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The Social Regulation of Pain: Autonomic and Neurophysiological Changes Associated With Perceived Threat

  • Xianwei Che
    Correspondence
    Address reprint requests to Xianwei Che, PhD candidate, Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Road, Melbourne, Vic. 3004, Australia.
    Affiliations
    Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
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  • Robin Cash
    Affiliations
    Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
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  • Paul Fitzgerald
    Affiliations
    Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia

    Epworth Clinic, Epworth Healthcare, Camberwell, Victoria, Australia
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  • Bernadette M. Fitzgibbon
    Affiliations
    Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
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Published:December 20, 2017DOI:https://doi.org/10.1016/j.jpain.2017.12.007

      Highlights

      • Social support was shown to reduce pain experience.
      • Social support decreased heart rate and frontal theta to the threat of pain.
      • Decreased heart rate and frontal theta were related to greater pain reduction.
      • Frontal theta was source localized to the insula and the anterior cingulate cortex.

      Abstract

      The analgesic effect of social support is proposed as a function of social support modulating perceived threat of painful stimuli. In the current study, we directly examined the social buffering effect in the context of the threat of pain. Eighteen healthy participants were subjected to the threat of pain while they held the hand of a close other, a stranger, or not at all. Neural and autonomic responses were recorded using electroencephalogram and heart rate, respectively. Close other hand-holding reduced pain perception. This was accompanied by decreased heart rate and frontal theta oscillation (4–8 Hz) during the threat phase preceding painful stimulation. Interestingly, decreased heart rate and frontal theta in the close other hand-holding condition were uniquely associated with greater pain reduction during subsequent nociceptive stimulation. Neural changes were source-localized to the insular cortex and the rostral-ventral portions of anterior cingulate cortex, regions involved in the processing of threat and pain. Together, our data build upon work to date linking social support to pain by showing autonomic and neurophysiological changes associated with pain reduction.

      Perspective

      Social support may reduce pain through buffering the autonomic and neurophysiological response to the threatening quality of noxious stimuli. Results implicate that in clinical settings the caregiver could help people with chronic pain reappraise pain and related conditions as less stressful.

      Key words

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