such decisions are a function of the subjective utility of the stimuli involved, i.e. the relative value assigned to the stimuli to compare the potential outcomes of a decision. To test perceptual pain modulation by varying degrees of motivational conflicts and the role of subjective utility, we implemented a task in which healthy volunteers had to decide between accepting a reward at the cost of receiving a nociceptive electrocutaneous stimulus or rejecting both. Subjective utility of the stimuli was assessed by a matching task between the stimuli. Accepting reward coupled to a nociceptive stimulus resulted in decreased perceived intensity, while rejecting the reward to avoid pain resulted in increased perceived intensity, but in both cases only if a high motivational conflict was present. Subjective utility of the stimuli involved moderated these bidirectional perceptual effects: the more a person valued money over pain, the more perceived intensity increased or decreased. These findings demonstrate pain modulation when pain and reward are simultaneously present and highlight the importance of subjective utility for such modulation.
Highlights
“No pain, no gain” – this popular motto of athletes portrays in a nutshell well-known pain-pleasure dilemmas: prioritizing pleasure over pain can enhance pleasure
Rejecting such a reward in order to avoid the nociceptive stimulus increased the perceived intensity of the nociceptive stimulus. These perceptual decreases and increases are moderated by the subjective utility of the stimuli involved: the more a person values money over pain, the stronger were the bidirectional effects on perceived intensity
The present results are in line with the predictions of Fields’ motivation decision model of pain[3, 4]: when participants prioritized receiving the reward over pain avoidance, pain-inhibitory effects occurred, while facilitatory effects occurred when participants prioritized pain avoidance over receiving the reward, demonstrated here on a perceptual level
Summary
“No pain, no gain” – this popular motto of athletes portrays in a nutshell well-known pain-pleasure dilemmas: prioritizing pleasure over pain can enhance pleasure. While the effects of choosing between two negative outcomes have been tested[7], conflicts induced by having to accept pain to avoid another negative outcome have not been investigated before Another aspect that has been neglected in the literature on the interaction of pain and reward/pleasure is how a motivational conflict arises. Given the gaps in the literature, the aims of this study were to (1) investigate facilitatory and inhibitory effects on perceived pain intensity with varying degrees of motivational conflicts induced by co-occurring pain and reward, either conceptualized by monetary wins or by the avoidance of monetary losses; (2) test modulatory effects of the subjective utility of pain avoidance and reward on such pain modulation
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