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Empathy for pain: The effects of prior experience and sex
No full textBackground: Empathy is considered as both a characteristic trait and a variable state. The present experiment examined whether or not prior exposure to pain, perceived similarity, sex and attributed pain intensity are associated with state empathy for pain. Methods: The state empathy of students (38 female, 42 male) in response to pictures displaying exposure to pressure pain was measured via self-reports, using a newly developed state empathy scale with the two subscales of emotional response and perspective taking. Physiological responses were also recorded. Half of the participants were exposed to pressure pain prior to the experiment. Perceived similarity to the person being exposed to pain and their estimated pain intensity were assessed. Results: The results revealed that perceived similarity and sex were significantly related to the emotional dimension of empathy. This sex difference was partially mediated by the estimated intensity of pain. Women rated the intensity of pain more highly and achieved higher scores on the emotional response subscale. Exposure to pain predicted empathy on the perspective-taking subscale, resulting in higher scores when the subject had been exposed to the same pain stimulus. The physiological recordings did not correlate with any of the empathy scores. Conclusions: Greater degrees of perceived similarity, being female and higher estimated pain were linked to a stronger emotional reaction, whereas previous exposure to pain facilitated perspective taking. Pointing out similarities between people and their past experiences, as well as focusing on the imagined discomfort being felt by another person, may modulate empathy for pain
Approach bias modification training to increase physical activity: A pilot randomized controlled trial in healthy volunteers
No full textRegular physical activity is associated with better physical and mental health outcomes as well as higher quality of life. This pilot randomized controlled trial examined whether approach bias modification, an economical and easily accessible computerized cognitive training, could increase objectively and subjectively measured physical activity in individuals aiming for more physical activity. Forty healthy volunteers of normal weight were randomly allocated to six sessions of approach bias modification or no treatment. The approach bias modification adopted an implicit learning paradigm that trained participants to show approach behavior in response to visual cues of physical activity. Approach bias modification did not increase objectively and subjectively measured physical activity
Examining differences in cognitive and affective theory of mind between persons with high and low extent of somatic symptoms: an experimental study
Full text linkBackgroundMedically unexplained somatic symptoms are common, associated with disability and strongly related to depression and anxiety disorders. One interesting, but to date rarely tested, hypothesis is that deficits in both theory of mind (ToM) and emotional awareness may undergird the phenomenon of somatization. This study sought to investigate whether or not differences in ToM functioning and self-reported emotional awareness are associated with somatic symptoms in a sample from the general population.MethodsThe sample consisted of 50 healthy participants (37 females, 13 males) aged between 22 and 64 years (46.8 ± 11.7) of whom 29 reported a high extent of somatic symptoms (HSR), whereas 21 reported a low extent of somatic symptoms (LSR) based on the 30 highest and lowest percentiles of the Symptom List norms. The participants’ affective and cognitive ToM were assessed with two experimental paradigms by experimenters who were blind to the participants’ group membership. In addition, self-reports regarding emotional awareness, alexithymia, depressive and anxiety symptoms and current affect were collected.ResultsIn the experimental tasks, HSR showed lower affective ToM than LSR but the groups did not differ in cognitive ToM. Although HSR reported lower emotional awareness than LSR in the self-report measure, this group difference vanished when we controlled for anxiety and depression. Depression, anxiety, emotional awareness and alexithymia were correlated positively.ConclusionsThe data supported the hypothesis that deficits in affective ToM are related to somatic symptoms. Neither cognitive ToM nor self-reported emotional awareness were associated with somatic symptoms. Self-reported emotional awareness, alexithymia and symptoms of depression and anxiety shared a considerable amount of variance
Improving emotion recognition in anorexia nervosa: An experimental proof‐of‐concept study
Full text linkObjective: Previous research has found increasing evidence for difficulties in emotion recognition ability (ERA) and social cognition in anorexia nervosa (AN), and recent models consider these factors to contribute to the development and maintenance of the disorder. However, there is a lack of experimental studies testing this hypothesis. Therefore, the present proof‐of‐concept study examined whether ERA can be improved by a single session of a computerized training in AN, and whether this has short‐term effects on eating disorder symptoms.
Method: Forty inpatients (22.20 ± 7.15 years) with AN were randomly assigned to receive a single session of computerized training of ERA (TERA) or a sham training (training the recognition of different types of clouds). ERA, self‐reported eating disorder symptoms, and body mass index (BMI) were assessed within 3 days before and after training.
Results: After training, both groups showed improved ERA, reduced self‐reported eating disorder symptoms, and an increased BMI. As compared to patients in the control group, patients who received TERA showed greater improvements in ERA and self‐reported eating disorder symptoms.
Discussion: ERA can be effectively trained in patients with AN. Moreover, short‐term improvements in self‐reported eating disorder symptoms provide tentative support for the hypothesis that difficulties in ERA contribute to the maintenance of AN, and that specific trainings of ERA hold promise as an additional component in AN treatment. Future studies are needed to replicate these findings in larger samples, and to investigate long‐term effects and transfer into real‐world settings
Training emotion recognition in depression—An experimental study
No full textAbstract Background Patients with depression often show a reduced emotion recognition ability (ERA), which is considered to contribute to interpersonal difficulties and thereby to the development and maintenance of the disorder. In light of the lack of experimental studies testing this hypothesis, the present study investigated whether a single session of computerized training can enhance ERA in patients with depression and whether this affects interpersonal problems and symptoms of depression. Methods Forty outpatients with major depressive disorder or persistent depressive disorder were randomly assigned to a single session of either computerized training of ERA (TERA) or a sham training. One day prior to and 14 days after training, ERA, interpersonal problems and symptoms of depression were recorded. Results Both groups showed significant improvements in ERA and in symptoms of depression. Participants who received TERA showed greater improvements in ERA than participants who received sham training. However, the groups did not differ regarding changes in symptoms of depression, and none of the groups showed significant changes in interpersonal problems. Conclusions A single session of computerized training can effectively improve ERA in patients with depression. In the short term, however, TERA neither affected interpersonal problems nor symptoms of depression
The effects of prior pain experience on neural correlates of empathy for pain: An fMRI study
No full textNeuroimaging studies have revealed partially shared neural substrates for both the actual experience of pain and empathy elicited by the pain of others. We examined whether prior pain exposure increased neural activity in the anterior midcingulate cortex (aMCC) and bilateral anterior insula (AI) as a correlate of empathy for pain. Participants (N = 64: 32 women, 32 men) viewed pictures displaying exposure to pressure pain (pain pictures) and pictures without any cue of pain (neutral pictures). Prior to the experiment, half of the participants were exposed to the same pain stimulus as the one seen in the pain pictures (pain exposure condition); the other half had no such experience (touch exposure condition). A balanced sex ratio was kept, to investigate possible sex differences. In the region-of-interest analyses, participants of the pain exposure condition showed decreased activity in the right AI and the aMCC relative to participants of the touch exposure condition. While in men, no differences were found in relation to their exposure condition, women with pain exposure showed decreased activity in the aMCC and additionally, in bilateral AI. Based on the entire sample, whole brain analyses revealed stronger activation in the retrosplenial cortex, dorsomedial prefrontal cortex, and medial prefrontal cortex in the pain exposure condition. In conclusion, prior pain exposure did not increase, but decreased activity in regions regularly associated with empathy for pain. However, pain experience increased activity in regions associated with memory retrieval, perspective taking, and top-down emotion regulation, which might facilitate empathizing with others. (C) 2012 International Association for the Study of Pain. Published by Elsevier B. V. All rights reserved
Neural Correlates of Empathy with Pain Show Habituation Effects. An fMRI Study.
No full textNeuroimaging studies have demonstrated that the actual experience of pain and the perception of another person in pain share common neural substrates, including the bilateral anterior insular cortex and the anterior midcingulate cortex. As many fMRI studies include the exposure of participants to repeated, similar stimuli, we examined whether empathic neural responses were affected by habituation and whether the participants' prior pain experience influenced these habituation effects.In 128 trials (four runs), 62 participants (31 women, 23.0 ± 4.2 years) were shown pictures of hands exposed to painful pressure (pain pictures) and unexposed (neutral pictures). After each trial, the participants rated the pain of the model. Prior to the experiment, participants were either exposed to the same pain stimulus (pain exposure group) or not (touch exposure group). In order to assess possible habituation effects, linear changes in the strength of the BOLD response to the pain pictures (relative to the neutral pictures) and in the ratings of the model's pain were evaluated across the four runs.Although the ratings of the model's pain remained constant over time, we found neural habituation in the bilateral anterior/midinsular cortex, the posterior midcingulate extending to dorsal posterior cingulate cortex, the supplementary motor area, the cerebellum, the right inferior parietal lobule, and the left superior frontal gyrus, stretching to the pregenual anterior cingulate cortex. The participant's prior pain experience did neither affect their ratings of the model's pain nor their maintenance of BOLD activity in areas associated with empathy. Interestingly, participants with high trait personal distress and fantasy tended to show less habituation in the anterior insula.Neural structures showed a decrease of the BOLD signal, indicating habituation over the course of 45 minutes. This can be interpreted as a neuronal mechanism responding to the repeated exposure to pain depictions, which may be regarded as functional in a range of contexts
Neural Correlates Differ in High and Low Fear-Avoidant Chronic Low Back Pain Patients When Imagining Back-Straining Movements
No full textThe fear-avoidance model postulates that in an initial acute phase chronic low back pain (CLBP) patients acquire a fear of movement that results in avoidance of physical activity and contributes to the pain becoming chronic. The current functional magnetic resonance imaging study investigated the neural correlates of imagining back-straining and neutral movements in CLBP patients with high (HFA) and low fear avoidance (LFA) and healthy pain-free participants. Ninety-three persons (62 CLBP patients, 31 healthy controls; age 49.7 +/- 9.2 years) participated. The CLBP patients were divided into an HFA and an LFA group using the Tampa Scale of Kinesiophobia. The participants viewed pictures of back-straining and neutral movements and were instructed to imagine that they themselves were executing the activity shown. When imagining back-straining movements, HFA patients as well as healthy controls showed stronger anterior hippocampus activity than LFA patients. The neural activations of HFA patients did not differ from those of healthy controls. This may indicate that imagining back-straining movements triggered pain-related evaluations in healthy controls and HFA participants, but not in LFA participants. Although heightened pain expectancy in HFA compared with LFA patients fits well with the fear-avoidance model, the difference between healthy controls and LFA patients was unexpected and contrary to the fear-avoidance model. Possibly, negative evaluations of the back-straining movements are common but the LFA patients use some kind of strategy enabling them to react differently to the back-straining events. Perspective: It appears that low fear-avoidant back pain patients use some kind of strategy or underlying mechanism that enables them to react with less fear in the face of potentially painful movements. This warrants further investigation because countering fear and avoidance provide an important advantage with respect to disability. (C) 2016 by the American Pain Societ
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