Different psychophysiological and clinical symptoms are linked to affective versus sensory vicarious pain experiences

For some people, seeing pain in others triggers a pain-like experience in themselves: these experiences can either be described in sensory terms and localized to specific body parts (sensory-localized, or S/L) or in affective terms and nonlocalized or whole-body experiences (affective-general, or A/G). In two studies, it is shown that these are linked to different clinical and psychophysiological profiles relative to controls. Study 1 shows that the A/G profile is linked to symptoms of Blood-Injection-Injury Phobia whereas the S/L profile shows some tendency toward eating disorders. Study 2 shows that the A/G profile is linked to poor interoceptive accuracy (for heartbeat detection) whereas the S/L profile is linked to higher heart-rate variability (HRV) when observing pain, which is typically regarded as an index of good autonomic emotion regulation. Neither group showed significant differences in overall heart rate, systolic blood pressure (SBP), or skin conductance response (SCR) when observing pain, and no overall differences in state or trait anxiety. Overall, the research points to different underlying mechanisms linked to different manifestations of vicarious pain response. Affective-General pain responders have strong subjective bodily experiences (likely of central origin given the absence of major differences in autonomic responsiveness) coupled with a worse ability to read objective interoceptive signals. Sensory-localized pain responders have differences in their ability to construct a multi-sensory body schema (as evidenced by prior research on the Rubber Hand Illusion) coupled with enhanced cardiovagal (parasympathetic) reactivity often indicative of better stress adaptation.