Effects of early life adversity on socially learned analgesia and empathy in virtual reality

Many digital interventions rely on learning from social and contextual cues, yet it remains unclear how early life adversity influences responsiveness to these mechanisms. Early life adversity (ELA), commonly assessed using Adverse Childhood Experiences (ACEs), is associated with long-lasting alterations in stress regulation and social information processing that may shape learning-based pain modulation. Using an observational learning paradigm implemented in immersive virtual reality (VR), we examined how ELA modulates socially learned analgesia and empathy-related processes. Adults with Low or High ACE exposure observed Human or Avatar demonstrators experiencing pain relief and subsequently underwent standardized pain testing in immersive and non-immersive contexts. Individuals with higher ACE exposure showed stronger socially learned analgesia, particularly in immersive VR, despite exhibiting reduced affective state empathy and preserved cognitive empathy. These findings indicate that ELA is associated with altered sensitivity to socially transmitted treatment cues, highlighting immersive VR as a platform for probing individual differences and informing the personalization of digital pain interventions.