A novel social perception task for testing the social interaction model in pharmaco-fMRI protocols with selective serotonin reuptake inhibitors (SSRIs) N. Beinhölzl1,2*, N. Naor3*, H. Okon-Singer3, A. Buchenau1, 2, U. Scharrer2, E. Molloy1,2, L. Backhausen1,2, A. Villringer2, J. Sacher1, 2 poster number: P.1.i.047

1 Max Planck Institute for Human Cognitive and Brain Sciences, Minerva Research Group “EGG( & neuroimaging)-Labor”, Leipzig, Germany 2 Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology, Leipzig, Germany 3 Department of Psychology, University of Haifa, Israel

* These authors contributed equally. [email protected] Acknowledgements: This research was supported by the Max Planck Society and Science-Branco Weiss Fellowship Grant to JS. Background represents an essential ability that allows for social interaction by using one’s own emotional state to interpret the emotions of others. This ability also has a cognitive cost that is manifested in biasing perceived emotional intensity. Major depressive disorder (MDD) has been associated with empathy deficits [1], particularly in the altercentric related to heightened emotional distress [2]. A current neuropsychological hypothesis suggests enhanced promotion of social relationships as a potential therapeutic mechanism for selective serotonin reuptake inhibitors (SSRIs) [3], which are the class of antidepressants most highly prescribed in most European countries [4]. Accumulating evidence suggests that acute changes in serotonergic signaling can impact moral judgement and moral behavior and enhance harm aversion [5,6]. Such alteration in cognitive appraisal may influence social behavior and alter mood [7]. The current study introduces an innovative task to study the link between empathy and processing of emotional information in healthy subjects in order to test suitability for further acute serotonergic challenge designs in health and pathology.

Methods 1 Non-painful Painful

1) Scenario

happy neutral 30% 50 % 70% 2) Facial expression

3

3) Judgement of the intensity

Figure 1. Stimulus material for painful and neutral Figure 2. Rating score of expressed facial ranging from Figure 3. Task schematics. After viewing either a scenarios. Two representative examples of our neutral to happy or to painful. Participants were asked to rate the painful or non-painful scenario, the participants are stimulus material are displayed contrasting a expression of the facial emotion displayed in range between 1% confronted with pictures of faces depicting either a neutral (non- painful) version (panel A) versus a intensity (neutral) and 100% expression (either painful or happy). The painful or a happy expression. Participants were painful (and empathy provoking) alternative (panel range shown was created by gradually morphing well validated faces then asked to judge the intensity of the presented B), out of a total set of 23 matched picture-pairs. from neutral to a 100 % happy or painful expression. on a scale of 1-100.

Results

4 13 13 11 11

9 9

7 7 5 Painful Scenario 5 Painful Scenario

Non-Painful Scenario Non-painful Scenario BiasScore 3 BiasScore 3 1 1 -1 Happy Expressions Pain Expressions Modified from Naor, N., (In press). -1 Happy Expressions Pain Expressions -3 -3 Emotion Emotion Figure 4. Emotional bias following painful scenarios. Analysis of the intensity score in a sample of Figure 5. Confirmation of increased recognition bias for pain We find a 24 healthy Israeli individuals (7 male, mean age=23+/-2) using a 2x2 ANOVA with emotion similar bias for overestimating the intensity of a painful facial expression after (happy/pain) and scenario (painful/non-painful) as within-subjects factors showed an interaction empathizing with a painful scenario, calculating a 2x2 ANOVA: 2 between emotion and scenario [F(1,23) = 7.334, p = .013,휂푝 = .242], due to an increased bias for 2 F(1, 23)= 20.072, p .000, 휂푝= .466 in an independent dataset of 24 German painful facial expressions after an empathic watch of painful scenarios. healthy subjects (7 male, mean age= 24+/-4).

• We show increased recognition bias for painful facial expressions after observation of painful scenarios compared to neutral scenarios in an Israeli (n=24) & a German (n=24) sample of healthy participants. • This suggests that provoking empathy for pain hinders accurate valence recognition of painful facial expressions. • As a next step, we aim to test the feasibility of this task in a repeated-measures design in order to investigate whether an acute change in serotonergic signaling will improve accuracy of judgement by decreasing empathic bias for pain. References There is no potential conflict of 6 [1] Hirschfeld, R. et al., (2000). Social functioning in : a review. J. Clin. Psychiatry, 61

[2] Hoffmann, F. et al., (2016). Empathy in depression: Egocentric and altercentric and the role of alexithymia. Journal of Affective Disorders, 199, 23-29.

[3] Young, S. N. et al., (2014). Possible role of more positive social behaviour in the clinical effect of antidepressant drugs. Journal of Psychiatry & , 39(1), 60–65.

[4] Huerta, C. et al., (2014).Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications. Eur J Clin Pharmacol,70, 849-857. [5] Harmer, C. J. et al., (2013). `It's the way that you look at it’--a cognitive neuropsychological account of SSRI action in Figure 6. Acute serotonergic challenge design: 60 healthy, female participants on oral contraception will undergo depression. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 368(1615), 20120407.

[6] Crockett, M. J. et al., (2010). Serotonin selectively influences moral judgment and behavior through effects on harm three sessions of a task measuring empathy-related bias (1. baseline, 2. at peak concentration aversion. Proceedings of the National Academy of Sciences of the United States of America, 107(40), 17433–8. following a single dose; and 3. following a seven-day period of administration of either escitalopram (n=30) or [7] Crockett, M. J. et al., (2015). Dissociable Effects of Serotonin and Dopamine on the Valuation of Harm in Moral Decision

Making. Current Biology, 25(14), 1852–1859. placebo (n=30), according to a double-blind, randomized, placebo-controlled design. , , Year [8] Naor,N. et al., (In press). The impact of empathy and reappraisal on emotional intensity recognition. and Emotion

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