The Influence of Social Threat on Pain, Aggression, and Empathy in Women

Karos, Kai; Meulders, Ann; Goubert, Liesbet

doi:10.1016/j.jpain.2017.11.003

Cited by 20 publications

(43 citation statements)

References 52 publications

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“…Pain is a global health problem with broad negative impacts on physical (Sturgeon, Darnall, Kao, & Mackey, 2015; Sturgeon, Dixon, Darnall, & Mackey, 2015), mental (Bair, Robinson, Katon, & Kroenke, 2003; Feinstein et al, 2017; Ziadni, Sturgeon, & Darnall, 2018), spiritual (Halawa, Al-Diri, McLean, & Darnall, 2015), psychosocial (Karos, Meulders, Goubert, & Vlaeyen, 2018; Karos, Williams, Meulders, & Vlaeyen, 2018; Sturgeon et al, 2016; Ziadni, You, Wilson, & Darnall, 2018), and economic domains (Groenewald, Essner, Wright, Fesinmeyer, & Palermo, 2014; Gustavsson et al, 2012). The 2016 Institute of Medicine report on Relieving Pain in America estimated that roughly one-third of the world population is living with ongoing pain of some type (IOM Committee on Advancing Pain Research, 2011).…”

Section: Introductionmentioning

confidence: 99%

Optimizing Placebo and Minimizing Nocebo to Reduce Pain, Catastrophizing, and Opioid Use: A Review of the Science and an Evidence-Informed Clinical Toolkit

Darnall

Colloca

2018

International Review of Neurobiology

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Pain, a noxious psychosensory experience, motivates escape behavior to assure protection and survival. Psychological factors alter the experience and trajectory of pain, as well as behavior and treatment response. In the context of pain, the placebo effect (expectation for pain relief) releases endogenous opioids and facilitates analgesia from exogenously administered opioids. Nocebo hyperalgesia (expectation for persistent or worsening pain) opposes endogenous opioid analgesia and patient engagement in prescription opioid tapering. Reductions in nocebo hyperalgesia and pain catastrophizing may enhance descending modulation of pain, mediate adaptive structural brain changes and promote patient engagement in opioid tapering. Interventions that minimize nocebo and optimize placebo may adaptively shape the central nervous system toward pain relief and potentially opioid reduction. Here we provide a critical description of catastrophizing and its impact on pain, placebo and nocebo effects. We also consider the importance of minimizing nocebo and optimizing placebo effects during prescription opioid tapering, and offer a clinical toolkit of resources to accomplish these goals clinically.

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Section: Introductionmentioning

confidence: 99%

Optimizing Placebo and Minimizing Nocebo to Reduce Pain, Catastrophizing, and Opioid Use: A Review of the Science and an Evidence-Informed Clinical Toolkit

Darnall

Colloca

2018

International Review of Neurobiology

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“…Second, more research into the modulation of defensive behaviors (e.g., freezing, pain-related avoidance behavior) by social context is warranted. One possibility is the use of more dynamic and ecologically valid social manipulations such as virtual reality, video materials or actual social interactions using confederates ( Karos et al, 2019 ; Karos et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

“… Peeters & Vlaeyen (2011) found that participants show less painful facial expression when receiving electrical stimuli in a threatening social context, possibly a result of freeze-like reductions of overall body movement. Subsequent attempts to replicate this finding have been mixed ( Karos et al, 2019 ; Karos et al, 2018 ). However, no study to date has investigated the effect of pain on actual body sway and bradycardia, or its modulation by social context.…”

Section: Introductionmentioning

confidence: 99%

“…Growing evidence suggests that the social context can play an important role. A threatening social context can worsen the experience of painful stimuli ( Karos et al, 2019 ; Karos et al, 2018a ; Krahé et al, 2013 ), the communication of pain to others ( Karos et al, 2019 ; Karos et al, 2018 ; Peeters & Vlaeyen, 2011 ), and facilitate the acquisition of pain-related fear ( Karos, Meulders & Vlaeyen, 2015 ). More generally, chronic pain has been associated with a whole host of threatening social experiences such as social isolation and injustice ( Karos et al, 2018a ).…”

Section: Introductionmentioning

confidence: 99%

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Freeze-like responses to pain in humans and its modulation by social context

Karos

Meulders

Leyssen

et al. 2020

PeerJ

Self Cite

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Background Maladaptive defensive responses such as excessive avoidance behavior have received increasing attention as a main mechanism for the development and maintenance of chronic pain complaints. However, another defensive response which is commonly studied in animals as a proxy for fear is freezing behavior. No research to date has investigated human freezing behavior in the context of pain. In addition, there is an increasing realization that social context can affect pain-relevant processes such as pain experience and pain behavior but less is known about the effects of social context on defensive responses to pain. Hence, this study investigated freezing behavior and facial pain expression in the context of pain, and their modulation by social context. Methods Healthy, pain-free participants (N = 39) stood on a stabilometric force platform in a threatening or safe social context, which was manipulated using angry or happy facial stimuli. In some trials, an auditory cue (conditioned stimulus; CS) predicted the occurrence of painful electrocutaneous stimulus (unconditioned stimulus; pain-US). We assessed body sway (an index of freezing), heart rate, facial pain expression, self-reported pain intensity, unpleasantness, and pain-US expectancy during the CS and the context alone (no CS). Results The results were mixed. Neither the anticipation of pain, nor social context affected body sway. Heart rate and painful facial expression were reduced in the threatening social context at high anxiety levels. A threatening social context also elicited higher pain-US expectancy ratings. In sum, a threatening social context increases the expectation of pain, but reduces the facial expression of pain and lowers heart rate in highly anxious individuals.

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“…Growing evidence suggests that the social context can play an important role. A threatening social context can worsen the experience of painful stimuli [33,38,39], the communication of pain to others [33,34,58], and facilitate the acquisition of pain-related fear [36]. More generally, chronic pain has been associated with a whole host of threatening social experiences such as social isolation and injustice [37].…”

Section: Introductionmentioning

confidence: 99%

Peer Review #1 of "Freeze-like responses to pain in humans and its modulation by social context (v0.2)"

2020

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Background. Maladaptive defensive responses such as excessive avoidance behavior have received increasing attention as a main mechanism for the development and maintenance of chronic pain complaints. However, another defensive response which is commonly studied in animals as a proxy for fear is freezing behavior. No research to date has investigated human freezing behavior in the context of pain. In addition, there is an increasing realization that social context can affect pain-relevant processes such as pain experience and pain behavior but less is known about the effects of social context on defensive responses to pain. Hence, this study investigated freezing behavior and facial pain expression in the context of pain, and their modulation by social context. Methods. Healthy, pain-free participants (N = 39) stood on a stabilometric force platform in a threatening or safe social context, which was manipulated using angry or happy facial stimuli. In some trials, an auditory cue (conditioned stimulus; CS) predicted the occurrence of painful electrocutaneous stimulus (unconditioned stimulus; pain-US). We assessed body sway (an index of freezing), heart rate, facial pain expression, self-reported pain intensity, unpleasantness, and pain-US expectancy during the CS and the context alone (no CS). Results. The results were mixed. Neither the anticipation of pain, nor social context affected body sway. Heart rate and painful facial expression were reduced in the threatening social context at high anxiety levels. A threatening social context also elicited higher pain-US expectancy ratings. In sum, a threatening social context increases the expectation of pain, but reduces the facial expression of pain and lowers heart rate in highly anxious individuals.

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The Influence of Social Threat on Pain, Aggression, and Empathy in Women

Abstract: A threatening social context affects how threatening pain is perceived and has interpersonal consequences such as increased aggression and reduced empathy, thereby creating a double burden on the individual suffering from pain.

Cited by 20 publications

References 52 publications

Optimizing Placebo and Minimizing Nocebo to Reduce Pain, Catastrophizing, and Opioid Use: A Review of the Science and an Evidence-Informed Clinical Toolkit

Optimizing Placebo and Minimizing Nocebo to Reduce Pain, Catastrophizing, and Opioid Use: A Review of the Science and an Evidence-Informed Clinical Toolkit

Freeze-like responses to pain in humans and its modulation by social context

Peer Review #1 of "Freeze-like responses to pain in humans and its modulation by social context (v0.2)"

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