Resisting repeated exposure: Characteristics of pain empathy for experienced physicians

Using event-related potentials (ERPs), the present study tested whether state empathy for pain of experienced physicians could resist the influences of repeated exposure to depictions of people experiencing pain. We employed a three-phase paradigm which integrated a classical pain empathy measurement procedure and a multi-block free-view habituation procedure. In this paradigm, 18 experienced physicians with reduced empathy traits (clinical experience > 5 years) and 18 non-physician controls completed a pre-test phase of pain empathy, followed by a phase of repeated emotional exposure, and a post-test phase of pain empathy. Behavioral pain intensity rating and critical ERP components associated with pain empathy (i.e., N1, N2, and LPP) were measured and compared across participant groups, stimulus types, and experimental phases. Experienced physicians differed from controls in neural processes related to pain empathy, but their pain intensity ratings did not. Specifically, for early ERP components related to empathic arousal such as N1 and N2, we replicated and extended previous findings that physicians can inhibit these bottom-up processes of empathic arousal. In contrast, the P3 didn't reflect a distinctive empathy process for the physicians. For the later reappraisal-related LPP component, however, we found a significant three-way interaction among participant groups, stimulus types, and experimental phases. This interaction provided the first evidence that pain empathy of experienced physicians with low empathic traits can resist repeated exposure to pain. Based on this evidence, the characteristics of pain empathy for experienced physicians and the relative adaptability of pain empathy for human beings are discussed.