Healthcare experience disrupts representational similarity between one’s and others’ pain in middle-anterior insula
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Description: Medical students and professional healthcare providers often underestimate patients’s pain. It is presumed that this effect reflects experience-driven changes in the processing of pain-related information, rooted in neural plasticity of brain areas such as the insula and cingulate cortex. Previous research reported lower responses in these areas to the sight of people’s injuries in healthcare professionals. However, the functional properties of these brain regions are still debated, raising questions about the significance of such changes. We tested the effects of both scholarly (Experiment 1) and professional (Experiment 2) healthcare experience on behavioral and neural reactivity to other’s pain, emotions, and beliefs, as well as to first-hand nociceptive stimulations. We confirmed that healthcare experience negatively impacted the sensitivity to others’ suffering, as measured by subjective ratings and neural activity in middle-anterior insula. This effect was independent from stimulus modality (pictures vs. texts), but specific for pain, as it did not generalize to the processing of emotions or beliefs. Critically, multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others’ pain that is shared with that of first-hand nociception. This suggests a reduced likelihood of appraising others’ sufferance as one’s own, and might offer a mechanistic explanation for pain underestimation in clinical settings.