1 Medical education and distrust modulate the response of insular-cingulate 2 network and ventral striatum in pain diagnosis. 3 Giada Dirupoa,b,c, Sabrina Totaroa, Jeanne Richardc,d and Corrado Corradi-Dell’Acquaa,b 4 5 a Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and 6 Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland. 7 b Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland. 8 c Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland. 9 d Department of Psychology, Swiss Distance University Institute, Brig, Switzerland. 10 11 Corresponding author: Giada Dirupo, University of Geneva – Campus Biotech, Ch. des Mines 12 9, CH-1211, Geneva, Switzerland. Tel: +41223790966. E-mail:
[email protected] 13 14 Keywords: Medical Students, Negative Feedback, Social Conformity, Medial Prefrontal 15 Cortex, Insula. 16 1 Abstract 2 Healthcare providers often underestimate patients’ pain, sometimes even when aware of 3 their reports. This could be the effect of experience reducing sensitivity to others pain, or 4 distrust towards patients’ self-evaluations. Across multiple experiments (375 participants), we 5 tested whether senior medical students differed from younger colleagues and lay controls in 6 the way they assess people’s pain and take into consideration their feedback. We found that 7 medical training affected the sensitivity to pain faces, an effect shown by the lower ratings 8 and highlighted by a decrease in neural response of the insula and cingulate cortex. Instead, 9 distrust towards the expressions’ authenticity affected the processing of feedbacks, by 10 decreasing activity in the ventral striatum whenever patients’ self-reports matched 11 participants’ evaluations, and by promoting strong reliance on the opinion of other doctors.