Beliefs and expectations often persist despite evidence to the contrary. Here we examine two potential mechanisms underlying such ‘self-reinforcing’ expectancy effects in the pain domain: modulation of perception and biased learning. In two experiments, cues previously associated with symbolic representations of high or low temperatures preceded painful heat. We examined trial-to-trial dynamics in participants’ expected pain, reported pain and brain activity. Subjective and neural pain responses assimilated towards cue-based expectations, and pain responses in turn predicted subsequent expectations, creating a positive dynamic feedback loop. Furthermore, we found evidence for a confirmation bias in learning: higher- and lower-than-expected pain triggered greater expectation updating for high- and low-pain cues, respectively. Individual differences in this bias were reflected in the updating of pain-anticipatory brain activity. Computational modelling provided converging evidence that expectations influence both perception and learning. Together, perceptual assimilation and biased learning promote self-reinforcing expectations, helping to explain why beliefs can be resistant to change.
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The single-trial behavioural and NPS data, which are needed to reproduce all behavioural and NPS analyses in the paper, are available through the Open Science Framework repository, https://osf.io/bqkz3/. The fMRI data, which are needed to reproduce the analyses on anticipatory brain activity, are available from the corresponding author upon request.
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We thank M. Powell and D. Ryan for assistance with data collection, and M. Roy and M. López-Solà for discussions. This research was made possible with the support of National Institutes of Health grants NIMH 2R01MH076136 and R01DA027794 (to T.D.W.), a VENI grant of the Netherlands Organization for Scientific Research (to M. Jepma), and AFOSR grant FA9550-14-1-0318 (to M. Jones). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
The authors declare no competing interests.
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Jepma, M., Koban, L., van Doorn, J. et al. Behavioural and neural evidence for self-reinforcing expectancy effects on pain. Nat Hum Behav 2, 838–855 (2018). https://doi.org/10.1038/s41562-018-0455-8
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