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

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 toward patients’ self-evaluations. Across multiple experiments (375 participants), we tested whether senior med...

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Autores principales: Dirupo, Giada, Totaro, Sabrina, Richard, Jeanne, Corradi-Dell'Acqua, Corrado
Formato: Online Artículo Texto
Lenguaje:English
Publicado: eLife Sciences Publications, Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104963/
https://www.ncbi.nlm.nih.gov/pubmed/33904406
http://dx.doi.org/10.7554/eLife.63272
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author Dirupo, Giada
Totaro, Sabrina
Richard, Jeanne
Corradi-Dell'Acqua, Corrado
author_facet Dirupo, Giada
Totaro, Sabrina
Richard, Jeanne
Corradi-Dell'Acqua, Corrado
author_sort Dirupo, Giada
collection PubMed
description 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 toward 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 toward 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.
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spelling pubmed-81049632021-05-11 Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis Dirupo, Giada Totaro, Sabrina Richard, Jeanne Corradi-Dell'Acqua, Corrado eLife Neuroscience 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 toward 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 toward 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. eLife Sciences Publications, Ltd 2021-04-27 /pmc/articles/PMC8104963/ /pubmed/33904406 http://dx.doi.org/10.7554/eLife.63272 Text en © 2021, Dirupo et al https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Neuroscience
Dirupo, Giada
Totaro, Sabrina
Richard, Jeanne
Corradi-Dell'Acqua, Corrado
Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
title Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
title_full Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
title_fullStr Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
title_full_unstemmed Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
title_short Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
title_sort medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104963/
https://www.ncbi.nlm.nih.gov/pubmed/33904406
http://dx.doi.org/10.7554/eLife.63272
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