Cognitive exertion affects the appraisal of one’s own and other people’s pain

Abstract

Evaluating correctly others' pain is a crucial prosocial ability, especially relevant for the healthcare system. In clinical settings, caregivers assess their patients' pain under high workload and fatigue, often while dealing with competing information/tasks. However, the effect played by such cognitive strain in the appraisal of others' pain remains unclear. Following embodied accounts that posit a shared representational code between self and others' states, it could be hypothesized that the representation of people's pain might be influenced by cognitive exertion similarly to first-hand experiences. Fifty participants underwent one of two demanding tasks, involving either working memory (Experiment 1: N-Back task) or cognitive interference (Experiment 2: Stroop task). After each task, participants were exposed to painful laser stimulations at three intensity levels (low, medium, high), or video-clips of patients experiencing three intensity levels of pain (low, medium, high). Participants rated the intensity of each pain event on a visual analogue scale. We found that the two tasks influenced rating of both one's own and others' pain, by decreasing the sensitivity to medium and high events. This was observed either when comparing the demanding condition to a control (Stroop), or when modelling linearly the difficulty/performance of each depleting task (N-Back). These effects were mirrored by the analysis of physiological responses (Heart Variability and Skin Conductance) evoked by one's own pain. We provide converging evidence that cognitive exertion affects the subsequent appraisal of one's own and likewise others' pain. Healthcare personnel should be aware that high workload might alter their cognitive abilities.

Distraction and cognitive control independently impact parietal and prefrontal response to pain

“…It is reasonable that hidden moderators/confounds might have influenced previous and current results. For instance, we recently found that cognitive control after-effects in pain are influenced by the intensity of the noxious input, with mild stimulations associated with hyperalgesia but more intense events with hypoalgesia ( Riontino et al , 2022 ). Hence, it is possible that the stimulation adopted here fell within a ‘medium’ range where its susceptibility to cognitive control manipulations was minimum.…”

“…Then, participants were engaged in a practice session for a Stroop paradigm from previous research ( Silvestrini and Rainville, 2013 ; Silvestrini et al. , 2020 ; Riontino et al , 2022 ). They were exposed to sets of one-to-four identical words presented vertically on the screen in capital letters (font Verdana and size 24).…”

“…Although optimal for testing cognitive control after-effects on pain ( Silvestrini and Rainville, 2013 ; Silvestrini et al. , 2020 ; Riontino et al , 2022 ), such a long block structure would make the analysis of task-related activity vulnerable to low-frequency confounds and poorly accords with default filtering in SPM (128 s). To circumvent this, we analysed specific Stroop trials in an event-related fashion as a delta function (without distinguishing between ‘Interference’ and ‘Neutral’ condition) and specifying an additional predictor in which trials’ Reaction Times were modulated parametrically.…”

Distraction and cognitive control independently impact parietal and prefrontal response to pain

“…It is reasonable to assume that hidden moderators/confounds might have influenced previous and current results. For instance, we recently found that cognitive control after-effects in pain are influenced by the intensity of the noxious input, with mild stimulations associated with hyperalgesia but more intense events with hypoalgesia (Riontino et al ., 2022). Hence, it is possible that the stimulation adopted here fell within a “medium” range where its’ susceptibility to cognitive control manipulations was minimum.…”

“…In addition to the main analysis, we also looked at the neural responses evoked by the Stroop task, where each of the two conditions ( Interference and Neutral ) was delivered through ∼2 minutes blocks. Although optimal for testing cognitive control after-effects on pain (Silvestrini and Rainville, 2013; Silvestrini et al ., 2020; Riontino et al ., 2022), such long block structure would make the analysis of task-related activity vulnerable to low-frequency confounds and poorly accords with default filtering in SPM (128 sec). To circumvent this, we adopted a different strategy, by analysing specific Stroop trials in an event-related fashion as a delta function (without distinguishing between Interference and Neutral condition) and specifying an additional predictor in which trials Reaction Times were modulated parametrically.…”