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Emotional modulation of cold pressor pain: Facial expressions as emotion-evoking stimuli

Klanci M. McCabe, MA, Amy E. Williams, MA, Lauren Maynard, Jennifer L. Russell, MA, and Jamie L. Rhudy, PhD. Department of Psychology, The University of Tulsa, 600 South College, Tulsa, OK 74104

Emotionally-charged stimuli have been shown to modulate pain and other reactions to noxious stimulation. Facial expressions are some of the most omnipresent emotional stimuli in the social environment. Evidence suggests that observing facial expressions results in the perceiver experiencing a similar emotion (i.e., emotional contagion) as well as amygdala activity. However, it is unclear whether facial expressions induce emotions strong enough to modulate nociceptive reactions. Indeed, research from our laboratory suggests that emotional stimuli must evoke significant emotional arousal (intensity) before nociceptive processes are modulated. The present study examined the impact of viewing emotional facial expressions (Montreal Set of Facial Displays of Emotion) on pain threshold and tolerance resulting from a cold pressor task. In a between-subjects design, participants viewed pictures of fear, neutral, or happy expressions while they placed their arm in cold water (33 degrees F) and kept it submerged for as long as they could tolerate it. During arm submersion, pain unpleasantness ratings were continuously assessed using a mechanical visual analog scale (M-VAS). Time from arm submersion to first movement of the M-VAS was used to index pain threshold, and time to arm withdrawal was used to index tolerance. Results suggested facial expressions did not evoke significant subjective emotions. Nonetheless, pain threshold and tolerance latencies were shorter (enhanced pain) during fear expressions relative to happy and neutral expressions. This suggests that facial expressions of fear may elicit emotional modulation of pain better than expressions of happiness, but that activation of modulatory circuitry may be outside of awareness.