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Empathy for Pain Involves theAffective but not Sensory
Components of Pain
Tania Singer,1 Ben Seymour,1 John O’Doherty,1
Holger Kaube,2
Raymond J. Dolan,1 ChrisD. Frith1
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Understanding others' mental states is important for social interaction
“Theory of mind” Understand other
peoples' cognitive states
e.g. Sally-Anne test
Empathy Understand other
peoples' emotional or sensory states
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Empathy
Preston and de Wall's model
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Past studies of empathy
Watch videos of others telling sad, happy, or neutral stories accompanied by sad or happy expressions
Imitating vs. observing sad and happy faces Responses to smelling aversive or pleasant
odors compared to watching videos of other people smelling those odors
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Past Studies of empathy
Results: Latter two studies found activation in same areas
when watching an emotion and experiencing or imitating it
“Emotional contagion”
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Methods
16 couples Female partner sees her and her partners'
hands and screen with cues Cues indicate whether herself or her partner will
receive high (painful) or low (not painful) stimulation
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Methods
Demonstrates empathy without exposure to an emotional cue Subjects don't see partner's face Only know of emotional state though neutral cues
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Methods
After scanning, subjects respond to questions about: Pain intensity Unpleasantness Empathy (“Balanced Emotional Empathy Scale”
and “Empathic Concern Scale”)
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Methods
Pain intensity questionnaire confirms that low stimulus isn't painful but high stimulus is
Unpleasantness confirms that subjects are empathizing with their partners “other” and “self” trials with pain were both rated as
more unpleasant than those without pain Difference between “pain” and “no pain” trials was
significant at p < .001, difference between self and other trials had p = .73, not significant
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“Self” trials: pain vs. no pain
“Pain matrix” SI/MI SII Bilateral mid and anterior insula ACC Right ventrolateral and mediodorsal thalumus Brainstem Mid and right lateral cerebellum
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Areas activated by pain trials for both “self” and “other”
Caudal and posterior rostral ACC
Bilateral middle insula and anterior insula
Brainstem Lateral cerebellum
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Time course of activation
Time courses of peak activation during self (green lines) and other (red lines)
Authors suggest two peaks Anticipation upon
seeing cue and actual receipt of pain?
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“Self” vs. “other” pain trials
Differential activation in “self” trials with pain but not “other” trials SI/MI SII/posterior insula Part of caudal ACC
Activation only during “other” pain trials Extrastriate areas
associated with vision
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“Self” trials
Differential activation in “self” trials with pain but not “other” trials SI/MI SII/posterior insula Part of caudal ACC
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Time Course
Only one peak (late) in activation Receipt of pain? Sensory
components of pain not triggered by cue
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In which areas does pain-related activation correlate with individual
empathy? Individual empathy assessed with two
questionnaires Balanced Emotional Empathy Scale Empathic Concern Scale
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In which areas does pain-related activation correlate with empathy?
Areas with significant correlation: Posterior rostral ACC Left, but not right, anterior insula Part of anterior ACC Lateral right cerebellum
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ACC and left AI
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Rostral ACC
Previous report on a precingulotomy patient Single neuron recordings in ACC respond both to
painful stimuli and observing or anticipating delivery of painful stimulus to experimenter
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Sensory v. Affective components of pain?
Possible interpretation self-specific areas in the pain matrix are associated
with sensory components of pain Areas active in empathy condition are associated
with affective, subjective components of pain
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Sensory v. Affective components of pain?
Makes intuitive sense, but is there any more evidence for this interpretation?
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Sensory v. Affective components of pain?
SI, parts of SII, posterior insula, and lateral thalmus have contralaterally biased representations of painful stimulus Suggests that these regions may provide sensory
information such as location, quality, and intensity of the pain
AI and ACC do not show contralateral bias
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Sensory v. Affective components of pain?
Studies using hypnosis to dissociate sensory from affective pain components Posterior rostral ACC modulated by reported
unpleasantness SI and SII unaffected by unpleasantness
Similar results from using attentional manipulations (ACC activation modulated, SII not)
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Sensory v. Affective components of pain?
Anticipation of pain activates more anterior insular regions, experience of pain modulates more posterior regions Implicates anterior insula in affective experience of
pain, posterior insula in sensory experience
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Sensory v. Affective components of pain?
Subjective pain reduction in placebo and opioid analgesia Increased rostral ACC and right AI activation
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Conclusions
Rostral ACC and AI reflect emotional response to pain
Pain as one of the homeostatic emotions AI and ACC also involved in representing internal
bodily states In many studies, activation in AI and ACC
correlated with positive/negative subjective feelings “Second order representations of bodily
homeostatic states”
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Conclusions
Authors conclude that the ability to empathize may have evolved from a system for representing internal states, including subjective feeling states