Behavioural and neural evidence for self-reinforcing expectancy effects on pain

Marieke Jepma (), Leonie Koban, Johnny Doorn, Matt Jones and Tor D. Wager
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Marieke Jepma: University of Amsterdam
Leonie Koban: University of Colorado Boulder
Johnny Doorn: University of Amsterdam
Matt Jones: University of Colorado Boulder
Tor D. Wager: University of Colorado Boulder

Nature Human Behaviour, 2018, vol. 2, issue 11, 838-855

Abstract: Abstract Beliefs and expectations often persist despite evidence to the contrary. Here we examine two potential mechanisms underlying such ‘self-reinforcing’ expectancy effects in the pain domain: modulation of perception and biased learning. In two experiments, cues previously associated with symbolic representations of high or low temperatures preceded painful heat. We examined trial-to-trial dynamics in participants’ expected pain, reported pain and brain activity. Subjective and neural pain responses assimilated towards cue-based expectations, and pain responses in turn predicted subsequent expectations, creating a positive dynamic feedback loop. Furthermore, we found evidence for a confirmation bias in learning: higher- and lower-than-expected pain triggered greater expectation updating for high- and low-pain cues, respectively. Individual differences in this bias were reflected in the updating of pain-anticipatory brain activity. Computational modelling provided converging evidence that expectations influence both perception and learning. Together, perceptual assimilation and biased learning promote self-reinforcing expectations, helping to explain why beliefs can be resistant to change.

Date: 2018
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DOI: 10.1038/s41562-018-0455-8

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