Pain Response Shaped by Subconscious Learning

In a new study led from Sweden’s Karolinska Institutet, researchers report that people can be conditioned to associate images with particular pain responses – such as improved tolerance to pain – even when they are not consciously aware of the images. The findings are being published in the journal PNAS.

Previous studies have shown that a person’s pain experience can be increased or decreased by associating a specific cue, such as an image, with high or low intensity pain. However, until now it has been unclear if it is necessary to be consciously aware of the cue in order to learn the association. In this recent study, Dr Karin Jensen and colleagues tested whether unconscious learning affected pain responses, by using subliminal images and training participants to associate a certain image with high pain and another image with low pain.

The study involved 49 participants in all, randomly assigned into four experimental groups that would elucidate the impact of different levels of conscious awareness during the experiment. All participants were generally healthy, with no chronic illnesses or psychiatric diagnoses. None of the participants reported receiving any medication apart from hormonal contraceptives.

In the experiment, images of different faces were presented on a computer screen. To some of the participants the images were shown so quickly that they could not be consciously recognized. For each image exposure, participants were subjected to pain stimulation and asked to rate the pain according to a specific scale. As each image was repeatedly associated with either high or low pain, it turned into a high pain cue or a low pain cue that would affect the participants’ expectations.

This image shows a person holding his head, as if he is in pain.
Previous studies have shown that a person’s pain experience can be increased or decreased by associating a specific cue, such as an image, with high or low intensity pain. This image is for illustrative purposes only.

The results suggest that pain cues could be learned without conscious awareness, as participants reported increased pain when shown the high pain image and reduced pain when shown the low pain image during identical levels of pain stimulation, regardless of whether or not the images were shown subliminally,

“These results demonstrate that pain responses can be shaped by learning that takes place outside conscious awareness, suggesting that unconscious learning may have an extensive effect on higher cognitive processes in general”, says Karin Jensen.

About this pain and learning research

Funding: This work was funded by the Osher Center for Integrative Medicine at Karolinska Institutet, and support was also provided by a NCCIH/NIH Grant. The study was conducted by researchers from the Osher Center at the Department of Clinical Neuroscience at Karolinska Institutet, Sweden and from Beth Israel Deaconess Medical Center and Harvard Medical School, USA.

Source: Karolinska Institute
Image Credit: The image is in the public domain
Original Research: Abstract for “Classical conditioning of analgesic and hyperalgesic pain responses without conscious awareness” by Karin Jensen, Irving Kirsch, Sara Odmalm, Ted J. Kaptchuk, and Martin Ingvar in PNAS. Published online May 15 2015 doi:10.1073/pnas.1504567112


Abstract

Classical conditioning of analgesic and hyperalgesic pain responses without conscious awareness

Pain reduction and enhancement can be produced by means of conditioning procedures, yet the role of awareness during the acquisition stage of classical conditioning is unknown. We used psychophysical measures to establish whether conditioned analgesic and hyperalgesic responses could be acquired by unseen (subliminally presented) stimuli. A 2 × 2 factorial design, including subliminal/supraliminal exposures of conditioning stimuli (CS) during acquisition/extinction, was used. Results showed significant analgesic and hyperalgesic responses (P < 0.001), and responses were independent of CS awareness, as subliminal/supraliminal cues during acquisition/extinction led to comparable outcomes. The effect was significantly larger for hyperalgesic than analgesic responses (P < 0.001). Results demonstrate that conscious awareness of the CS is not required during either acquisition or extinction of conditioned analgesia or hyperalgesia. Our results support the notion that nonconscious stimuli have a pervasive effect on human brain function and behavior and may affect learning of complex cognitive processes such as psychologically mediated analgesic and hyperalgesic responses. "Classical conditioning of analgesic and hyperalgesic pain responses without conscious awareness" by Karin Jensen, Irving Kirsch, Sara Odmalm, Ted J. Kaptchuk, and Martin Ingvar in PNAS. Published online May 15 2015 doi:10.1073/pnas.1504567112

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