Search

Introduction: In the early days of the COVID-19 pandemic, individuals were asked to perform costly actions to reduce harm to strangers, even while the general population, including authorities and experts, grappled with the uncertainty surrounding thenovel virus. Many studies have examined health decision-making by experts, but the study of lay, non-expert, individual decisionmaking on a stranger's health has been left to the wayside, as ordinary citizens are usually not tasked with such decisions. Methods: We sought to capture a snapshot of this specific choice behavior by administering two surveys to the general population in the spring of 2020, when much of the global community was subject to COVID-19-related restrictions, as well as uncertainty surrounding the virus. We presented study participants with fictitious diseases varying in severity that threatened oneself, a loved one or a stranger. Participants were asked to choose between treatment options that could either provide a sure, but mild improvement (sure option) or cure the affected person at a given probability of success (risky option). Results: Respondents preferred gambles overall, but risk-seeking decreased progressively with higher expected severity of disease. This pattern was observed regardless of the recipient's identity. Distinctions between targets emerged however whendecisions were conditioned on a treatment's monetary cost, with participants preferring cheaper options for strangers. Discussion: Overall, these findings provide a descriptive model of individual decision-making under risk for others; and inform on the limits of what can be asked of an individual in service to a stranger. [ABSTRACT FROM AUTHOR]

Objective: The COVID‐19 pandemic had a profound negative impact on the psychological wellbeing of healthcare providers (HPs), but little is known about the factors that positively predict mental health of primary care staff during these dire situations. Methods: We conducted an online questionnaire survey among 702 emergency department workers across 10 hospitals in Switzerland and Belgium following the first COVID‐19 wave in 2020, to explore their psychological vulnerability, perceived concerns, self‐reported impact and level of pandemic workplace preparedness. Participants included physicians, nurses, psychologists and nondirect care employees (administrative staff). We tested for predictors of psychological vulnerability through both an exploratory cross‐correlation with rigorous correction for multiple comparisons and model‐based path modelling. Results: Findings showed that the self‐reported impact of COVID‐19 at work, concerns about contracting COVID‐19 at work, and a lack of personal protective equipment were strong positive predictors of Depression, Anxiety, and Stress, and low Resilience. Instead, knowledge of the degree of preparedness of the hospital/department, especially in the presence of a predetermined contingency plan for an epidemic and training sessions about protective measures, showed the opposite effect, and were associated with lower psychological vulnerability. All effects were confirmed after accounting for confounding factors related to gender, age, geographical location and the role played by HPs in the hospital/department. Conclusions: Difficult working conditions during the pandemic had a major impact on the psychological wellbeing of emergency department HPs, but this effect might have been lessened if they had been informed about adequate measures for minimizing the risk of exposure. [ABSTRACT FROM AUTHOR]

Medical students and professional healthcare providers often underestimate patients' pain, together with decreased neural responses to pain information in the anterior insula (AI), a brain region implicated in self‐pain processing and negative affect. However, the functional significance and specificity of these neural changes remains debated. Across two experiments, we recruited university medical students and emergency nurses to test the role of healthcare experience on the brain reactivity to other's pain, emotions, and beliefs, using both pictorial and verbal cues. Brain responses to self‐pain was also assessed and compared with those to observed pain. Our results confirmed that healthcare experience decreased the activity in AI in response to others' suffering. This effect was independent from stimulus modality (pictures or texts), but specific for pain, as it did not generalize to inferences about other mental or affective states. Furthermore, representational similarity and multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others' pain that is shared with that of first‐hand nociception, and related more to AI than to other pain‐responsive regions. Taken together, our study suggests a decreased propensity to appraise others' suffering as one's own, associated with a reduced recruitment of pain‐specific information in AI. These findings provide new insights into neural mechanisms leading to pain underestimation by caregivers in clinical settings. [ABSTRACT FROM AUTHOR]

Embodied theories hold that understanding what another person is doing requires the observer to map that action directly onto his or her own motor representation and simulate it internally. The human motor system may, thus, be endowed with a "mirror matching" device through which the same motor representation is activated, when the subject is either the performer or the observer of another's action ("self-other shared representation"). It is suggested that understanding action verbs relies upon the same mechanism; this implies that motor responses to these words are automatic and independent of the subject of the verb. In the current study, participants were requested to read silently and decide on the syntactic subject of action and nonaction verbs, presented in first (1P) or third (3P) person, while TMS was applied to the left hand primary motor cortex (M1). TMS-induced motor-evoked potentials were recorded from hand muscles as a measure of cortico-spinal excitability. Motor-evoked potentials increased for 1P, but not for 3P, action verbs or 1P and 3P nonaction verbs. We provide novel demonstration that the motor simulation is triggered "only" when the conceptual representation of a word integrates the action with the self as the agent of that action. This questions the core principle of "mirror matching" and opens to alternative interpretations of the relationship between conceptual and sensorimotor processes.

The "irrational" rejections of unfair offers by people playing the Ultimatum Game (UG), a widely used laboratory model of economical decision-making, have traditionally been associated with negative emotions, such as frustration, elicited by unfairness ([Sanfey et al., 2003] and [van't Wout et al., 2006]). We recorded skin conductance responses as a measure of emotional activation while participants performed a modified version of the UG, in which they were asked to play both for themselves and on behalf of a third-party. Our findings show that even unfair offers are rejected when participants' payoff is not affected ("third-party" condition); however, they show an increase in the emotional activation specifically when they are rejecting offers directed towards themselves ("myself" condition). These results suggest that theories emphasizing negative emotions as the critical factor of "irrational" rejections (Pillutla & Murninghan, 1996) should be re-discussed. Psychological mechanisms other than emotions might be better candidates for explaining this behaviour. (Contains 5 figures and 2 tables.)

In the last 2 years, governments of many countries imposed heavy social restrictions to contain the spread of the COVID-19 virus, with consequent increase of bad mood, distress, or depression for the people involved. Few studies investigated the impact of these restrictive measures on individual social proficiency, and specifically the processing of emotional facial information, leading to mixed results. The present research aimed at investigating systematically whether, and to which extent, social isolation influences the processing of facial expressions. To this end, we manipulated the social exclusion experimentally through the well-known Cyberball game (within-subject factor), and we exploited the occurrence of the lockdown for the Swiss COVID-19 first wave by recruiting participants before and after being restricted at home (grouping factor). We then tested whether either form of social segregation influenced the processing of pain, disgust, or neutral expressions, across multiple tasks probing access to different components of affective facial responses (state-specific, shared across states). We found that the lockdown (but not game-induced exclusion) affected negatively the processing of pain-specific information, without influencing other components of the affective facial response related to disgust or broad unpleasantness. In addition, participants recruited after the confinement reported lower scores in empathy questionnaires. These results suggest that social isolation affected negatively individual sensitivity to other people's affect and, with specific reference to the processing of facial expressions, the processing of pain-diagnostic information. [ABSTRACT FROM AUTHOR]

Vocal emotion recognition, a key determinant to analyzing a speaker's emotional state, is known to be impaired following cerebellar dysfunctions. Nevertheless, its possible functional integration in the large-scale brain network subtending emotional prosody recognition has yet to be explored. We administered an emotional prosody recognition task to patients with right versus left-hemispheric cerebellar lesions and a group of matched controls. We explored the lesional correlates of vocal emotion recognition in patients through a network-based analysis by combining a neuropsychological approach for lesion mapping with normative brain connectome data. Results revealed impaired recognition among patients for neutral or negative prosody, with poorer sadness recognition performances by patients with right cerebellar lesion. Network-based lesion-symptom mapping revealed that sadness recognition performances were linked to a network connecting the cerebellum with left frontal, temporal, and parietal cortices. Moreover, when focusing solely on a subgroup of patients with right cerebellar damage, sadness recognition performances were associated with a more restricted network connecting the cerebellum to the left parietal lobe. As the left hemisphere is known to be crucial for the processing of short segmental information, these results suggest that a corticocerebellar network operates on a fine temporal scale during vocal emotion decoding. [ABSTRACT FROM AUTHOR]

Extensive neuroimaging literature suggests that understanding others' thoughts and emotions engages a wide network encompassing parietal, temporal and medial frontal brain areas. However, the causal role played by these regions in social inferential abilities is still unclear. Moreover very little is known about theory of mind deficits in brain tumours and whether potential anatomical substrates are comparable to those identified in functional MRI literature. This study evaluated the performance of 105 tumour patients, before and immediately after brain surgery, on a cartoon-based non-verbal task evaluating cognitive (intention attribution) and affective (emotion attribution) theory of mind, as well as a non-social control condition (causal inference). Across multiple analyses, we found converging evidence of a double dissociation between patients with right superior parietal damage, selectively impaired in intention attribution, and those with right anteromedial temporal lesion, exhibiting deficits only in emotion attribution. Instead, patients with damage to the frontal cortex were impaired in all kinds of inferential processes, including those from the non-social control conditions. Overall, our data provide novel reliable causal evidence of segregation between different aspects of the theory of mind network from both the cognitive and also the anatomical point of view. [ABSTRACT FROM AUTHOR]

Background: Estimating others' pain is a challenging inferential process, associated with a high degree of uncertainty. While much is known about uncertainty's effect on self‐regarding actions, its impact on other‐regarding decisions for pain have yet to be characterized. Aim: The present study exploited models of probabilistic decision‐making to investigate how uncertainty influences the valuation and assessment of another's pain. Materials & Methods: We engaged 63 dyads (43 strangers and 20 romantic couples) in a task where individual choices affected the pain delivered to either oneself (the agent) or the other member of the dyad. At each trial, agents were presented with cues predicting a given pain intensity with an associated probability of occurrence. Agents either chose a sure (mild decrease of pain) or risky (50% chance of avoiding pain altogether) management option, before bidding on their choice. A heat stimulation was then issued to the target (self or other). Decision‐makers were then asked to rate the pain administered to the target. Results: We found that the higher the expected pain, the more risk‐averse agents became, in line with findings in value‐based decision‐making. Furthermore, agents gambled less on another individual's pain (especially strangers) and placed higher bids on pain relief than they did for themselves. Most critically, the uncertainty associated with expected pain dampened ratings made for strangers' pain. This contrasted with the effect on an agent's own pain, for which risk had a marginal hyperalgesic effect. Discussion & Conclusion: Overall, our results suggested that risk selectively affects decision‐making on a stranger's suffering, both at the level of assessment and treatment selection, by (1) leading to underestimation, (2) privileging sure options and (3) altruistically allocating more money to insure the treatment's success. Significance: Uncertainty biases decision‐making but it is unclear if it affects choice behavior on pain for others. In examining this question, we found individuals were generally risk‐seeking when faced with looming pain, but more so for self; and assigned higher monetary values and subjective ratings on another's pain. However, uncertainty dampened agents' assessment of a stranger's pain, suggesting latent variables may contradict overt altruism. This bias may underlie pain underestimation in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Embodied models of social cognition argue that others' affective states are processed by re-enacting a sensory-specific representation of the same state in the observer. However, neuroimaging studies suggest that a reliable part of the representation shared between self and others is supramodal and relates to dimensions such as Unpleasantness or arousal, common to qualitatively different experiences. Here we investigated whether representations of first-hand pain and disgust influenced the subsequent evaluation of facial expressions in Modality-specific fashion, or in terms of Unpleasantness or arousal.Methods: Thirty volunteers were subjected to thermal painful and olfactory disgusting events, and subsequently were asked to classify computer-generated faces expressing pain (characterized by high Unpleasantness and arousal), disgust (high Unpleasantness and low arousal), surprise (low Unpleasantness and high arousal) and hybrid combinations thereof.Results: Thermal and olfactory events were associated with comparable Unpleasantness ratings and heart rate (but stronger galvanic response was found for painful temperatures). Furthermore, we found that the appraisal of facial expressions was biased by the prior stimulus, with more frequent pain classifications following thermal stimuli, and more frequent disgust classifications following olfactory stimuli. Critically, this modulation was cross-modal in nature, as each first-hand stimulation influenced in comparable fashion facial traits diagnostic of both pain and disgust, without instead generalizing to features of surprise.Conclusion: Overall, these data support the presence of shared coding between one's aversive experiences and the appraisal of others' facial responses, which is best describable as supramodal representation of the Unpleasantness of the experience.Significance: These results extend previous findings about common representational coding between the experience of first-hand and others' pain. In particular, they highlight that reliable part of the information shared is supramodal in nature and relates to a broad dimension of Unpleasantness common also to painless aversive states such as disgust. [ABSTRACT FROM AUTHOR]

Patients with borderline personality disorder (BPD) often engage in dangerous self-injurious behaviors (SIBs) as a maladaptive technique to decrease heightened feelings of distress (e.g. negative feelings caused by social exclusion). The reward system has recently been proposed as a plausible neural substrate, which may influence the interaction between social distress and physical pain processing in patients that engage in SIBs. Using functional magnetic resonance imaging (fMRI) in 20 adult BPD patients with a history of SIBs and 23 healthy controls (HCs), we found a hyper-activation of the nucleus accumbens (NAcc) and amygdala when painful stimuli were presented to BPD patients (but not HCs) in a state of heightened distress, induced via social exclusion. This differential NAcc activity was mediated by anxious attachment style, which is a key developmental feature of the disorder. Altogether, these results suggest a neural mechanism underlying the pathophysiology of SIBs in these patients, which is likely reinforced via the reward system. [ABSTRACT FROM AUTHOR]

Expectations modulate the subjective experience of pain by increasing sensitivity to nociceptive inputs, an effect mediated by brain regions such as the insula. However, it is still unknown whether the neural structures underlying pain expectancy hold sensory-specific information or, alternatively, code for modality-independent features (eg, unpleasantness), potentially common with other negative experiences. We used functional magnetic resonance imaging to investigate neural activity underlying the expectation of different, but comparably unpleasant, pain and disgust. We presented participants with visual cues predicting either a painful heat or disgusting odor, and assessed how they affected the subsequent subjective experience of stimuli from the same (within-modality) or opposite (cross-modal) modality. We found a reliable influence of expectancy on the subjective experience of stimuli whose modality matched that of the previous cue. At the brain level, this effect was mediated by the intermediate dysgranular section of the insula, whereas it was suppressed by more anterior agranular portions of the same region. Instead, no expectancy modulation was observed when the modality of the cue differed from that of the subsequent stimulus. Our data suggest that the insular cortex encodes prospective aversive events in terms of their modality-specific features, and whether they match with subsequent stimulations. [ABSTRACT FROM AUTHOR]

The identification of reliable brain endophenotypes of autism spectrum disorders (ASD) has been hampered to date by the heterogeneity in the neuroanatomical abnormalities detected in this condition. To handle the complexity of neuroimaging data and to convert brain images in informative biomarkers of pathology, multivariate analysis techniques based on Support Vector Machines (SVM) have been widely used in several disease conditions. They are usually trained to distinguish patients from healthy control subjects by making a binary classification. Here, we propose the use of the One-Class Classification (OCC) or Data Description method that, in contrast to two-class classification, is based on a description of one class of objects only. This approach, by defining a multivariate normative rule on one class of subjects, allows recognizing examples from a different category as outliers. We applied the OCC to 314 regional features extracted from brain structural Magnetic Resonance Imaging (MRI) scans of young children with ASD (21 males and 20 females) and control subjects (20 males and 20 females), matched on age [range: 22-72 months of age; mean = 49 months] and non-verbal intelligence quotient (NVIQ) [range: 31-123; mean = 73]. We demonstrated that a common pattern of features characterize the ASD population. The OCC SVM trained on the group of ASD subjects showed the following performances in the ASD vs. controls separation: the area under the receiver operating characteristic curve (AUC) was 0.74 for the male and 0.68 for the female population, respectively. Notably, the ASD vs. controls discrimination results were maximized when evaluated on the subsamples of subjects with NVIQ ≥ 70, leading to AUC = 0.81 for the male and AUC = 0.72 for the female populations, respectively. Language regions and regions from the default mode network--posterior cingulate cortex, pars opercularis and pars triangularis of the inferior frontal gyrus, and transverse temporal gyrus--contributed most to distinguishing individuals with ASD from controls, arguing for the crucial role of these areas in the ASD pathophysiology. The observed brain patterns associate preschoolers with ASD independently of their age, gender and NVIQ and therefore they are expected to constitute part of the ASD brain endophenotype. [ABSTRACT FROM AUTHOR]

In his article Grush proposes a potentially useful framework for explaining motor control, imagery, and perception. In our commentary we will address two issues that the model does not seem to deal with appropriately: one concerns motor control, and the other, the visual and motor imagery domains. We will consider these two aspects in turn.

Rejections of unfair offers in the ultimatum game (UG) are commonly assumed to reflect negative emotional arousal mediated by the anterior insula and medial prefrontal cortex. We aimed to disentangle those neural mechanisms associated with direct personal involvement (‘I have been treated unfairly’) from those associated with fairness considerations, such as the wish to discourage unfair behavior or social norm violations (‘this person has been treated unfairly’). For this purpose, we used fMRI and asked participants to play the UG as responders either for themselves (myself) or on behalf of another person (third party). Unfair offers were equally often rejected in both conditions. Neuroimaging data revealed a dissociation between the medial prefrontal cortex, specifically associated with rejections in the myself condition, thus confirming its role in self-related emotional responses, and the left anterior insula, associated with rejections in both myself and third-party conditions, suggesting a role in promoting fair behavior also toward third parties. Our data extend the current understanding of the neural substrate of social decision making, by disentangling the structures sensitive to direct emotional involvement of the self from those implicated in pure fairness considerations. [ABSTRACT FROM PUBLISHER]

A crucial feature of socially adaptive behavior is the ability to recognize when our actions harm other individuals. Previous research demonstrates that dorsal mediofrontal cortex (dMFC) and anterior insula (AI) are involved in both action monitoring and empathy for pain. Here, we tested whether these regions could integrate monitoring of error agency with the representation of others' pain. While undergoing event-related fMRI, participants played a visual task in turns with a friend placed outside the scanner, who would receive painful stimulation in half of the error trials. Brain activity was enhanced in dMFC and AI for painful compared with non-painful errors. Left AI and dorsolateral pFC also exhibited a significant interaction with agency and increased responses when painful errors were caused by oneself. We conclude that AI is crucial for integrating inferences about others' feeling states with information about action agency and outcome, thus generating an affective signal that may guide subsequent adjustment. [ABSTRACT FROM AUTHOR]

Structural and functional studies have shown that schizophrenia is often associated with frontolimbic abnormalities in the prefrontal and mediotemporal regions. It is still unclear, however, if such dysfunctional interaction extends as well to relay regions such as the thalamus and the anterior insula. Here, we measured gray matter volumes of five right-hemisphere regions in 68 patients with schizophrenia and 77 matched healthy subjects. The regions were amygdala, thalamus, and entorhinal cortex (identified as anomalous by prior studies on the same population) and dorsolateral prefrontal cortex and anterior insula (isolated by voxel-based morphometry analysis). We used structural equation modeling and found altered path coefficients connecting the thalamus to the anterior insula, the amygdala to the DLPFC, and the entorhinal cortex to the DLPFC. In particular, patients exhibited a stronger thalamus-insular connection than healthy controls. Instead, controls showed positive entorhinal-DLPFC and negative amygdalar-DLPFC connections, both of which were absent in the clinical population. Our data provide evidence that schizophrenia is characterized by an impaired right-hemisphere network, in which intrahemispheric communication involving relay structures may play a major role in sustaining the pathophysiology of the disease. Hum Brain Mapp, 2012. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The discovery of regions in the human brain (e.g., insula and cingulate cortex) that activate both under direct exposure to pain and when perceiving pain in others has been interpreted as a neural signature of empathy. However, this overlap raises the question of whether it may reflect a unique distributed population of bimodal neurons or, alternatively, the activity of intermingled but independent populations. We used fMRI on 28 female volunteers and used multivariate pattern analysis techniques to probe for more fine-grain spatial representations of seen and felt pain. Using a whole-brain approach, we found that only in the anterior insula (bilaterally) the distribution of cortical activity evoked by seeing another person's hand in pain was spatially similar to that of pain felt on one's own hand. Subsequent region of interest analyses also implicated the middle insula (right hemisphere) and the middle cingulate cortex. Furthermore, for the anterior insula, the spatial distribution of activity associated with one's pain also replicates that of the perception of negative but painless stimuli. Our data show how the neural representations of aversive events affecting oneself are also recruited when the same events affect others, and provide the stronger evidence thus far of a unique distributed cortical ensemble coding for aversive events regardless of the subject who is affected. [ABSTRACT FROM AUTHOR]

Traditionally the motor system was thought of as a movement output device that, after brain damage, can impede patients from correctly planning and executing an action. In the last 20 years neuropsychological observations have contributed to the development of a new view that attributes higher-level functions to this system. Rapidly, this area of investigation has grown very popular, with motor representations being considered critical for action and object recognition, imagery and even language understanding. At present, we can distinguish between embodied and disembodied theories. The former predominantly are built on associations of deficits in these abilities whereas the latter rely on dissociations between deficits. Neuroimaging research has also showed that different action-related functions activate either overlapping or discrete regions, thus sustaining either association-based or dissociation-based models. Although no convincing theory is, to date, available to explain both sets of observations, cognitive neuroscientists have begun to explore this intermediate hypothesis space. Here we suggest that concepts like strategy and simulation seem promising in explaining how the cognitive system alternates between action-related functions. [ABSTRACT FROM AUTHOR]

Neuropsychological studies suggest that the human brain is endowed with two body representations: the body schema (BS), coding the orientation of one's body parts in space, and the body structural description (BSD), coding the location of body parts relative to a standard body.Weused fMRI to disentangle the neural mechanisms underlying these putatively distinct body representations. Participants saw an arm or a pot's handle (stimulus: arm, handle) rotated at different angles (angle: 30 -150°). If the stimulus was an arm, subjects were instructed to imagine (1) rotating their own arm until it matched the stimulus orientation (comparing the seen arm to their own) or (2) seeing the stimulus moving toward its appropriate position on a simultaneously presented human body [comparing the arm to the one of a standard body (strategy: motor, visual imagery)]. If the stimulus was a handle, subjects were instructed to imagine (1) placing the handle on its appropriate position on a simultaneously presented pot or (2) seeing it moving toward its pot's position. The analysis of the interaction stimulus × strategy revealed activation of left secondary somatosensory cortex (SII), specifically when comparing the stimulus arm to one's own. The analysis of the parameters describing the linear effect of angle revealed that neural activity of left posterior intraparietal sulcus was modulated by the stimulus's rotation, but only when relating the arm to a standard body. The results associate BS and BSD with differential neural substrates, thereby suggesting that these are independent body representations, and furthermore extend current concepts of SII function. [ABSTRACT FROM AUTHOR]