Dispositional empathy modulates vicarious effects of dynamic pain expressions on spinal nociception, facial responses and acute pain.

Pain communication is thought to promote automatic vicarious self-protective responses as well as empathic concern towards others' suffering. This duality was recently highlighted in a study showing that highly empathic individuals display increased vicarious facilitation of low-level pain processing (nociceptive flexion reflex, NFR) combined with an unexpected reduced facilitation of self-pain perception (pain ratings) while viewing static pictures evoking pain in others. The present study sought to test further the moderating effects of dispositional empathy on vicarious responses induced by viewing dynamic pain expressions. Twenty-four healthy volunteers viewed 1-s videos showing different levels of pain expression before noxious electric shocks were delivered to the sural nerve. Viewing stronger pain expressions generally increased shock-pain unpleasantness ratings, the amplitude of the NFR, and facial responses (corrugator muscle) to the noxious stimulation. However, self-pain ratings (intensity and unpleasantness) increased less or were reduced following clips of pain expression in individuals scoring higher on the Empathy Quotient. These results suggest that vicarious processes facilitate low-level defensive responses, while the experience of self-pain and the associated negative affect may be partly tuned-down by higher-order empathic processes.