Self-reassurance reduces neural and self-report reactivity to negative life events
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Summary: Kim and colleagues present a secondary analysis of an already published imaging dataset in 40 participants going through a two-week compassion training paradigm. They show participants standardized statements that are emotional or neutral and further have participants either engage in "self-criticism" or "self-reassurance" while considering the statements. The authors report on differences in brain regions (what they refer to as "neural pain") depending on criticism or reassurance condition. Concerns with the conceptual framework, approach, and interpretation substantially dampened our enthusiasm.
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Abstract
Background
Whilst research has shown how self-criticism may increase both neural and self-report markers of negative emotion, less well known is how self-reassurance - a compassionately-motivated cognitive self-relating style - may regulate negative emotion.
Method
Using fMRI, we invited participants to engage in self-criticism and self-reassurance toward written descriptions of negative life events (mistakes, setbacks, failures).
Results
Our results identify that neural markers of negative emotion and self-report markers of trial intensity during fMRI are suppressed under conditions of self-reassurance, relative to self-criticism.
Limitations
Future work to control for autobiographical memory during this fMRI task is needed, to explore how memory can contribute to self-reassurance and self-criticism.
Conclusions
Engagement in self-reassurance can reduce the ‘sting’ of negative life-events, both neural and self-report, which holds important implications for therapy.
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Reviewer #2:
The manuscript prepared by Kim and Colleagues provides a solid attempt at understanding the neural correlates associated with self-reassurance and self-criticism in relation to what they term neural pain. While it is well written and there is a clear story presented here, there appears to be insufficient details in the introduction and discussion. The methodology appears sound for the most part, but I have some concerns relating to stimuli and gender effects that I believe would make the findings more compelling if addressed.
Criticisms:
The example items of the neutral statements appear to involve an external agent (i.e., a reference to a friend), while the neural pain is purely about the self. Are there also references to other people in the neural pain condition? If not, how have the authors ensured that the neutral …
Reviewer #2:
The manuscript prepared by Kim and Colleagues provides a solid attempt at understanding the neural correlates associated with self-reassurance and self-criticism in relation to what they term neural pain. While it is well written and there is a clear story presented here, there appears to be insufficient details in the introduction and discussion. The methodology appears sound for the most part, but I have some concerns relating to stimuli and gender effects that I believe would make the findings more compelling if addressed.
Criticisms:
The example items of the neutral statements appear to involve an external agent (i.e., a reference to a friend), while the neural pain is purely about the self. Are there also references to other people in the neural pain condition? If not, how have the authors ensured that the neutral condition is actually neutral. It seems likely that the inclusion of an external agent for many of the neutral statements could pose problems with interpretation, especially when talking about self-criticism and self-reassurance. The presence of an external agent in the neutral statements changes the meaning from a purely self-oriented experience to a shared experience.
I am curious as to why the inverse contrasts (i.e., reassurance - criticism) were not run? Knowing whether there was a unique network associated with self-reassurance would provide a more comprehensive understanding of the authors' findings.
I am wondering why the authors did not accommodate for gender differences in their study? Given recent evidence (See citation) it seems likely that this may play a part in self-compassion. The authors report an almost equal distribution of males and females, so it should be possible. If the authors did explore this and found no difference with gender as a regressor then this should be noted in the manuscript. Mercadillo, R. E., Díaz, J. L., Pasaye, E. H., & Barrios, F. A. (2011). Perception of suffering and compassion experience: brain gender disparities. Brain and cognition, 76(1), 5-14.
It seems as though a whole body of literature is being very lightly touched on here but would benefit from inclusion. I think it would be useful to have some information in the introduction regarding moral emotions (i.e., compassion) and the link with empathy and emotion regulation (see work by Jean Decety). This would also be beneficial for the discussion as the authors are in essence describing empathy.
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Reviewer #1:
This is a potentially interesting analysis, but there is a lack of framing, details, and specificity that dampens my enthusiasm for the work.
As far as I can tell, the authors do not really demonstrate that "markers of negative emotion and pain" can be down-regulated during self-reassurance". They simply show that regions surviving multiple comparisons change depending on condition, but they don't show data supporting their hypothesis. How much do regions activated during criticism actually change during reassurance? What is the time course of these differences?
Behaviorally, the neutral statements from the two "conditions" appeared to have distinct intensity levels. Specifically the "intensity" for neutral trials during criticism blocks appears significantly lower than neutral trials for reassuring blocks. Because of this …
Reviewer #1:
This is a potentially interesting analysis, but there is a lack of framing, details, and specificity that dampens my enthusiasm for the work.
As far as I can tell, the authors do not really demonstrate that "markers of negative emotion and pain" can be down-regulated during self-reassurance". They simply show that regions surviving multiple comparisons change depending on condition, but they don't show data supporting their hypothesis. How much do regions activated during criticism actually change during reassurance? What is the time course of these differences?
Behaviorally, the neutral statements from the two "conditions" appeared to have distinct intensity levels. Specifically the "intensity" for neutral trials during criticism blocks appears significantly lower than neutral trials for reassuring blocks. Because of this behavioral effect, within their design it is difficult to identify the cause of the brain changes.
How were subjects trained in self-criticism vs. reassurance? Is there any way to confirm that they were in fact doing the "task"? Further, at what point in the 2-week compassion training paradigm were FMRI data collected?
Figure 2 is quite confusing to me: (1) the authors refer to brain maps as "neural pain"? I would strongly advise against this as it is very reverse-inferency. I would recommend against using this phrase throughout the paper. (2) How would one interpret the phrase "neural pain during self-reassurance"? Is this emotional > neutral during reassurance?
Figure 3 refers to "trial by trial ratings of intensity" but if I am understanding the figure, this is not an accurate description. The authors are reporting the mean across subjects for each condition. It is unclear in fact how much variability there is on a trial-by-trial level within persons for the intensity of each condition. One idea is to use an amplitude modulation analysis to scale FMRI parameter estimates by the intensity rating on a per-trial basis. That would be an interesting analysis, IMO.
It is unclear from this paper what was done previously. It appears that the authors examined physiological data (e.g., HRV) in their previous report but don't talk about other measures that were collected here. It would be useful to know the extent to which they buttress the authors findings (or if they do not).
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Summary: Kim and colleagues present a secondary analysis of an already published imaging dataset in 40 participants going through a two-week compassion training paradigm. They show participants standardized statements that are emotional or neutral and further have participants either engage in "self-criticism" or "self-reassurance" while considering the statements. The authors report on differences in brain regions (what they refer to as "neural pain") depending on criticism or reassurance condition. Concerns with the conceptual framework, approach, and interpretation substantially dampened our enthusiasm.
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