The effect of uncertainty on pain decisions for self and others.
Journal
European journal of pain (London, England)
ISSN: 1532-2149
Titre abrégé: Eur J Pain
Pays: England
ID NLM: 9801774
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
pubmed:
16
3
2022
medline:
21
4
2022
entrez:
15
3
2022
Statut:
ppublish
Résumé
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. The present study exploited models of probabilistic decision-making to investigate how uncertainty influences the valuation and assessment of another's pain. 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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 35290697
doi: 10.1002/ejp.1940
pmc: PMC9322544
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1163-1175Informations de copyright
© 2022 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®.
Références
JAMA. 2014 Aug 27;312(8):825-36
pubmed: 25157726
Pain. 2017 Aug;158(8):1528-1537
pubmed: 28715353
Exp Psychol. 2018 Jul;65(4):226-235
pubmed: 30165805
Biol Psychiatry. 2010 Jun 1;67(11):1083-90
pubmed: 20303069
Ann Emerg Med. 2016 Aug;68(2):202-8
pubmed: 26875061
J Neurosci Psychol Econ. 2017 Jun-Sep;10(2-3):59-80
pubmed: 29456782
Philos Trans R Soc Lond B Biol Sci. 2004 Sep 29;359(1449):1367-78
pubmed: 15347528
Annu Rev Neurosci. 2012;35:1-23
pubmed: 22715878
Eur J Pain. 2022 May;26(5):1163-1175
pubmed: 35290697
Neuron. 2010 Apr 15;66(1):149-60
pubmed: 20399736
Neuropsychologia. 2018 Jul 31;116(Pt A):99-116
pubmed: 29258849
Brain Stimul. 2020 Jan - Feb;13(1):60-68
pubmed: 31636023
Cereb Cortex. 2007 Sep;17(9):2214-22
pubmed: 17124286
Lancet Oncol. 2015 Sep;16(12):1231-72
pubmed: 26431866
Behav Res Methods. 2019 Feb;51(1):195-203
pubmed: 30734206
Pain. 2008 May;136(1-2):168-76
pubmed: 17822850
Front Artif Intell. 2020 Feb 28;3:5
pubmed: 33733125
Proc Natl Acad Sci U S A. 2014 Dec 2;111(48):17320-5
pubmed: 25404350
Nat Hum Behav. 2018 Aug;2(8):573-580
pubmed: 31209312
Front Neurosci. 2013 Nov 20;7:218
pubmed: 24311997
Pain. 2019 Jan;160(1):1-4
pubmed: 30086114
Elife. 2021 Apr 27;10:
pubmed: 33904406
F1000Res. 2019 Feb 6;8:164
pubmed: 30863539
Neuroimage. 2010 Jun;51(2):923-9
pubmed: 20188182
Patient Educ Couns. 2015 Oct;98(10):1197-206
pubmed: 26223850
J Physiol. 2006 Nov 15;577(Pt 1):235-48
pubmed: 16973704
J Gen Intern Med. 2007 May;22(5):632-8
pubmed: 17443371
J Clin Med. 2021 Mar 25;10(7):
pubmed: 33805916
Br J Anaesth. 2019 Aug;123(2):e284-e292
pubmed: 30916038
Pain. 2003 Nov;106(1-2):101-8
pubmed: 14581116
PLoS One. 2011;6(8):e22759
pubmed: 21826205
Neuron. 2019 Mar 20;101(6):1029-1041
pubmed: 30897355
Clin Neuropsychol. 2013;27(1):30-48
pubmed: 23181338
Elife. 2017 May 19;6:
pubmed: 28524817
Sci Rep. 2018 Aug 27;8(1):12857
pubmed: 30150657
Neuron. 2014 Mar 19;81(6):1223-1239
pubmed: 24656247
Soc Cogn Affect Neurosci. 2017 Mar 1;12(3):401-408
pubmed: 27798249
Trends Cogn Sci. 2009 Apr;13(4):154-9
pubmed: 19269881
J Pain Palliat Care Pharmacother. 2002;16(1):105-9
pubmed: 14650454
J Neurosci. 2010 Sep 29;30(39):12964-77
pubmed: 20881115
Neuron. 2010 Oct 6;68(1):149-60
pubmed: 20920798
J Neurosci. 2009 Jul 1;29(26):8525-9
pubmed: 19571143
J Clin Nurs. 2018 Feb;27(3-4):669-676
pubmed: 28793374
J Neurosci. 2013 Mar 27;33(13):5638-46
pubmed: 23536078
Psychopathology. 2003 Jul-Aug;36(4):171-80
pubmed: 14504450
Trends Cogn Sci. 2003 May;7(5):197-200
pubmed: 12757820
Cognition. 2019 Jan;182:127-139
pubmed: 30243037
Pain. 1998 Jun;76(3):365-375
pubmed: 9718255
Pain. 2008 Jan;134(1-2):140-7
pubmed: 17532141
J Health Econ. 2016 Jul;48:121-34
pubmed: 27179198
Wiley Interdiscip Rev Cogn Sci. 2010 Sep;1(5):736-749
pubmed: 26271657