Why rejection hurts: a common neural alarm system for physical and social pain

The social-emotional processing stream: five core constructs and their translational potential for schizophrenia and beyond

BACKGROUND

Cognitive neuroscience approaches to translational research have made great strides toward understanding basic mechanisms of dysfunction and their relation to cognitive deficits, such as thought disorder in schizophrenia. The recent emergence of Social Cognitive and Affective Neuroscience has paved the way for similar progress to be made in explaining the mechanisms underlying the social and emotional dysfunctions (i.e., negative symptoms) of schizophrenia and that characterize virtually all DSM Axis I and II disorders more broadly.

METHODS

This article aims to provide a roadmap for this work by distilling from the emerging literature on the neural bases of social and emotional abilities a set of key constructs that can be used to generate questions about the mechanisms of clinical dysfunction in general and schizophrenia in particular.

RESULTS

To achieve these aims, the first part of this article sketches a framework of five constructs that comprise a social-emotional processing stream. The second part considers how future basic research might flesh out this framework and translational work might relate it to schizophrenia and other clinical populations.

CONCLUSIONS

Although the review suggests there is more basic research needed for each construct, two in particular--one involving the bottom-up recognition of social and emotional cues, the second involving the use of top-down processes to draw mental state inferences--are most ready for translational work.

Neuroanatomical correlates of temperament in early adolescents

OBJECTIVE

Temperament refers to enduring behavioral characteristics that underpin individual differences in human behavior, including risk for psychopathology. Research attempting to investigate the neurobiological basis of temperament represents an important step toward elucidating the biological mechanisms underlying these individual differences. In the present study, we examined the relation between four core temperament dimensions and anatomically defined regions of the limbic and prefrontal cortices.

METHOD

We used a cross-sectional design to examine a large sample (N = 153; mean age 12.6 years, SD 0.4, range 11.4-13.7) of healthy early adolescents who were selected from a larger sample to maximize variation in temperament. The main outcome measures were psychometric measures of temperament (four factors: effortful control, negative affectivity, surgency, and affiliativeness) based on the Early Adolescent Temperament Questionnaire-Revised, and volumetric measures of a priori brain regions of interest (anterior cingulate cortex [ACC], orbitofrontal cortex, amygdala, and hippocampus).

RESULTS

We found regional brain volumes to account for small but significant amounts of the variance in self-reported temperament scores. Specifically, higher effortful control was associated with larger volume of the left orbitofrontal cortex and hippocampus. Higher negative affectivity was associated with smaller volume of the left dorsal paralimbic relative to limbic portion of the ACC. Higher affiliativeness was associated with larger volume of the right rostral/ventral limbic portion of the ACC. Affiliativeness and surgency also showed a number of female-specific associations, primarily involving the rostral/ventral ACC.

CONCLUSIONS

Our results provide support for a neuroanatomical basis for individual differences in temperament and have implications for understanding the neurobiological mechanisms underlying the development of a number of psychiatric disorders.

Frequency of adolescent self-cutting as a predictor of HIV risk

OBJECTIVE

A wide range exists in the frequency of adolescent self-cutting behavior; however, the implications of this variability are relatively unexplored. Although evidence suggesting a relationship between self-harm and sexual risk behaviors has been identified, little is known regarding the relationship between frequency of self-cutting and sexual risk. The present study aimed to test the hypothesis that adolescents who repeatedly self-cut would report more HIV risk behaviors and riskier attitudes than those who had engaged in infrequent self-injury.

METHOD

Adolescents (11-18 years; mean age, 15 years) from intensive psychiatric treatment programs with a history of self-cutting (N = 105, 53% female) completed measures of self-cutting, sexual risk behaviors, and risk attitudes.

RESULTS

Frequent self-cutting (more than three times, lifetime) was associated with being sexually active, using condoms inconsistently, and sharing cutting instruments. Frequent self-cutters were significantly more likely to be female and nonwhite, and report low self-restraint. They also showed a trend toward being more likely to have a history of sexual abuse.

CONCLUSIONS

This study found important differences in self-cutters based on frequency of cutting. Adolescent self-cutting may be a spectrum of behavior that ranges from habitual, repeated behavior contrasted with infrequent, experimental, socially motivated cutting. The associations between frequent cutting, sexual risk, and low self-restraint suggest that common underlying mechanisms may determine these patterns.

Your pain or mine? Common and distinct neural systems supporting the perception of pain in self and other

Humans possess a remarkable capacity to understand the suffering of others. Cognitive neuroscience theories of empathy suggest that this capacity is supported by 'shared representations' of self and other. Consistent with this notion, a number of studies have found that perceiving others in pain and experiencing pain oneself recruit overlapping neural systems. Perception of pain in each of these conditions, however, may also cause unique patterns of activation, that may reveal more about the processing steps involved in each type of pain. To address this issue, we examined neural activity while participants experienced heat pain and watched videos of other individuals experiencing injuries. Results demonstrated (i) that both tasks activated anterior cingulate cortex and anterior insula, consistent with prior work; (ii) whereas self-pain activated anterior and mid insula regions implicated in interoception and nociception, other pain activated frontal, premotor, parietal and amygdala regions implicated in emotional learning and processing social cues; and (iii) that levels of trait anxiety correlated with activity in rostral lateral prefrontal cortex during perception of other pain but not during self-pain. Taken together, these data support the hypothesis that perception of pain in self and other, while sharing some neural commonalities, differ in their recruitment of systems specifically associated with decoding and learning about internal or external cues.

Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer

Patients with cancer experience a host of behavioral alterations that include depression, fatigue, sleep disturbances, and cognitive dysfunction. These behavioral comorbidities are apparent throughout the process of diagnosis and treatment for cancer and can persist well into the survivorship period. There is a rich literature describing potential consequences of behavioral comorbidities in patients with cancer including impaired quality of life, reduced treatment adherence, and increased disease-related morbidity and mortality. Medical complications of cancer and its treatment such as anemia, thyroid dysfunction, and the neurotoxicity of cancer chemotherapeutic agents account in part for these behavioral changes. Nevertheless, recent advances in the neurosciences and immunology/oncology have revealed novel insights into additional pathophysiologic mechanisms that may significantly contribute to the development of cancer-related behavioral changes. Special attention has been focused on immunologic processes, specifically activation of innate immune inflammatory responses and their regulation by neuroendocrine pathways, which, in turn, influence CNS functions including neurotransmitter metabolism, neuropeptide function, sleep-wake cycles, regional brain activity, and, ultimately, behavior. Further understanding of these immunologic influences on the brain provides a novel conceptual framework for integrating the wide spectrum of behavioral alterations that occur in cancer patients and may reveal a more focused array of translational targets for therapeutic interventions and future research. Such developments warrant complementary advances in identification of cancer patients at risk as well as those currently suffering, including an increased emphasis on the status of behavior as a "sixth vital sign" to be assessed in all cancer patients throughout their disease encounter.

Emotions and emotional approach and avoidance strategies in fibromyalgia

OBJECTIVE

Disturbances in emotional functioning may contribute to psychological and physical symptoms in patients with fibromyalgia. This study examined emotions and emotion-regulation strategies in women with fibromyalgia and in controls, and how these variables relate to symptoms of fibromyalgia.

METHODS

We compared 403 women with fibromyalgia to 196 control women using self-report questionnaires.

RESULTS

Negative emotions and the use of emotional-avoidance strategies were elevated, and positive emotions were reduced, in fibromyalgia patients; the alexithymia scale "difficulty identifying feelings" showed a large deviation from normal. Emotional-approach measures were not deviant. In the fibromyalgia sample, emotional-avoidance strategies were highly correlated with more mental distress and were modestly correlated with more pain and fatigue, while emotional-approach strategies were only minimally related to better functioning. We tested two interaction models. The intense experiencing of emotions was related to more pain only in patients who lack the ability to process or describe emotions. Although fibromyalgia patients showed deficits in the experiencing of positive affect, positive affect did not buffer the association between pain and negative affect.

CONCLUSION

This study demonstrates increased negative emotions and decreased positive emotions, as well as increased emotional-avoidance strategies, in women with fibromyalgia. Research should test whether interventions that reduce emotional avoidance lead to health improvements in women with fibromyalgia.

‘Eavesdropping’ on social interactions biases threat perception in visuospatial pathways

Using fMRI, we measured brain activity while participants viewed photographs in which one person posed a potential threat to another. Visuospatial areas, specifically temporal-occipital junction, extrastriate, and fusiform cortices and right superior parietal lobe (BA7), responded when a threatening person was close to the personal space of another. Strikingly, this selectivity was absent when the people were further apart. Furthermore, posterior parietal areas, which code the space surrounding one's own body, responded when the individual was close to the other person's body space, regardless of whether he appeared threatening. We suggest that the spatial dimension of social interactions contributes to an observer's understanding of potentially dangerous social situations, and that higher level visual cortices play a role in distinguishing social categories based on a person's features.

Common regions of dorsal anterior cingulate and prefrontal-parietal cortices provide attentional control of distracters varying in emotionality and visibility

Top-down attentional control is necessary to ensure successful task performance in the presence of distracters. Lateral prefrontal cortex, parietal cortex and anterior cingulate cortex have been previously implicated in top-down attentional control. However, it is unclear whether these regions are engaged independent of distracter type or whether, as has been suggested for anterior cingulate cortex, different regions provide attentional control over emotional versus other forms of salient distracter. In the current task, subjects viewed targets that were preceded by distracters that varied in both emotionality and visibility. We found that behaviorally, the presence of preceding distracters significantly interfered with target judgment. At the neural level, increases in the emotional and visual saliency of distracters were both associated with increased activity in proximal regions of prefrontal, parietal and cingulate cortex. Moreover, a conjunction analysis indicated considerable overlap in the regions of prefrontal, parietal cortex and anterior cingulate cortex responding to distracters of increased emotionality and visibility.

Oxytocin increases generosity in humans

Human beings routinely help strangers at costs to themselves. Sometimes the help offered is generous-offering more than the other expects. The proximate mechanisms supporting generosity are not well-understood, but several lines of research suggest a role for empathy. In this study, participants were infused with 40 IU oxytocin (OT) or placebo and engaged in a blinded, one-shot decision on how to split a sum of money with a stranger that could be rejected. Those on OT were 80% more generous than those given a placebo. OT had no effect on a unilateral monetary transfer task dissociating generosity from altruism. OT and altruism together predicted almost half the interpersonal variation in generosity. Notably, OT had twofold larger impact on generosity compared to altruism. This indicates that generosity is associated with both altruism as well as an emotional identification with another person.

Functional neuroimaging and the law: trends and directions for future scholarship

Under the umbrella of the burgeoning neurotransdisciplines, scholars are using the principles and research methodologies of their primary and secondary fields to examine developments in neuroimaging, neuromodulation and psychopharmacology. The path for advanced scholarship at the intersection of law and neuroscience may clear if work across the disciplines is collected and reviewed and outstanding and debated issues are identified and clarified. In this article, I organize, examine and refine a narrow class of the burgeoning neurotransdiscipline scholarship; that is, scholarship at the interface of law and functional magnetic resonance imaging (fMRI).

Neural dynamics of rejection sensitivity

Rejection sensitivity (RS) is the tendency to anxiously expect, readily perceive, and intensely react to rejection. This study used functional magnetic resonance imaging to explore whether individual differences in RS are mediated by differential recruitment of brain regions involved in emotional appraisal and/or cognitive control. High and low RS participants were scanned while viewing either representational paintings depicting themes of rejection and acceptance or nonrepresentational control paintings matched for positive or negative valence, arousal and interest level. Across all participants, rejection versus acceptance images activated regions of the brain involved in processing affective stimuli (posterior cingulate, insula), and cognitive control (dorsal anterior cingulate cortex; medial frontal cortex). Low and high RS individuals' responses to rejection versus acceptance images were not, however, identical. Low RS individuals displayed significantly more activity in left inferior and right dorsal frontal regions, and activity in these areas correlated negatively with participants' self-report distress ratings. In addition, control analyses revealed no effect of viewing negative versus positive images in any of the areas described above, suggesting that the aforementioned activations were involved in rejection-relevant processing rather than processing negatively valenced stimuli per se. Taken together, these findings suggest that responses in regions traditionally implicated in emotional processing and cognitive control are sensitive to rejection stimuli irrespective of RS, but that low RS individuals may activate prefrontal structures to regulate distress associated with viewing such images.

Nightmares: A new neurocognitive model

Nightmares are a prevalent parasomnia associated with a range of psychiatric conditions and pathological symptoms. Current knowledge about how nightmares are produced is still influenced by neo-psychoanalytic speculations as well as by more recent personality, evolutionary and neurobiological models. A majority of these models stipulate some type of emotionally adaptive function for dreaming, e.g., image contextualization, affect desomatization, mood regulation or fear extinction. Nightmares are widely seen to be either an intensified expression of an emotionally adaptive function or, conversely, as evidence of its breakdown. Our recent, affective network dysfunction (AND) model, integrates the tenets of many prior models in proposing that nightmares reflect problems with the fear extinction function of dreaming. This new model accounts for a wide range of dysphoric dream imagery (bad dreams, idiopathic nightmares, post-traumatic nightmares) and incorporates recent findings in the areas of brain imaging, sleep physiology, PTSD, anxiety disorders and the consolidation and extinction of fear memories.

Keeping one's cool: trait anger, hostile thoughts, and the recruitment of limited capacity control

A regulatory perspective on trait anger suggests that low-trait-anger individuals may recruit limited-capacity cognitive control resources following the activation of hostile thoughts. Because no prior studies directly examine such processes, the present studies seek to do so. Study 1 reveals that a simple word-evaluation paradigm can be used to examine individual differences in hostile reactivity, in that high-trait-anger individuals display more pronounced tendencies to evaluate words negatively following a hostile prime. Studies 2-4 examine a cognitive control account of such findings. Study 2 finds that time-limiting evaluations eliminate trait-linked differences in evaluative priming. Studies 3 and 4 find that low-trait-anger individuals display deficits on a secondary task immediately following the activation of a hostile thought. All studies, then, converge on the link between low trait anger and the spontaneous recruitment of limited-capacity cognitive control resources following hostile primes.

Associations between iris characteristics and personality in adulthood

Variable and person-oriented analyses were used to explore the associations between personality and three previously untested general iris characteristics: crypts, pigment dots and contraction furrows. Personality data, as measured by the NEO PI-R and ratings of iris characteristics from 428 undergraduate students were collected. Crypts were significantly associated with five approach-related behaviors, i.e., feelings, tendermindedness, warmth, trust and positive emotions, whereas furrows were associated with impulsiveness. These findings suggest that because Pax6 induces tissue deficiencies in both the iris and the left anterior cingulate cortex, Pax6 may influence the extent people engage in approach-related behaviors. The results from using a person-oriented analysis suggested that people with different iris configurations tend to develop along different personality trajectories. Future longitudinal studies, twin-studies and genetic association studies, may benefit from collecting iris data and testing candidate genes for crypts and furrows.

The regulation of cognitive control following rostral anterior cingulate cortex lesion in humans

The contribution of the medial prefrontal cortex, particularly the anterior cingulate cortex (ACC), to cognitive control remains controversial. Here, we examined whether the rostral ACC is necessary for reactive adjustments in cognitive control following the occurrence of response conflict [Botvinick, M. M., Braver, T. S., Barch, D. M., Carter, C. S., & Cohen, J. D. Conflict monitoring and cognitive control. Psychological Review, 108, 624-652, 2001]. To this end, we assessed 8 patients with focal lesions involving the rostral sector of the ACC (rACC patients), 6 patients with lesions outside the frontal cortex (non-FC patients), and 11 healthy subjects on a variant of the Simon task in which levels of conflict were manipulated on a trial-by-trial basis. More specifically, we compared Simon effects (i.e., the difference in performance between congruent and incongruent trials) on trials that were preceded by high-conflict (i.e., incongruent) trials with those on trials that were preceded by low-conflict (i.e., congruent) trials. Normal controls and non-FC patients showed a reduction of the Simon effect when the preceding trial was incongruent, suggestive of an increase in cognitive control in response to the occurrence of response conflict. In contrast, rACC patients attained comparable Simon effects following congruent and incongruent events, indicating a failure to modulate their performance depending on the conflict level generated by the preceding trial. Furthermore, damage to the rostral ACC impaired the posterror slowing, a further behavioral phenomenon indicating reactive adjustments in cognitive control. These results provide insights into the functional organization of the medial prefrontal cortex in humans and its role in the dynamic regulation of cognitive control.

Social cognitive neuroscience: a review of core processes

Social cognitive neuroscience examines social phenomena and processes using cognitive neuroscience research tools such as neuroimaging and neuropsychology. This review examines four broad areas of research within social cognitive neuroscience: (a) understanding others, (b) understanding oneself, (c) controlling oneself, and (d) the processes that occur at the interface of self and others. In addition, this review highlights two core-processing distinctions that can be neurocognitively identified across all of these domains. The distinction between automatic versus controlled processes has long been important to social psychological theory and can be dissociated in the neural regions contributing to social cognition. Alternatively, the differentiation between internally-focused processes that focus on one's own or another's mental interior and externally-focused processes that focus on one's own or another's visible features and actions is a new distinction. This latter distinction emerges from social cognitive neuroscience investigations rather than from existing psychological theories demonstrating that social cognitive neuroscience can both draw on and contribute to social psychological theory.

Attitudes and evaluations: a social cognitive neuroscience perspective

Automatic evaluations are crucial for survival, but conscious self-reflection enables the formulation of nuanced evaluations to serve long-term goals. To operate effectively, both automatic and reflective evaluative processes need to integrate stored representations from previous experience (attitudes) with current contexts and goals, but contexts and goals have a more prominent role in reflective evaluation. Recent neuroimaging data provide new insights into the structure and function of evaluation and the dynamic ways that attitudes and reflective processing contribute to evaluation. In this paper, we propose a new iterative-reprocessing (IR) model of the neural bases of evaluation that highlights the role of the prefrontal cortex in the reprocessing of evaluative information. This model makes predictions that inform social-cognitive and cognitive-neuroscientific accounts of evaluation.

Alone but feeling no pain: Effects of social exclusion on physical pain tolerance and pain threshold, affective forecasting, and interpersonal empathy

Prior findings of emotional numbness (rather than distress) among socially excluded persons led the authors to investigate whether exclusion causes a far-reaching insensitivity to both physical and emotional pain. Experiments 1-4 showed that receiving an ostensibly diagnostic forecast of a lonesome future life reduced sensitivity to physical pain, as indicated by both (higher) thresholds and tolerance. Exclusion also caused emotional insensitivity, as indicated by reductions in affective forecasting of joy or woe over a future football outcome (Experiment 3), as well as lesser empathizing with another person's suffering from either romantic breakup (Experiment 4) or a broken leg (Experiment 5). The insensitivities to pain and emotion were highly intercorrelated.

Vagus nerve stimulation for treatment-resistant depression: behavioral and neural effects on encoding negative material

OBJECTIVES

Vagus nerve stimulation (VNS) can improve depression. Cognitive models of depression highlight an over-representation of negative thoughts and memories, with depressed individuals showing memory facilitation for negative material. We hypothesized that the antidepressant action of VNS may emerge through corrective influences on 'negativity bias' in memory. We therefore examined the impact of VNS on emotional memory and its underlying brain activity.

METHODS

We tested a single patient undergoing VNS for treatment-resistant depression (TRD). Stimulation was set at a 30/66-second on/off cycle during three encoding blocks when the patient viewed randomly presented positive, negative, and neutral words. Following each block, VNS was switched off and the patient identified previously seen words from distractors in a subsequent recognition memory task. The patient was scanned using functional magnetic resonance imaging (fMRI) during the first encoding block.

RESULTS

There was robust recall of negative material viewed during 'off' cycles of VNS but subsequent memory of negative words was attenuated during active VNS ('on' cycles). VNS did not influence memory for neutral and positive words. With neuroimaging, direct modulatory effects of VNS were observed in dorsomedial, dorsolateral, and orbital regions of the prefrontal cortex. Moreover, during encoding of negative words, compared with positive and neutral words, VNS also modulated activity within orbitofrontal, ventromedial and polar prefrontal cortices, midcingulate cortex, and brain stem.

CONCLUSIONS

Our observations show that VNS can interfere with memory of negative information, an effect that may contribute to its antidepressant role. Neuroimaging implicated regions including the ventral and medial prefrontal cortex as an underlying neural substrate.

Race, race-based discrimination, and health outcomes among African Americans

Persistent and vexing health disadvantages accrue to African Americans despite decades of work to erase the effects of race discrimination in this country. Participating in these efforts, psychologists and other social scientists have hypothesized that African Americans' continuing experiences with racism and discrimination may lie at the root of the many well-documented race-based physical health disparities that affect this population. With newly emerging methodologies in both measurement of contextual factors and functional neuroscience, an opportunity now exists to cleave together a comprehensive understanding of the ways in which discrimination has harmful effects on health. In this article, we review emerging work that locates the cause of race-based health disparities in the external effects of the contextual social space on the internal world of brain functioning and physiologic response. These approaches reflect the growing interdisciplinary nature of psychology in general, and the field of race relations in particular.

Empathy and Judging Other's Pain: An fMRI Study of Alexithymia

Because awareness of emotional states in the self is a prerequisite to recognizing such states in others, alexithymia (ALEX), difficulty in identifying and expressing one's own emotional states, should involve impairment in empathy. Using functional magnetic resonance imaging (fMRI), we compared an ALEX group (n = 16) and a non-alexithymia (non-ALEX) group (n = 14) for their regional hemodynamic responses to the visual perception of pictures depicting human hands and feet in painful situations. Subjective pain ratings of the pictures and empathy-related psychological scores were also compared between the 2 groups. The ALEX group showed less cerebral activation in the left dorsolateral prefrontal cortex (DLPFC), the dorsal pons, the cerebellum, and the left caudal anterior cingulate cortex (ACC) within the pain matrix. The ALEX group showed greater activation in the right insula and inferior frontal gyrus. Furthermore, alexithymic participants scored lower on the pain ratings and on the scores related to mature empathy. In conclusion, the hypofunction in the DLPFC, brain stem, cerebellum, and ACC and the lower pain-rating and empathy-related scores in ALEX are related to cognitive impairments, particularly executive and regulatory aspects, of emotional processing and support the importance of self-awareness in empathy.

Psychological pain: a review of evidence

This paper defines a symptom construct termed psychological pain and reviews clinical and neuroimaging evidence relevant to it. The psychological pain associated with severe depression is often perceived as worse than any physical pain that the individual has experienced and could be a critical component of suicidality that could be systematically assessed in potentially suicidal patients. Converging evidence from brain imaging studies suggests overlapping patterns of brain activation induced by both psychological pain and by physical pain. Future research on the role of psychological pain and its interaction with nociceptive pathways may provide novel clues to the understanding and treatment of depression and other psychiatric illnesses.

Anatomical changes in the emerging adult brain: a voxel-based morphometry study

Research has consistently confirmed changes occur in brain morphometry between adolescence and adulthood. The purpose of the present study was to explore anatomical change during a specific environmental transition. High-resolution T1-weighted structural magnetic resonance imaging (MRI) scans were acquired from 19 participants (mean age at initial scan = 18.6 years) during their freshman year. Scans were completed during the fall term and 6 months later before the conclusion of the school year. Voxel-based morphometry was used to assess within-subject change. Significant intensity increases were observed along the right midcingulate, inferior anterior cingulate gyrus, right caudate head, right posterior insula, and bilateral claustrum. Regional changes were not observed in two control groups; one controlling for method and another controlling for age-specific change over time. The results suggest that significant age-related changes in brain structure continue after the age of 18 and may represent dynamic changes related to new environmental challenges. Findings from the regions of change are discussed in the context of specific environmental demands during a period of normative maturation.

An experimental study of shared sensitivity to physical pain and social rejection

Recent evidence points to a possible overlap in the neural systems underlying the distressing experience that accompanies physical pain and social rejection (Eisenberger et al., 2003). The present study tested two hypotheses that stem from this suggested overlap, namely: (1) that baseline sensitivity to physical pain will predict sensitivity to social rejection and (2) that experiences that heighten social distress will heighten sensitivity to physical pain as well. In the current study, participants' baseline cutaneous heat pain unpleasantness thresholds were assessed prior to the completion of a task that manipulated feelings of social distress. During this task, participants played a virtual ball-tossing game, allegedly with two other individuals, in which they were either continuously included (social inclusion condition) or they were left out of the game by either never being included or by being overtly excluded (social rejection conditions). At the end of the game, three pain stimuli were delivered and participants rated the unpleasantness of each. Results indicated that greater baseline sensitivity to pain (lower pain unpleasantness thresholds) was associated with greater self-reported social distress in response to the social rejection conditions. Additionally, for those in the social rejection conditions, greater reports of social distress were associated with greater reports of pain unpleasantness to the thermal stimuli delivered at the end of the game. These results provide additional support for the hypothesis that pain distress and social distress share neurocognitive substrates. Implications for clinical populations are discussed.

The neural basis of social tactics: An fMRI study

One of the most powerful ways of succeeding in complex social interactions is to read the minds of companions and stay a step ahead of them. In order to assess neural responses to reciprocal mind reading in socially strained human relationships, we used a 3-T scanner to perform an event-related functional magnetic resonance imaging study in 16 healthy subjects who participated in the game of Chicken. Statistical parametric mapping showed that the counterpart effect (human minus computer) exclusively activated the medial frontal area corresponding to the anterior paracingulate cortex (PCC) and the supramarginal gyrus neighboring the posterior superior temporal sulcus (STS). Furthermore, when we analyzed the data to evaluate whether the subjects made risky/aggressive or safe/reconciliatory choices, the posterior STS showed that the counterpart had a reliable effect regardless of risky or safe decisions. In contrast, a significant opponent x selection interaction was revealed in the anterior PCC. Based on our findings, it could be inferred that the posterior STS and the anterior PCC play differential roles in mentalizing; the former serves as a general mechanism for mentalizing, while the latter is exclusively involved in socially risky decisions.

Alternative mechanisms for regulating racial responses according to internal vs external cues

Personal (internal) and normative (external) impetuses for regulating racially biased behaviour are well-documented, yet the extent to which internally and externally driven regulatory processes arise from the same mechanism is unknown. Whereas the regulation of race bias according to internal cues has been associated with conflict-monitoring processes and activation of the dorsal anterior cingulate cortex (dACC), we proposed that responses regulated according to external cues to respond without prejudice involves mechanisms of error-perception, a process associated with rostral anterior cingulate cortex (rACC) activity. We recruited low-prejudice participants who reported high or low sensitivity to non-prejudiced norms, and participants completed a stereotype inhibition task in private or public while electroencephalography was recorded. Analysis of event-related potentials revealed that the error-related negativity component, linked to dACC activity, predicted behavioural control of bias across conditions, whereas the error-perception component, linked to rACC activity, predicted control only in public among participants sensitive to external pressures to respond without prejudice.

Meeting of minds: the medial frontal cortex and social cognition

Social interaction is a cornerstone of human life, yet the neural mechanisms underlying social cognition are poorly understood. Recently, research that integrates approaches from neuroscience and social psychology has begun to shed light on these processes, and converging evidence from neuroimaging studies suggests a unique role for the medial frontal cortex. We review the emerging literature that relates social cognition to the medial frontal cortex and, on the basis of anatomical and functional characteristics of this brain region, propose a theoretical model of medial frontal cortical function relevant to different aspects of social cognitive processing.

Pediatric pain prevalence and parents' attitudes at a cancer hospital in Jordan

There has been little research on implementation of pediatric pain programs. These studies are part of a project to develop such a program for the King Hussein Cancer Centre in Jordan. Study 1 captured information on pain prevalence in 35 children using chart reviews and parent/child interviews to establish baseline pain burden. Forty-seven percent of children had pain at the time of interview; 11% had "a lot" of pain and only 22% received analgesics. Twenty-two parents were interviewed in Study 2 to identify attitudes toward pain management. Thematic analysis revealed six themes: 1) pain can and should be managed; 2) God's will; 3) parent's worst pain was emotional pain due to child's diagnosis; 4) belief that their presence could ameliorate their child's pain; 5) desire for shared decision making; and 6) the child's responsibility to express pain. These study results were used to inform the action research approach in the overall project.

A model of the hierarchy of behaviour, cognition, and consciousness

Processes comparable in important respects to those underlying human conscious and non-conscious processing can be identified in a range of species and it is argued that these reflect evolutionary precursors of the human processes. A distinction is drawn between two types of processing: (1) stimulus-based and (2) higher-order. For 'higher-order,' in humans the operations of processing are themselves associated with conscious awareness. Conscious awareness sets the context for stimulus-based processing and its end-point is accessible to conscious awareness. However, the mechanics of the translation between stimulus and response proceeds without conscious control. The paper argues that higher-order processing is an evolutionary addition to stimulus-based processing. The model's value is shown for gaining insight into a range of phenomena and their link with consciousness. These include brain damage, learning, memory, development, vision, emotion, motor control, reasoning, the voluntary versus involuntary debate, and mental disorder.

Integrating automatic and controlled processes into neurocognitive models of social cognition

Interest in the neural systems underlying social perception has expanded tremendously over the past few decades. However, gaps between behavioral literatures in social perception and neuroscience are still abundant. In this article, we apply the concept of dual-process models to neural systems in an effort to bridge the gap between many of these behavioral studies and neural systems underlying social perception. We describe and provide support for a neural division between reflexive and reflective systems. Reflexive systems correspond to automatic processes and include the amygdala, basal ganglia, ventromedial prefrontal cortex, dorsal anterior cingulate cortex, and lateral temporal cortex. Reflective systems correspond to controlled processes and include lateral prefrontal cortex, posterior parietal cortex, medial prefrontal cortex, rostral anterior cingulate cortex, and the hippocampus and surrounding medial temporal lobe region. This framework is considered to be a working model rather than a finished product. Finally, the utility of this model and its application to other social cognitive domains such as Theory of Mind are discussed.

Administration of corticosterone after the first downshift trial enhances consummatory successive negative contrast

Rats given access to a 32% sucrose solution and then downshifted to a 4% solution exhibit less contact with the sipper tube than unshifted controls always given access to 4% solution. This phenomenon, called consummatory successive negative contrast, was facilitated in Experiment 1 by a post-trial injection of corticosterone (3 mg/kg) administered immediately after the first downshift trial. Experiment 2 demonstrated that this facilitatory effect of post-trial corticosterone does not occur when administered 3 hr after the first downshift trial. These results support the hypothesis that corticosterone strengthens an aversive emotional component elicited by the surprising downshift in reward magnitude during the initial downshift trial.

Neural correlates of individual differences in pain-related fear and anxiety

Although individual differences in fear and anxiety modulate the pain response and may even cause more suffering than the initiating physical stimulus, little is known about the neural systems mediating this relationship. The present study provided the first examination of the neural correlates of individual differences in the tendency to (1) feel anxious about the potentially negative implications of physical sensations, as measured by the anxiety sensitivity index (ASI), and (2) fear various types of physical pain, as indexed by the fear of pain questionnaire (FPQ). In separate sessions, participants completed these questionnaires and experienced alternating blocks of noxious thermal stimulation (45-50 degrees C) and neutral thermal stimulation (38 degrees C) during the collection of whole-brain fMRI data. Regression analyses demonstrated that during the experience of pain, ASI scores predicted activation of a medial prefrontal region associated with self-focused attention, whereas FPQ scores predicted activation of a ventral lateral frontal region associated with response regulation and anterior and posterior cingulate regions associated with monitoring and evaluation of affective responses. These functional relationships cannot be wholly explained by generalized anxiety (indexed by STAI-T scores), which did not significantly correlate with activation of any regions. The present findings may help clarify both the impact of individual differences in emotion on the neural correlates of pain, and the roles in anxiety, fear, and pain processing played by medial and orbitofrontal systems.

Principles, processes, and puzzles of social cognition: an introduction for the special issue on social cognitive neuroscience

This article introduces the special issue of NeuroImage focused on social cognitive neuroscience. Social psychology has a rich history of making sense of the often paradoxical aspects of social cognition and the social world. This article reviews the principles, processes, and puzzles of social cognition and behavior that have been examined by social psychologists for decades. Five principles of social cognition and behavior are reviewed including: (1) the power of the situation over behavior, (2) blindness for situational influences, (3) social perception and self-perception are constructive processes, (4) blindness for the constructed nature of social and self-perception, and (5) self-processes are social. Four processes of social cognition are reviewed including: (1) cognitive architecture; (2) automaticity and control; (3) motivated reasoning; and (4) accessibility, frames, and expectations. Finally, five areas of social cognition that contain enduring puzzles are described including (1) the self, (2) attitudes, (3) reflective social cognition, (4) automatic social cognition, and (5) social motives. In several of the areas of study reviewed, cognitive neuroscience is well positioned to make important contributions to these research traditions either by allowing for new tests of hypotheses or by allowing for unobtrusive measurement of social cognitive processes.

Attachment-style differences in the ability to suppress negative thoughts: exploring the neural correlates

Beginning in infancy, people can be characterized in terms of two dimensions of attachment insecurity: attachment anxiety (i.e., fear of rejection and abandonment) and attachment avoidance (distancing oneself from close others, shunning dependency; Bowlby, J., 1969/1982. Attachment and loss: Vol. 1. Attachment, 2nd ed., Basic Books, New York). The capacity for emotion regulation varies with attachment style, such that attachment-anxious individuals become highly emotional when threatened with social rejection or relationship loss, whereas avoidant individuals tend to distance themselves or disengage from emotional situations. In the present study, 20 women participated in an fMRI experiment in which they thought about--and were asked to stop thinking about--various relationship scenarios. When they thought about negative ones (conflict, breakup, death of partner), their level of attachment anxiety was positively correlated with activation in emotion-related areas of the brain (e.g., the anterior temporal pole, implicated in sadness) and inversely correlated with activation in a region associated with emotion regulation (orbitofrontal cortex). This suggests that anxious people react more strongly than non-anxious people to thoughts of loss while under-recruiting brain regions normally used to down-regulate negative emotions. Participants high on avoidance failed to show as much deactivation as less avoidant participants in two brain regions (subcallosal cingulate cortex; lateral prefrontal cortex). This suggests that the avoidant peoples' suppression was less complete or less efficient, in line with results from previous behavioral experiments. These are among the first findings to identify some of the neural processes underlying adult attachment orientations and emotion regulation.

Self-esteem, locus of control, hippocampal volume, and cortisol regulation in young and old adulthood

Self-esteem, the value we place on ourselves, has been associated with effects on health, life expectancy, and life satisfaction. Correlated with self-esteem is internal locus of control, the individual's perception of being in control of his or her outcomes. Recently, variations in self-esteem and internal locus of control have been shown to predict the neuroendocrine cortisol response to stress. Cumulative exposure to high levels of cortisol over the lifetime is known to be related to hippocampal atrophy. We therefore examined hippocampal volume and cortisol regulation, to investigate potential biological mechanisms related to self-esteem. We investigated 16 healthy young (age range 20-26 years of age) and 23 healthy elderly subjects (age range 60-84 years). The young subjects were exposed to a psychosocial stress task, while the elderly subjects were assessed for their basal cortisol regulation. Structural Magnetic Resonance Images were acquired from all subjects, and volumetric analyses were performed on medial temporal lobe structures, and whole brain gray matter. Standardized neuropsychological assessments in the elderly were performed to assess levels of cognitive performance, and to exclude the possibility of neurodegenerative disease. Self-esteem and internal locus of control were significantly correlated with hippocampal volume in both young and elderly subjects. In the young, the cortisol response to the psychosocial stress task was significantly correlated with both hippocampal volume and levels of self-esteem and locus of control, while in the elderly, these personality traits moderated age-related patterns of cognitive decline, cortisol regulation, and global brain volume decline.

A pain in the ACC

An emerging theme in systems neurobiology is that even simple forms of memory depend on activity in a broad network of cortical and subcortical brain regions. One key challenge is to understand how different components of these complex networks contribute to memory. In a new study in Molecular Pain, Tang and colleagues use a novel set of approaches to characterize the role of the anterior cingulate cortex (ACC) in the formation of Pavlovian fear memories.