Posted on 05/07/2006 12:10:34 AM PDT by neverdem
AP MEDICAL WRITER
WASHINGTON -- Anyone who's ever taken a preschooler to the doctor knows they often cry more before the shot than afterward. Now researchers using brain scans to unravel the biology of dread have an explanation: For some people, anticipating pain is truly as bad as experiencing it.
How bad? Among people who volunteered to receive electric shocks, almost a third opted for a stronger zap if they could just get it over with, instead of having to wait.
More importantly, the research found that how much attention the brain pays to expected pain determines whether someone is an "extreme dreader" - suggesting that simple diversions could alleviate the misery.
The research, published Friday in the journal Science, is part of a burgeoning new field called neuroeconomics that uses brain imaging to try to understand how people make choices. Until now, most of that work has focused on reward, the things people will do for positive outcomes.
"We were interested in the dark side of the equation," explained Dr. Gregory Berns of Emory University, who led the new study.
"Dread often makes us make bad decisions."
Standard economic theory says that people should postpone bad outcomes for as long as possible, because something might happen in the interim to change improve the outlook.
In real life, the "just get it over with" reaction is more likely, said Berns, a professor of psychiatry and behavioral sciences. He offers a personal example: He usually pays credit card bills as soon as they arrive instead of waiting until they're due, even though "it doesn't make any sense economically."
So Berns designed a study to trace dread inside the brain. He put 32 volunteers into an MRI machine while giving them a series of 96 electric shocks to the foot. The shocks varied in intensity, from barely detectable to the pain of a needle jab.
Participants were told one was coming, how strong it would be, and how long the wait for it would be, from 1 to 27 seconds.
Later, participants were given choices: Would they prefer a medium jolt in 5 seconds or 27 seconds? What about a mild jolt in 20 seconds vs. a sharp one in 3 seconds?
When the voltage was identical, the volunteers almost always chose the shortest wait. But those Berns dubbed "extreme dreaders" picked the worst shock if it meant not having to wait as long.
The MRI scans showed that a brain network that governs how much pain people feel became active even before they were shocked, particularly the parts of this "pain matrix" that are linked to attention - but not brain regions involving fear and anxiety. The more dread bothered someone, the more attention the pain-sensing parts of the brain were paying to the wait.
In other words, the mere information that you're about to feel pain "seems to be a source of misery," George Lowenstein, a specialist in economics and psychology at Carnegie Mellon University, wrote in an accompanying review of the work.
"These findings support the idea that the decision to delay or expedite an outcome depends critically on how a person feels while waiting," Lowenstein added.
The National Institute on Drug Abuse funded the research. What's the link between dread and drug use? It's indirect, but now that scientists know how healthy people's brains anticipate unpleasant consequences, future studies can compare how drug abusers process such information.
On the Net:
National Institute on Drug Abuse: http://www.nida.gov
Journal Science: http://www.science.com
Neurobiological Substrates of Dread (Science abstract)
Given the choice of waiting for an adverse outcome or getting it over with quickly, many people choose the latter. Theoretical models of decision-making have assumed that this occurs because there is a cost to waiting—i.e., dread. Using functional magnetic resonance imaging, we measured the neural responses to waiting for a cutaneous electric shock. Some individuals dreaded the outcome so much that, when given a choice, they preferred to receive more voltage rather than wait. Even when no decision was required, these extreme dreaders were distinguishable from those who dreaded mildly by the rate of increase of neural activity in the posterior elements of the cortical pain matrix. This suggests that dread derives, in part, from the attention devoted to the expected physical response and not simply from fear or anxiety. Although these differences were observed during a passive waiting procedure, they correlated with individual behavior in a subsequent choice paradigm, providing evidence for a neurobiological link between the experienced disutility of dread and subsequent decisions about unpleasant outcomes.
I learned this as a kid when I put a Band-Aid on my leg and it stuck to the hair.
It was either pull slowly or yank it off....
This could also explain the pain from torture that the "courageous," Islamic terrorists are always crying and whining about when we detain them. It's just the anticipation that gets them all riled up.
The rotor that spins on a bubble
FReepmail me if you want on or off my health and science ping list.
So, they performed a study using subjects who volunteered to receive electric shocks. That isn't exactly the mainstream population is it?
Heck, this ain't new. The first year of "24" one of the characters said "threatened pain works better than realized pain". Of course Jack did both.
"The shocks varied in intensity, from barely detectable to the pain of a needle jab."
The science seems sound to me. Caveat Emptor!
The anticipation of pain causes stress, which in and of itself is painful. However, given the choice between stress and actual pain, I think I'd choose the former.
Doesn't the alcohol burn the wound?
That's funny. I have been working with electricity for almost 25 years. A 'needle jab'. Hah. If that's all I ever got I would never worry. Try getting hit with 577VAC or three phases of 480VAC and then tell me which you would choose.
Billions of electrons travelling through your body at the speed of light can be very stimulating - or painful - it depends on your outlook. :)
As an extreme dreader (learned behavior, due to sado-dentistry) who would put off pain on the slightest chance the test would be called off before I got there...I wonder how many procrastinators were interested in participating in this experiment involving electrical shocks, and missed the deadline to sign up.
And I wonder what part of that result can be attributed to procrastination and what part to the inclination to avoid electrical shock and the company of people paid to deliver them.
My middle name is 'extreme dreader'......
Don't watch when they stick you; you are less likely to flinch.
Been there and done that. A year ago, I tore my right bicep in 3 places and the bicep head. This was over previous shoulder injuries including a torn rotator cuff.
I started Physical Therapy, tp in late May. I got where I dreaded visits to my physical therapist in just a few visits.
One day my wife, who had just recovered from a broken right shoulder from a fall with over a years therapy told me I had to view these trips differently.
She said I needed to think about how much better I felt 1-2 days after the PT. So I focused on the positive side, and I no longer dreaded the PT.
After this change I asked my phyiscal therapist to treat me 3 times a week instead of twice. When this happened, I made some dramatic break throughs and was able to start casting my fly rods again. After about 3 months, the therapist suggested that I make a film of what I did and go back to twice a week, with me being the therapist the third day.
At the end of 7 months, I was discharged from pt. Then I saw the original assessment, where the therapist hoped that I would regain 40 to 50% of my pre injury mobility, strength, standing up straight and walking correctly. I'm happy to say that in many of these areas, my functions are better than before the injuries.
Thanks to my wife suggesting that I not focus on the pain of the session but on how much better I was after the session. The dread went away and recovery speeded up.
Good point. I just dab a bit on the tape part with a Q-tip.
Ha ha. I thought there was more to the story. :)
The same applies to loose baby teeth. Remember having a loose front tooth, and hiding from your elders because you didn't want them to touch it, and (much worse) they might have wanted a dentist to pull it?:)
This is the whole concept behind Lamaze. His method was to do things mentally to distract the brain from feeling/sensing pain, and to do physical things as well, such as standing up and getting the diaphragm and rib cage high off of the uterus during the contractions. Worked for me - my 2nd and 3rd births were virtually pain free, once I figured out what Dr. Lamaze was going for.
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