Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland.
Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.
Eur J Pain. 2022 May;26(5):1163-1175. doi: 10.1002/ejp.1940. Epub 2022 Apr 1.
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.
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.
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.
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.
估计他人的疼痛是一种具有高度不确定性的挑战性推断过程。虽然人们已经了解不确定性对自我关注行为的影响，但尚未描述其对他人疼痛相关决策的影响。
本研究利用概率决策模型来探讨不确定性如何影响对他人疼痛的评估和估值。
我们邀请了 63 对（43 名陌生人，20 对情侣）参与一项任务，其中个体的选择会影响自身（代理人）或对的成员所经历的疼痛。在每次试验中，代理人会看到提示，提示预测给定的疼痛强度及其发生的概率。代理人可以选择一个确定的（疼痛轻度减轻）或冒险的（有 50%的机会完全避免疼痛）管理选项，然后对他们的选择进行出价。然后对目标（自身或他人）进行热刺激。决策者随后被要求对施予目标的疼痛进行评分。
我们发现，预期疼痛越高，代理人的风险规避性越强，这与基于价值的决策一致。此外，代理人对他人的疼痛下注较少（尤其是陌生人），并对疼痛缓解的出价高于自身。最重要的是，预期疼痛的不确定性降低了对陌生人疼痛的评分。这与对代理人自身疼痛的影响形成对比，风险对自身疼痛有轻微的痛觉过敏效应。
总的来说，我们的结果表明，风险选择性地影响对陌生人痛苦的决策，包括评估和治疗选择，这是通过（1）导致低估，（2）优先选择确定的选项，以及（3）利他主义地分配更多的资金来确保治疗的成功。
不确定性会影响决策，但尚不清楚它是否会影响他人对疼痛的选择行为。在研究这个问题时，我们发现个体在面临迫在眉睫的疼痛时通常会冒险，但对自身更为如此；并且对他人的疼痛赋予更高的货币价值和主观评分。然而，不确定性降低了代理人对陌生人疼痛的评估，这表明潜在变量可能与公开的利他主义相矛盾。这种偏见可能是临床环境中疼痛低估的基础。
