The blame game: the effect of responsibility and social stigma on empathy for pain

This investigation combined behavioral and functional neuroimaging measures to explore whether perception of pain is modulated by the target's stigmatized status and whether the target bore responsibility for that stigma. During fMRI scanning, participants were exposed to a series of short video clips featuring age-matched individuals experiencing pain who were (a) similar to the participant (healthy), (b) stigmatized but not responsible for their stigmatized condition (infected with AIDS as a result of an infected blood transfusion), or (c) stigmatized and responsible for their stigmatized condition (infected with AIDS as a result of intravenous drug use). Explicit pain and empathy ratings for the targets were obtained outside of the MRI environment, along with a variety of implicit and explicit measures of AIDS bias. Results showed that participants were significantly more sensitive to the pain of AIDS transfusion targets as compared with healthy and AIDS drug targets, as evidenced by significantly higher pain and empathy ratings during video evaluation and significantly greater hemodynamic activity in areas associated with pain processing (i.e., right anterior insula, anterior midcingulate cortex, periaqueductal gray). In contrast, significantly less activity was observed in the anterior midcingulate cortex for AIDS drug targets as compared with healthy controls. Further, behavioral differences between healthy and AIDS drug targets were moderated by the extent to which participants blamed AIDS drug individuals for their condition. Controlling for both explicit and implicit AIDS bias, the more participants blamed these targets, the less pain they attributed to them as compared with healthy controls. The present study reveals that empathic resonance is moderated early in information processing by a priori attitudes toward the target group.