Empathy For Pain Research Articles

Up-regulation of neural indicators of empathic concern in an offender population

ABSTRACTEmpathic concern has traditionally been conceived of as a spontaneous reaction to others experiencing pain or distress. As such, the potential role of more deliberate control over empathic responses has frequently been overlooked. The present fMRI study evaluated the role of such deliberate control in empathic concern by examining the extent to which a sample of offenders recruited through probation/parole could voluntarily modulate their neural activity to another person in pain. Offenders were asked to either passively view pictures of other people in painful or non-painful situations, or to actively modulate their level of concern for the person in pain. During passive viewing of painful versus non-painful pictures, offenders showed minimal neural activity in regions previously linked to empathy for pain (e.g., dorsal anterior cingulate cortex and bilateral insula). However, when instructed to try to increase their concern for the person in pain, offenders demonstrated significant increases within these regions. These findings are consistent with recent theories of empathy as motivational in nature, and suggest that limitations in empathic concern may include a motivational component.

Linkage between pain sensitivity and empathic response in adolescents with autism spectrum conditions and conduct disorder symptoms.

Lack of empathy is one of the behavioral hallmarks in individuals with autism spectrum conditions (ASC) as well as youth with conduct disorder symptoms (CDS). Previous research has reliably documented considerable overlap between the perception of others' pain and first-hand experience of pain. However, the linkage between empathy for pain and sensitivity to physical pain needs to be empirically determined, particularly in individuals with empathy deficits. This study measured the pressure pain threshold, which indexes sensitization of peripheral nociceptors, and assessed subjective ratings of unpleasantness and pain intensity in response to empathy-eliciting stimuli depicting physical bodily injuries in three age- and sex-matched participant groups: ASC, CDS, and typically developing controls (TDC). The results indicated that the pain threshold was lowest in the ASC group and highest in the CDS group. The ASC group displayed lower ratings of unpleasantness and pain intensity than did the TDC and CDS groups. Within the ASC and CDS, pain intensity ratings were significantly correlated with unpleasantness ratings to others' pain. Moreover, the ASC significantly differed from the TDC in the correlation between pain threshold values and unpleasantness ratings. These findings may cast some light on the linkage between atypical low-level sensory functioning, for instance altered pain sensitivity, and high-level empathic processing. Autism Res 2017, 10: 267-275. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Reliability and Construct Validity of the Psychopathic Personality Inventory-Revised in a Swedish Non-Criminal Sample - A Multimethod Approach including Psychophysiological Correlates of Empathy for Pain.

Cross-cultural investigation of psychopathy measures is important for clarifying the nomological network surrounding the psychopathy construct. The Psychopathic Personality Inventory-Revised (PPI-R) is one of the most extensively researched self-report measures of psychopathic traits in adults. To date however, it has been examined primarily in North American criminal or student samples. To address this gap in the literature, we examined PPI-R’s reliability, construct validity and factor structure in non-criminal individuals (N = 227) in Sweden, using a multimethod approach including psychophysiological correlates of empathy for pain. PPI-R construct validity was investigated in subgroups of participants by exploring its degree of overlap with (i) the Psychopathy Checklist: Screening Version (PCL:SV), (ii) self-rated empathy and behavioral and physiological responses in an experiment on empathy for pain, and (iii) additional self-report measures of alexithymia and trait anxiety. The PPI-R total score was significantly associated with PCL:SV total and factor scores. The PPI-R Coldheartedness scale demonstrated significant negative associations with all empathy subscales and with rated unpleasantness and skin conductance responses in the empathy experiment. The PPI-R higher order Self-Centered Impulsivity and Fearless Dominance dimensions were associated with trait anxiety in opposite directions (positively and negatively, respectively). Overall, the results demonstrated solid reliability (test-retest and internal consistency) and promising but somewhat mixed construct validity for the Swedish translation of the PPI-R.

Somatic and vicarious pain are represented by dissociable multivariate brain patterns.

Understanding how humans represent others' pain is critical for understanding pro-social behavior. 'Shared experience' theories propose common brain representations for somatic and vicarious pain, but other evidence suggests that specialized circuits are required to experience others' suffering. Combining functional neuroimaging with multivariate pattern analyses, we identified dissociable patterns that predicted somatic (high versus low: 100%) and vicarious (high versus low: 100%) pain intensity in out-of-sample individuals. Critically, each pattern was at chance in predicting the other experience, demonstrating separate modifiability of both patterns. Somatotopy (upper versus lower limb: 93% accuracy for both conditions) was also distinct, located in somatosensory versus mentalizing-related circuits for somatic and vicarious pain, respectively. Two additional studies demonstrated the generalizability of the somatic pain pattern (which was originally developed on thermal pain) to mechanical and electrical pain, and also demonstrated the replicability of the somatic/vicarious dissociation. These findings suggest possible mechanisms underlying limitations in feeling others' pain, and present new, more specific, brain targets for studying pain empathy.

Decreased Empathic Responses to the 'Lucky Guy' in Love: The Effect of Intrasexual Competition.

People have a greater desire to date highly attractive partners, which induces intrasexual competition between same-sex individuals. The present study used functional magnetic resonance imaging to explore whether and how intrasexual competition modulates pain empathy for a same-sex rival and the underlying neural mechanism. Participants were scanned while processing the pain of a same-sex ‘lucky guy’ who had an attractive partner and one with a plain partner. The results revealed that participants reported lower pain intensity for the lucky guy. Neurally, reduced pain-related activations in anterior insula and anterior mid-cingulate cortex and increased activations in right superior frontal gyrus (SFG) and medial prefrontal gyrus (MPFC) were found for the lucky guy compared to the one with a plain partner. Right SFG and MPFC activations could predict participants’ subsequent pain intensity ratings for the lucky guy. These findings suggest intrasexual competition can modulate normal empathic responses.

From painkiller to empathy killer: acetaminophen (paracetamol) reduces empathy for pain

Simulation theories of empathy hypothesize that empathizing with others' pain shares some common psychological computations with the processing of one's own pain. Support for this perspective has largely relied on functional neuroimaging evidence of an overlap between activations during the experience of physical pain and empathy for other people's pain. Here, we extend the functional overlap perspective to the neurochemical level and test whether a common physical painkiller, acetaminophen (paracetamol), can reduce empathy for another's pain. In two double-blind placebo-controlled experiments, participants rated perceived pain, personal distress and empathic concern in response to reading scenarios about another's physical or social pain, witnessing ostracism in the lab, or visualizing another study participant receiving painful noise blasts. As hypothesized, acetaminophen reduced empathy in response to others' pain. Acetaminophen also reduced the unpleasantness of noise blasts delivered to the participant, which mediated acetaminophen's effects on empathy. Together, these findings suggest that the physical painkiller acetaminophen reduces empathy for pain and provide a new perspective on the neurochemical bases of empathy. Because empathy regulates prosocial and antisocial behavior, these drug-induced reductions in empathy raise concerns about the broader social side effects of acetaminophen, which is taken by almost a quarter of adults in the United States each week.

Sex-dependent effects of stress on brain correlates to empathy for pain

Empathy is a fundamental attribute required for appropriate social functioning. The extent to which we empathize with others in pain is influenced by numerous factors. Being highly social species, humans face social stress on a regular basis, which undoubtedly affects how we react to our environment. It is not yet known how social stress may modulate our neural mechanisms when we empathize with others in painful circumstances, and its effects on empathic behavior are still unclear. For this reason, we recorded the electroencephalography (EEG) of healthy men and women, half of which were previously exposed to psychosocial stress, while they observed photographs of hands in painful and neutral situations. At the behavioral level, stress induced higher unpleasantness ratings to painful stimuli, and lower ratings to neutral pictures, independent of sex. At the neurophysiological level, we found that early (N110 over fronto-central sites) event-related potentials (ERPs) were not affected by stress, while late (P3 over centro-parietal regions) components showed a sex-dependent differential effect of stress. Correlation analyses further indicated a strong association between N110 with trait markers of empathy in all participants, while P3 was associated with the change in cortisol in stressed males. Our findings suggest that sex-dependent effects of social stress on the neural responses to empathy for pain give rise to comparable behaviors in men and women in the paradigm we employed, implying that each sex may engage in distinct mechanisms to cope with stress. Moreover, stress seems to modulate late neural mechanisms of empathy but not our early perception.

Alterations in event-related potential responses to empathy for pain in schizophrenia

Lack of empathy is a critical factor impacting on social functioning and quality of life in schizophrenia. There is, however, a paucity of research into the underlying neurophysiological correlates of empathy deficits in this disorder. Accordingly, we sought: (1) to identify whether dysfunctional empathic abilities in schizophrenia are related to alterations in early or late brain processes, and (2) to explore the potential relationship between brain activity and mood, self-reported empathy and symptom severity. Eighteen patients with schizophrenia and 21 healthy matched controls performed an empathy-for-pain paradigm where photographs of hands in neutral or painful situations were shown while we recorded their electroencephalography (EEG), and we examined mood, empathic concern for others and symptom severity. Significant group differences between patients and controls emerged in early (50–150ms after stimulus onset) and late (after 300ms) timeframes. Moreover, brain activity was related with unpleasantness ratings in all participants, with self-reported empathic concern only in controls and with negative mood and personal distress only in patients. Differences in social behavior in schizophrenia may be explained by early as well as late differences, affecting mostly the early frontocentral ERPs, i.e. those suggested to correspond to the emotional sharing component of empathy.

(331) Empathy for pain: hyper or hypoalgesia in mice living with a conspecific in chronic pain?

(331) Empathy for pain: hyper or hypoalgesia in mice living with a conspecific in chronic pain?

Spatiotemporal Brain Dynamics of Empathy for Pain and Happiness in Friendship.

Background: Although a large number of functional magnetic resonance imaging (fMRI) studies have investigated the neural bases of empathy, little is known about its spatiotemporal dynamics or its modulation by the level of friendship between the observer and the agent who is being hurt. Moreover, most of the previous studies on empathy have focused on empathy for pain rather than empathy for positive emotions, such as happiness. In the present study, we addressed this question by investigating the spatiotemporal brain dynamics of two different kinds of empathy (empathy for pain, empathy for happiness) with a behavioral priming empathy task involving two different level of primes (a close friend, a stranger).Method/Principal Findings: Electrical brain activity and behavioral data were analyzed from 30 subjects (12 males and 18 females). Half of the subjects performed a behavioral task on empathy for pain task (EPT), while the other half performed a behavioral task on empathy for happiness task (EHT). In each task, participants viewed prime photographs of either: (1) a stranger; or (2) a close friend (primes) followed by target photographs showing either a hand being hurt (or not; targets in the EPT), or a hand in happy circumstances (or not; targets in the EHT). In each task, participants were asked to judge the target situation and report whether they could feel the pain (in EPT) or the happiness (in the EHT), as a function of the primes i.e., either from the close friend’s or from the stranger’s perspective. Although our behavioral results didn’t reveal any explicit differences among the different types of primes within each task, our electrophysiological results showed variations as a function of the primes. First, a early smaller N110 amplitude for pain was observed in the anterior prefrontal cortex during the friend prime condition compared to the stranger prime condition. No similar early effects were found for happiness. On the other hand, both empathy for happiness (EHT) and empathy for pain (EPT) elicited later differences. In the EPT, the friend prime elicited a larger late positive potential (LPP) than the stranger prime. In the EHT, the friend prime elicited a larger N250, a smaller P300, and a smaller LPP than the stranger prime.Conclusions: Taking the perspective of a close friend (as a prime stimulus) does have a dual-stage effect on empathy that is characterized by an early modulation for pain and later modulations for both pain and happiness. The early differences between friend and stranger primes for pain (but not for happiness) suggest that empathy for pain is an automatic process that has been socially learned and passed among friends. On the other hand, the later differences observed between stranger and friend prime suggest that additional cognitive appraisal take place for both pain and happiness. Our results suggest that it takes more cognitive attentional efforts to judge a stranger’s happiness than a friend’s happiness, whereas the opposite is true for pain. These findings open new avenues toward a better understanding of the empathic mind.

A valid question: Could hate speech condition bias in the brain?

Here, we respond to three peer commentaries on our paper, ‘A hypothetical neurological association between dehumanization and human rights abuses’.1 In that paper, we hypothesized that dehumanizing implicit biases dampen the response of neural mechanisms of pain empathy to (and thereby reduce empathy for) implicitly subordinated or dehumanized targets, perhaps offering some insight into the association of dehumanization with human rights abuses.2 The commentaries we respond to are by Professor Robert Mark Simpson,3 Judge Morris B. Hoffman,4 and Dr Alexandra Roginsky and Professor Alexander Tsesis.5 We thank them all for their time and input.

Triggering Descending Pain Inhibition by Observing Ourselves or a Loved-One in Pain.

Recent studies demonstrate that empathy-evoked brain responses include the activation of brainstem structures responsible for triggering descending pain inhibition. Unfortunately, direct evidence linking empathy for pain and descending inhibitory controls (conditioned pain modulation) is lacking. This study, therefore, aimed to determine if the observation of ourselves or a loved-one in pain could activate descending pain inhibition without exposure to a noxious stimulation; which is otherwise required. Descending pain inhibition was triggered by immersing the right arm of participants (15 heterosexual couples; mean age±SE: 28.89±2.14) in a bath of cold water. The effects of empathy on descending pain inhibition were observed by immersing the right arm of participants in a bath of lukewarm water while having them watch a video of either themselves or their spouse during a previous nociceptive immersion. Immersion of the arm in a bath of lukewarm water without empathic (video) observation was also included as a control condition. A strong inhibitory response activated by the mere observation of the video of themselves or their spouse in pain without a nociceptive conditioning stimulus. Associative statistics also showed that strong pain catastrophizing responses while watching the video resulted in stronger pain inhibition. Moreover, high levels of empathy were associated with stronger pain inhibition, but only for women. This study showed that observing someone in pain triggers descending pain inhibition. Results also demonstrate how empathy and gender are affecting pain modulation mechanisms.

Voluntary control of anterior insula and its functional connections is feedback-independent and increases pain empathy

Real-time functional magnetic resonance imaging (rtfMRI)-assisted neurofeedback (NF) training allows subjects to acquire volitional control over regional brain activity. Emerging evidence suggests its potential clinical utility as an effective non-invasive treatment approach in mental disorders. The therapeutic potential of rtfMRI-NF training depends critically upon whether: (1) acquired self-regulation produces functionally relevant changes at behavioral and brain network levels and (2) training effects can be maintained in the absence of feedback. To address these key questions, the present study combined rtfMRI-NF training for acquiring volitional anterior insula (AI) regulation with a sham-controlled between-subject design. The functional relevance of acquired AI control was assessed using both behavioral (pain empathy) and neural (activity, functional connectivity) indices. Maintenance of training effects in the absence of feedback was assessed two days later. During successful acquisition of volitional AI up-regulation subjects exhibited stronger empathic responses, increased AI-prefrontal coupling in circuits involved in learning and emotion regulation and increased resting state connectivity within AI-centered empathy networks. At follow-up both self-regulation and increased connectivity in empathy networks were fully maintained, although without further increases in empathy ratings. Overall these findings support the potential clinical application of rtfMRI-NF for inducing functionally relevant and lasting changes in emotional brain circuitry.

The Neural Mechanisms of Social Learning from Fleeting Experience with Pain.

Social learning is critical for humans to adapt and cope with rapidly changing surroundings. Although, neuroscience has focused on associative learning and pain empathy, the neural mechanisms of social learning through fleeting pain remains to be determined. This functional MRI study included three participant groups, to investigate how the neuro-hemodynamic response and subjective evaluation in response to the observation of hand actions were modulated by first-hand experience (FH), as well as indirect experience through social-observational (SO), and verbal-informed (VI) learning from fleeting pain. The results indicated, that these three learning groups share the common neuro-hemodynamic activations in the brain regions implicated in emotional awareness, memory, mentalizing, perspective taking, and emotional regulation. The anterior insular cortex (AIC) was commonly activated during these learning procedures. The amygdala was only activated by the FH. Dynamic causal modeling further indicated, that the SO and VI learning exhibited weaker connectivity strength from the AIC to superior frontal gyrus than did the FH. These findings demonstrate, that social learning elicits distinct neural responses from associative learning. The ontogeny of human empathy could be better understood with social learning from fleeting experience with pain.

Moral judgment modulates neural responses to the perception of other's pain: an ERP study.

Morality and empathy are both crucial in building human society. Yet the relationship between them has been merely explored. The present study revealed how the morality influenced empathy for pain by comparing the ERPs elicited by pictures showing the targets’ in pain primed by different moral information about the targets. We found that when the target was a moral one or a neutral one, the painful pictures elicited significantly larger amplitude in N2 than the non-painful pictures, but when the target was an immoral one, the difference between the amplitudes of N2 component elicited by painful and non-painful pictures became insignificant. We proposed that this effect was induced by the decreased affective arousal when observing an immoral person in pain. The reduced neural response towards the immoral one’s pain can keep us alert when we face the potentially dangerous people thereby increasing our chance of survival. SLORTEA results showed the source of this difference in N2 localized in the ventral medial prefrontal cortex (vmPFC) and the rostral anterior cingulate cortex (rACC) areas.

ID 412 – Modulation of sensorimotor oscillations during observation of pain in others

Observing a human subject suffering from pain activates brain structures within the so-called pain matrix. It has been suggested that such resonant responses might underlie empathy for pain. While earlier accounts stressed the role of affective representations, an increasing body of evidence suggests that pain empathy might also be supported by sensorimotor resonance. To explore the vicarious sensorimotor activations in more detail, we recorded EEG while the study participants watched video clips of painful or non-painful hand treatments. We found that pain compared to no-pain videos elicited stronger event-related desynchronization of central beta, but not mu, rhythm. Interestingly, these empathic responses were only present when watching videos of ethnic in-group hands. Our findings suggest that sensorimotor resonance could play a role in understanding of the feelings and reactions of others and facilitate behavioral coordination within social groups. Supported by WWTF (projects CS11-005 and CS11-011), VEGA (projects 2/0080/13 and 2/0093/14), and University of Vienna (student research Grants) .

ID 402 – Do cortical regions encoding pain also respond to images of other’s pain?

The aim of this study was to detect whether cortical regions encoding pain stimuli do also respond to images of other’s pain using direct recordings of evoked potentials (EPs) through depth electrodes. Images depicting pain and no pain situations were presented during 100 ms, and immediately masked to thirteen patients with intracortical electrodes. Several regions were explored: insula, supra-sylvian opercular (SSop) regions, antero-medial cingulate areas (BA 24), inferior parietal cortex (BA 40), amygdala, dorso-lateral prefrontal cortex (BA 46, 9) and visual regions (V1, lingual and fusiform gyri). EPs to painful and non-painful images were averaged separately over an analysis time window of 1.5 s after the onset of image presentation. Results showed that EPs to painful and non-painful images were different in shape and amplitude especially in the posterior and anterior insulae and in the parietal part of the SSop cortex with a large negative component recorded in the painful condition. These areas were shown to be responsive to nociceptive skin Laser pain stimuli. These findings suggest that mirror pain neurons are present in these regions which might be involved in the process of human pain empathy.

Pain empathy in schizophrenia: an fMRI study.

Although it has been proposed that schizophrenia is characterized by impaired empathy, several recent studies found intact neural responses on tasks measuring the affective subdomain of empathy. This study further examined affective empathy in 21 schizophrenia outpatients and 21 healthy controls using a validated pain empathy paradigm with two components: (i) observing videos of people described as medical patients who were receiving a painful sound stimulation treatment; (ii) listening to the painful sounds (to create regions of interest). The observing videos component incorporated experimental manipulations of perspective taking (instructions to imagine 'Self' vs 'Other' experiencing pain) and cognitive appraisal (information about whether treatment was 'Effective' vs 'Not Effective'). When considering activation across experimental conditions, both groups showed similar dorsal anterior cingulate cortex (dACC) and anterior insula (AI) activation while merely observing others in pain. However, there were group differences associated with perspective taking: controls showed relatively greater dACC and AI activation for the Self vs Other contrast whereas patients showed relatively greater activation in these and additional regions for the Other vs Self contrast. Although patients demonstrated grossly intact neural activity while observing others in pain, they showed more subtle abnormalities when required to toggle between imagining themselves vs others experiencing pain.

心理学与非心理学专业大学生疼痛共情能力的差异性研究

疼痛共情是指个体对他人疼痛的感知、判断和情绪反应，是当下对痛觉研究的最热门的视角。现存的研究主要涵盖对疼痛共情的神经机制、认知机制、测量手段和影响因素四个方面的研究。对于心理学专业的本科生来说，疼痛共情能力是其应当具备的基本能力之一。本研究使用《人际反应指针量表》对不同专业的全日制在校本科大四学生的疼痛共情能力进行测量，通过SPSS分析测量数据发现，心理学专业的学生比非心理学专业的学生具备更高的疼痛共情能力，在观点采择、想象量表、同情关心和个人痛苦四个分量表上的得分也存在极其显著的差异。 Empathy for pain refers to the individual’s perception of pain to others, judgment and emotional reactions, which is one of the most popular perspective for the study of pain. Existing research mainly covers on the neural mechanisms of pain empathy, cognitive mechanisms, measuring in-struments and influencing factors. For undergraduate who majors in psychology, the ability of empathy for pain is one of the basic capabilities it should have. The study used “Interpersonal Reactivity Index (IRI)” for different professional full-time undergraduate senior students to mea- sure the empathy ability for pain. After analysising the data through SPSS, we found that students who study psychology have higher pain empathy than non-psychology students. Further study in-dicates the same extremely significant difference in four subscales named Perspcetive Taking, Fancy Scale, Sympathetic Concern and Personal Pain.

An Analysis of Pain Following Traumatic Spinal Cord Injury among Adults in Zimbabwe

The purpose of the study was to analyse on pain following traumatic spinal cord injury, its prevalence, the types of pain present, the common treatments used and their perceived effectiveness in the management of these reported pain types. A cross sectional study was carried out at St Giles Rehabilitation Centre and from members of the Spinal Injuries Association of Zimbabwe (SIAZ). A researcher-administered questionnaire was used to collect data from 24 participants with traumatic spinal cord injury. The questionnaire elicited information on demographic data, pain characteristics and the perceived effectiveness of the common treatments used. Among the 24 participants in the study, 17 were males (70.8%) and 7 were females (29.2%). Pain prevalence was 79.2% among the study participants and approximately a fifth (21.03%) of all participants rated their pain as severe. Eight (33.3%) of the participants had neuropathic pain while 11 (45.8%) had both nociceptive and neuropathic pain types. However, no association was found between sex, age, time post injury when tested against the presence of pain (p > 0.05). Weather changes aggravated almost every type of pain reported. Both pharmacological and non-pharmacological methods were used to manage the pain but their perceived effectiveness was rated as low. The majority of the traumatic spinal cord injured people experienced some pain and this pain was severe in a fifth of all participants. Pain significantly affected their quality of life. Physiotherapists and other medical professionals need to be aware of this and should employ pain reducing modalities and empathy when dealing with these patients.