Transforming Pain With Prosocial Meaning: A Functional Magnetic Resonance Imaging Study.

Abstract:

OBJECTIVE:Contextual factors can transform how we experience pain, particularly if pain is associated with other positive outcomes. Here, we test a novel meaning-based intervention. Participants were given the opportunity to choose to receive pain on behalf of their romantic partners, situating pain experience in a positive, prosocial meaning context. We predicted that the ventromedial prefrontal cortex (vmPFC), a key structure for pain regulation and generation of affective meaning, would mediate the transformation of pain experience by this prosocial interpersonal context. METHODS:We studied fMRI activity and behavioral responses in 29 heterosexual female participants during (1) a baseline pain challenge and (2) a task in which participants decided to accept a self-selected number of additional pain trials to reduce pain in their male romantic partners ("accept-partner-pain" condition). RESULTS:Enduring extra pain for the benefit of the romantic partner reduced pain-related unpleasantness (t = -2.54, p = .016) but not intensity, and increased positive thoughts (t = 3.60, p = .001) and pleasant feelings (t = 5.39, p < .0005). Greater willingness to accept the pain of one's partner predicted greater unpleasantness reductions (t = 3.94, p = .001) and increases in positive thoughts (r = .457, p = .013). The vmPFC showed significant increases (q < .05 FDR-corrected) in activation during accept-partner-pain, especially for women with greater willingness to relieve their partner's pain (t = 2.63, p = .014). Reductions in brain regions processing pain and aversive emotion significantly mediated reductions in pain unpleasantness (q < .05 FDR-corrected). CONCLUSIONS:The vmPFC has a key role in transforming the meaning of pain, which is associated with a cascade of positive psychological and brain effects, including changes in affective meaning, value, and pain-specific neural circuits.

journal_name

Psychosom Med

journal_title

Psychosomatic medicine

authors

López-Solà M,Koban L,Wager TD

doi

10.1097/PSY.0000000000000609

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

814-825

issue

9

eissn

0033-3174

issn

1534-7796

journal_volume

80

pub_type

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