Prof. Dr. Beate Ditzen

Institute of Medical Psychology
Medical Faculty Heidelberg
Heidelberg University

Dr. Edda Bilek

Department of Psychiatry and Psychotherapy
Medical Faculty Mannheim
Heidelberg University

Social modulation of chronic pelvic pain: Neural inter-individual co-variation and
partner interaction

Background and past work:
The perception of pain and the individual burden of chronic pain are modulated by social influences. In healthy
individuals, social support or affectionate interaction can reduce acute pain perception and negative affect.
Similarly, empathy for pain and neural covariation have been observed in both partners of healthy dyads during
painful stimulation in one of the partners. Such measures of between-brain coupling during social contact
relate to the state of mental disorders and recovery. In contrast, in patients with chronic pain, supportive and
caring partner behaviour in some patient groups can be associated with increased pain perception and intensified pain processing on the brain level. Within a social learning framework, these seemingly contradictory
effects may result from conditioning effects and temporal dynamics of salience, adaptive brain activation and
between-brain coupling during social support, attention, and positive interaction during long-term pain exposure. This becomes particularly relevant in pain conditions with immediate effects on close attachment relationships and intimate behaviour, such as chronic pelvic pain. While initial treatment schemes incorporate the
social environment into multimodal management of chronic pain, there are not yet data on actual changes in
activation of specific brain areas, psychobiological, or brain to brain coupling.
Central questions for current funding period:
Can a social intervention, involving the partner, lead to observable changes in pain perception and changes
in individual brain activation as well as between-brain coupling during exposure to painful stimuli? How do
these measures relate to everyday-life behaviour and endocrine readouts?