Background & Aims

Perceived partner responsiveness (PPR), i.e., perceptions of intimate relationship partners as understanding, validating and caring, has powerful health benefits (Reis & Clark, 2013). However, we still lack an understanding of the underlying physiological processes regulating PPR in intimate relationships. In contrast, neuroimaging and pharmacological research on empathy has associated physical pain sensitivity with increased empathic cognition and affect (Lamm, Decety, & Singer, 2011; Mischkowski, Crocker, & Way, 2016). This research demonstrates that empathic perceptions of other people’s pain and suffering are likely based in self-pain – an idea that suggests that physical pain sensitivity may also regulate empathic perceptions of responsiveness in intimate relationship partners. We thus tested the hypothesis whether a pharmacological manipulation of pain sensitivity, using the painkiller acetaminophen, would reduce PPR during intimate relationship conflict.

Methods

We tested this hypothesis in a sample of romantic couples (N=78; 39 dyads; 51.3% females; Mage = 19.47 years, SD = 1.41) who had been in a relationship for M = 18.83 months (SD = 15.91). Relationship partners (not dyads) were assigned to either consume 1000 mg liquid acetaminophen or placebo. Specifically, in two thirds of the couples, one of the partners was randomly assigned to consume 1000 mg acetaminophen and the other partner consumed an inert placebo. In another third of couples, both partners consumed a placebo. After one of the partners disclosed an area of conflict in their relationships for their partner to respond couples engaged in a conflict discussion and then rated PPR of their partners on 3 items (e.g., My partner understood me; 1=not at all true, 7=extremely true) and their own personal distress on six items (e.g., distressed; 1=not at all, 5=extremely) during the conflict discussion.

Results

We found that acetaminophen lowered PPR, B = -0.25, SE = 0.12, t = -2.04, p = .048, r = -.30, and increased personal, conflict-related distress, B = 0.20, SE = 0.09, t = 2.17, p = .035, r = .31, during the conflict discussion, after adjusting for participants’ sex. Furthermore, reduced PPR statistically accounted for the effect of acetaminophen on increased personal distress. As just reported, acetaminophen relative to placebo reduced PPR (mediation path a) and increased distress (path c). Additionally, PPR was associated with less distress, B = -0.25, SE = 0.07, t = -3.62, p < .001, r = .43 (path b). When controlling for PPR, the effect of acetaminophen relative to placebo on distress dropped to non-significance, B = 0.11, SE = 0.10, t = -3.62, p = .250, r = .16 (path c’). The indirect effect of acetaminophen on distress via reduced PPR [119] was significant as the 95% CI around the indirect effect did not overlap with zero, [0.003, 0.14].

Conclusions

Relationship theory on PPR has not fully considered adjacent work on the role of pain in regulating empathy. This literature gap is partly due to the methodological limitations of simultaneously assessing physical pain sensitivity and relationship maintenance processes as they occur live in existing relationships. By leveraging a pharmacological intervention in this research to directly manipulate physical pain sensitivity, we were able to examine the causal association of physical pain sensitivity with PPR and the stress response during live interactions, as they dynamically unfold. In doing so, our research expands the scope of relationship maintenance processes to incorporate physiological processes involved in physical pain and to reveal how physical pain sensitivity may play a critical role in perceptions of responsiveness and the maintenance of close relationships.

References

Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA (2002) Recent patterns of medication use in the ambulatory adult population of the United States: The Slone Survey. JAMA, 287(3):337–344. https://doi.org/10.1001/jama.287.3.337

Lamm C, Decety J, Singer T (2011) Meta-analytic evidence for common and distinct neural networks associated with directly experienced pain and empathy for pain. NeuroImage, 54(3):2492–2502. https://doi.org/10.1016/j.neuroimage.2010.10.014

Mischkowski D, Crocker J, Way BM (2016) From painkiller to empathy killer: Acetaminophen (paracetamol) reduces empathy for pain. Social Cognitive and Affective Neuroscience, 11(9):1345–1353. https://doi.org/10.1093/scan/nsw057

Reis HT, Clark MS (2013) Responsiveness. The Oxford Handbook of Close Relationships, 400–423.

Presenting Author

Dominik Mischkowski

Poster Authors

Dominik Mischkowski

PhD

University of Illinois at Urbana-Champaign

Lead Author

E-mail

Topics

  • Mechanisms: Psychosocial and Biopsychosocial