Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis

Abstract
Data availability
Article and author information
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Abstract

Healthcare providers often underestimate patients' pain, sometimes even when aware of their reports. This could be the effect of experience reducing sensitivity to others pain, or distrust towards patients' self-evaluations. Across multiple experiments (375 participants), we tested whether senior medical students differed from younger colleagues and lay controls in the way they assess people's pain and take into consideration their feedback. We found that medical training affected the sensitivity to pain faces, an effect shown by the lower ratings and highlighted by a decrease in neural response of the insula and cingulate cortex. Instead, distrust towards the expressions' authenticity affected the processing of feedbacks, by decreasing activity in the ventral striatum whenever patients' self-reports matched participants' evaluations, and by promoting strong reliance on the opinion of other doctors. Overall, our study underscores the multiple processes which might influence the evaluation of others' pain at the early stages of medical career.

Data availability

The behavioral data and script are stored and available at the following link: https://osf.io/qnp6m/The UPDATED (revision1) brain imaging data are stored and available at the following link: https://neurovault.org/collections/9006/

The following data sets were generated

1. Giada Dirupo
(2021) Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis.
OSF, DOI 10.17605/OSF.IO/QNP6M.

https://osf.io/qnp6m/
1. Giada Dirupo
(2021) Brain networks for pain diagnosis. Differential contribution of medical education and distrust in the appraisal of others' pain.
https://identifiers.org/neurovault.collection:9006.

https://neurovault.org/collections/9006/

Article and author information

Author details

Giada Dirupo

Psychology and Educational Science, University of Geneva, Geneve, Switzerland

For correspondence
giada.dirupo@gmail.com

Competing interests
The authors declare that no competing interests exist.

"This ORCID iD identifies the author of this article:" 0000-0003-4578-6943
Sabrina Totaro

Psychology and Educational Sciences, Univeristy of Geneva, Geneve, Switzerland

Competing interests
The authors declare that no competing interests exist.
Jeanne Richard

Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland

Competing interests
The authors declare that no competing interests exist.
Corrado Corradi-Dell'Acqua

Department of Psychology, University of Geneva, Geneva, Switzerland

Competing interests
The authors declare that no competing interests exist.

"This ORCID iD identifies the author of this article:" 0000-0002-7512-9023

Funding

SNSF (PP00O1_157424/1)

Corrado Corradi-Dell'Acqua

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: all subjects read and signed an informed consent prior to taking part to the experiement, thus agreeing that their data could be published under anonimity. They had the time to read and ask for clarification/ information the the researcher conductiong the experiment in case they wanted to.This research was conducted in accordance with the Declaration of Helsinki and was approved by the local ethical committee (Commission Cantonale d'Éthique e de la Recherce [CCER] of Geneva, protocol code: CCER N. 2016-01862).

Copyright

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.