Primed by Beauty or Not? How Facial Attractiveness Influences Neural and Behavioral Empathy for Pain

Primed by Beauty or Not? 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How Facial Attractiveness Influences Neural and Behavioral Empathy for Pain Natalia Kopiś-Posiej, Andrzej Cudo, Emilia Zabielska-Mendyk, Magdalena Szwed This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6683265/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Empathy for pain is a multifaceted process influenced by both affective and cognitive factors. The present study investigated whether priming faces of varying physical attractiveness modulates early empathic responses to pain, as measured by event-related potentials (ERPs). To explore these dynamics, the ‘sandwich-masked faces’ paradigm was used. Fifty-three healthy adults viewed photographs of faces rated as highly attractive or unattractive (prime), followed by target images depicting either painful or non-painful situations. Results revealed that attractive facial primes, when paired with painful target stimuli, elicited enhanced N2 amplitudes, indicative of affective conflict during early empathic processing. Additionally, P3 amplitude was higher for painful stimuli following unattractive primes, suggesting facilitated categorization and increased cognitive engagement. Behavioral data showed that pain intensity ratings were generally higher for unattractive models, especially when prime and target valence were congruent. These findings demonstrate that facial attractiveness and affective priming modulate both early and late stages of neural empathic processing, highlighting the complex role of unconscious affective cues in empathy for pain. Biological sciences/Psychology Biological sciences/Psychology/Human behaviour Empathy ERP priming attractiveness pain Figures Figure 1 Figure 2 Figure 3 Introduction Empathy as a theoretical construct is usually described through its two main aspects: the affective experience of the other's present or inferred emotional state, referred to as emotional empathy, and at least some recognition and understanding of other people's state known as cognitive empathy [ 1 ]. Empathy is frequently operationalised in research through the psychophysiological reaction elicited by observing stimuli related to other people's pain [e.g., 2]. For humans, pain is a stimulus that engages and focuses attention; this applies to stimuli from the external environment and those originating from the body. Based on the results of neuroimaging studies [see 4,5,6,7] it can be indicated that when observing stimuli showing painful situations, specific brain structures like: insular cortex and cingulate cortex, ventral medial prefrontal cortex, superior temporal cortex, and temporo-parietal junction, are active. Activation of these areas may be associated with personal suffering [ 3 ], perceived unpleasantness [ 8 ], and perceived intensity of pain [ 6 ]. In electroencephalographic (EEG) studies, there were differences in the amplitude of event-related potentials (ERP) components registered between painful and non-painful stimuli in time windows corresponding to the N1, N2, P2 and P3 components [ 2 ]. In previous research [ 2 ], this difference was interpreted as an occurrence of early process of the empathic reaction to the perception of painful social stimuli in contrast to non-painful social stimuli. Nevertheless, it is worth mentioning that, according to recent studies, the interpretation of early ERP results should also consider general affective processes rather than just affective empathy [see 9, 10]. Affect encompasses an emotional state strongly connected with valence [ 11 ]. Affect depends on the presence of specific stimuli [e.g., 12]. This implies that exposure to a stimulus associated with pain (e.g., a needle or a knife) may elicit in the participant a response linked to an affective reaction characterized by negative valence. Thus, the N2 ERP component was considered a "semiautomatic" component (after early automatic processing, reflected in the N1 and P2) that is often interpreted as early conflict detection [ 13 ]. Additionally, the N2 amplitude may be connected with processes related to affective arousal in response to the observed stimulus [ 14 ]. On the other hand, the amplitude of the P3 ERP component is sensitive to categorizing the target stimulus [ 15 ]. Also, according to Sessa et al. [ 16 , 17 ], higher P3 amplitudes have been linked to greater empathy levels, indicating that individuals are more engaged in evaluating the emotional context of the observed pain. This may suggest that when individuals see situations in which others perceive pain, their cognitive resources are mobilized to process the emotional and social implications of that pain. In this context, the general affective processes may be connected with the early process of the empathic reaction. Studies on early process of empathic response have focused on bias in empathy [e.g. 17 – racial bias in empathy]. However, differences in ERP empathic response emerge not only due to the participant's ethnic group status. Kopiś et al. [ 18 ] and Meng et al. [ 19 ] found that the early process of empathic reaction decreases when the participants see a physically attractive model compared to a less attractive model. In components such as N2 [ 18 ] and P3 [during pain judgment; 19], the difference between the painful and the non-painful stimulus occurred only when the participants look at less attractive models. It was found that looking at faces perceived as highly attractive may have a weakening effect on the early process of empathic response [ 19 ] and, at the same time, distract the attention of participants from pain [ 18 ]. Undoubtedly, facial physical attractiveness is strongly associated with the well-documented stereotype "what is beautiful is good" [e.g. 20]. However, within the specific context of empathy for pain as examined through EEG/ERP paradigms, physical attractiveness appears to exert a paradoxically adverse effect on pain perception. This raises important questions regarding the underlying factors that modulate these outcomes. In the present study, we aimed to investigate whether the affective valence linked to facial attractiveness influences early process of empathic responses. Prior research [ 21 ] has demonstrated that physically attractive faces typically elicit positive valence, whereas less attractive faces tend to evoke negative valence. Possibly, the simultaneous presentation of a highly attractive face alongside a negative, pain-related stimulus (e.g., a needle stuck in the cheek of the model) may induce affective conflict, thereby complicating the unambiguous evaluation of the affective valence content. To explore these dynamics, we used a ‘sandwich-masked faces’ paradigm. This paradigm is used to study unconscious visual processing, particularly of faces where the prime and probe belong to the same or different category —used, for example, to judge fame [ 23 ]. Our procedure involved presenting, in a very brief time, a face stimulus (the "prime" − 17 ms) that is preceded and followed by visual masks and subsequent probe stimuli. The prime stimuli were pictures of attractive (one block) or unattractive faces (another block). The probe stimuli that occurred after priming were attractive and unattractive faces in painful or non-painful situations [see. 18, 19]. The prime and target faces were different to demonstrate that the affective features of masked primes are processed. It has been shown that behavioural and neural responses are modulated by pre-exposure to a face from the same category [e.g., 23]. These effects suggest that category priming enhances processing efficiency for faces sharing categorical features even when the exact identity differs. Additionally, previous studies have shown that priming with faces of varying attractiveness can modulate the evaluation of subsequent stimuli [ 24 ] and influence social behaviours, including honesty [ 25 ], or altruism [ 26 ]. Within the framework of unconscious affective processing, it is posited that automatic processing of the primed stimulus activates its evaluative connotation, thereby “preparing” the cognitive and affective system for the response to the target stimulus despite the stimulus’ task irrelevance and masking [ 27 ]. Thus, our procedure was designed to isolate the influence of valence and to understand affective conflicts in the pain empathy paradigm. Considering previous research [ 21 ], it should be noted that attractive and unattractive model faces as a stimulus with opposite valance may lead to affective conflict in painful situations. Considering the ERP components relevant to affective priming research [ 28 , 29 ] and to research on empathy for pain [ 30 ], we decided to measure the amplitude of the N2 and P3 components. The N2 component is recognized as an index of early attentional allocation and the detection of cognitive or affective conflict; we hypothesize that the amplitude of the N2 will differ significantly under conditions of attractive faces as prime in painful situations. Specifically, we predict that the N2 amplitude will be significantly lower for painful stimuli compared to non-painful within the block with attractive primed stimuli (H1). Furthermore, we predict that the physical attractiveness of the target faces presented after priming will modulate the affective processing reflected in the N2 component. Accordingly, we expect a significant interaction effect whereby the N2 amplitude in the pain condition will differ between attractive and unattractive target faces, particularly in the context of priming with attractive faces as positive valence stimuli (H2). Additionally, we assumed that a masked prime related to the target image would enhance the P3 amplitude of the target, reflecting facilitated processing and easier target classification. Thus, the amplitude of the P3 component will be significantly larger for painful compared to non-painful stimulation within the block with unattractive primed stimuli (H3). Finally, in masked priming tasks, the participant's task is to classify the viewed stimulus into categories related to the prime. Still, in pain empathy studies, the tasks focus on pain assessment. Since the study aims to measure empathic response, the participant's task is to assess the intensity of pain experienced by the model in the picture, which is considered an appropriate approach in empathy research [ 31 ]. Thus, we assume that similarly to the hypotheses regarding ERP components, the assessment of the intensity of pain experienced by others will be lower when the target stimuli (faces in painful situations) are primed with an attractive face, compared to conditions primed with an unattractive face (H4). Moreover, this effect will be particularly visible when both the prime and the target stimulus are attractive (H5). Results Behavioural results For the pain intensity ratings, there was a statistically significant main effect of the ATTRACTIVENESS, F (1, 52) = 24.87, p < .001, η p 2 = 0.32 (see Table 1 ). Specifically, when unattractive models ( M = 2.30, SE = 0.06) were presented, the pain intensity rating was higher than when attractive models ( M = 2.10, SE = 0.07) were presented. Additionally, there was a main effect of the STIMULUS, F (1, 52) = 98.24, p < .001, η p 2 = 0.65. In this context, the painful stimuli were rated higher ( M = 2.93, SE = 0.12) than the non-painful stimuli ( M = 1.47, SE = 0.06) in the pain intensity rating scale. There was also a statistically significant interaction effect of the ATTRACTIVENESS × PRIME, F (1, 52) = 5.89, p = .019, η p 2 = 0.10 (see Table 1 ). The simple effects analysis showed differences between attractiveness conditions in the conditions related to priming by the unattractive-model ( p < .001) and the attractive model ( p < .001). For the unattractive model prime, the pain intensity ratings were higher when unattractive models ( M = 2.32, SE = 0.06) were presented than when attractive models (M = 2.08, SE = 0.07) were presented. Similarly, for the attractive-model prime, the pain intensity ratings were higher when unattractive models ( M = 2.29, SE = 0.06) were presented than when attractive models ( M = 2.11, SE = 0.07) were presented. Additionally, no significant differences between priming conditions were observed in the unattractive and attractive presented model conditions, separately. The STIMULUS × ATTRACTIVENESS × PRIME interaction effect was statistically significant, F (1, 52) = 13.06, p < .001, η p 2 = 0.20 (see Table 2 ). The simple effects analysis showed differences between the painful and non-painful stimuli in the unattractive presented model condition (p < .001) and attractive presented model condition ( p < .001) among priming condition related to presented unattractive models. Analogously, there were statistically significant differences between stimulus conditions in the unattractive presented model ( p < .001) and attractive presented model (p < .001) among priming condition related to presented attractive models. More specifically, painful stimuli were rated as more painful than non-painful stimuli at the level of the other conditions. The simple effects analysis showed differences between the unattractive presented model and the attractive presented model in the painful stimuli condition ( p < .001) and non-painful stimuli condition ( p < .001) among priming condition related to presented unattractive models. Analogously, there were statistically significant differences between attractiveness conditions in the painful stimuli condition ( p < .008) and non-painful stimuli condition ( p < .001) among priming condition related to presented attractive models. Specifically, when unattractive models were presented the pain intensity rating was higher than when attractive models were presented at the level of the other conditions (see supplementary materials). Moreover, the simple effects analysis showed differences between the priming condition in painful stimuli condition among unattractive presented model condition ( p = .007). More precisely, the pain intensity ratings were higher when unattractive model primes were presented ( M = 3.10, SE = 0.11) than when attractive model primes were presented ( M = 2.98, SE = 0.11) in painful stimuli among unattractive presented model condition. Other analogous comparisons were statistically insignificant ( ps > .219). The means and standard errors of the pain intensity rating scores for each condition are shown in supplementary materials. Other main effects and interaction effects were statistically insignificant ( Fs .129). Table 1 Behavioural results Effects F p ηp2 PRIMING 0.37 .56 0.006 ATTRACTIVENESS 27.55 < .001 0.330 STIMULUS 102.89 < .001 0.65 PRIMING x ATTRACTIVENESS 4.89 .031 0.08 PRIMING x STIMULUS 3.10 .084 0.052 ATTRACTIVENESS x STIMULUS 0.018 .89 .00 PRIMING x ATTRACTIVENESS x STIMULUS 14.606 < .001 0.21 Note: Statistically significant results were bolded. Electroencephalography results N2 component For the N2 component, the STIMULUS × ATTRACTIVENESS × PRIME interaction effect was statistically significant, F (1, 52) = 4.45, p = .040, η p 2 = 0.08. The simple effects analysis showed differences only in the attractiveness prime condition between attractive and unattractive models in the pain ( p = .004). Only when an attractive face was primed, the N2 component amplitude was more negative for the attractive model ( M =-2.66µV, SE = 0.40µV) than for the unattractive model ( M =-2.10µV, SE = 0.35µV) presented in painful condition (see Fig. 1 ). No analogous statistically significant differences were found between attractiveness conditions in the non-painful condition. The simple effects analysis showed no differences between the painful vs non-painful stimulus in unattractive and attractive presented model conditions, separately. The main effects and other interaction effects were statistically insignificant (see Table 3 ). P3 component There was a statistically significant main effect of the ATTRACTIVENESS, F (1, 52) = 15.05, p < .001, η p 2 = 0.22. More specifically, the amplitude of the P3 component was more positive in the attractive presented model condition ( M = 3.18 µV , SE = 0.3 µV ) than the unattractive presented model condition ( M = 2.96 µV , SE = 0.28 µV ). Additionally, there was a main effect of the STIMULUS, F (1, 52) = 9.12, p = .004, η p 2 = 0.15. More precisely, the amplitude of the P3 component was more positive in painful condition ( M = 3.21 µV , SE = 0.31 µV ) than in non-painful condition ( M = 2.93 µV , SE = 0.28 µV ). Moreover, there was a statistically significant interaction effect of the STIMULUS × PRIME, F (1, 52) = 5.63, p = .021, η p 2 = 0.98. The simple effects analysis showed differences between stimulus conditions in the unattractive model condition (p = .003). For the unattractive model condition, the P3 component amplitude was more positive in the painful condition (M = 3.32µV, SE = 0.33µV) than in the non-painful condition (M = 2.84µV, SE = 0.28µV) (see Fig. 2 ). There were no significant differences between stimulus conditions in the attractive model condition. Additionally, no significant differences between prime conditions (unattractive presented model vs. attractive presented model) were observed in the painful and non-painful condition, separately. Other main effects and interaction effects were statistically insignificant (see Table 2 ). Table 2 Electroencephalography results N2 component Effects F p ηp2 PRIMING 0.08 0.774 0.002 ATTRACTIVENESS 1.50 0.226 0.028 STIMULUS 0.02 0.900 0.000 PRIMING x ATTRACTIVENESS 1.49 0.228 0.028 PRIMING x STIMULUS 2.37 0.130 0.044 ATTRACTIVENESS x STIMULUS 0.37 0.547 0.007 PRIMING x ATTRACTIVENESS x STIMULUS 4.45 0.040 0.079 P3 component Effects F p ηp2 PRIMING 0.02 0.883 0.000 ATTRACTIVENESS 15.05 0.000 0.224 STIMULUS 9.12 0.004 0.149 PRIMING x ATTRACTIVENESS 0.47 0.495 0.009 PRIMING x STIMULUS 5.63 0.021 0.098 ATTRACTIVENESS x STIMULUS 0.04 0.853 0.001 PRIMING x ATTRACTIVENESS x STIMULUS 3.38 0.072 0.061 Note: Statistically significant results were bolded. Discussion Our study aimed to check whether affective valence associated with faces of different attractiveness influences early processes of empathy for pain. Previous studies have reported changes in the empathetic response for attractive vs. less attractive people. More precisely, no significant differences in the amplitude of ERP components were for physically attractive models. This effect was explained by processes related to attention or the lack of similarity between the participant and the model in the photo [ 18 , 19 ]. Nevertheless, an important issue that should be considered is the valence of the stimulus. Physically attractive faces are rated more positively than unattractive faces [ 21 ]. Combining attractive faces with a stimulus associated with pain (negative valence) may make the final assessment of the seen stimulus difficult. Therefore, in our study, we decided to use the sandwich-masked face priming paradigm. In our hypotheses, we assumed that the N2 component would register effects related to affective conflict. The first hypothesis (H1) concerning the interaction between prime and painful/non-painful stimuli was not confirmed. However, the second hypothesis (H2), which more particularly underlined the conflict related to the stimulus's valence, was confirmed. We registered a significant difference in the amplitude of the N2 component between the attractive and unattractive faces in the pain condition when the prime was also an attractive face. We noted that the N2 component may register conflict in the context of stimulus valence [ 13 , 14 ]. Specifically, we observed that stimuli depicting attractive individuals in situations of suffering could evoke conflict related to the ultimate evaluation and classification of the stimulus. We propose that the primed stimulus (i.e., an attractive face) influenced the overall evaluative connotation, thereby "preparing" the cognitive and affective systems to respond to the target stimulus [ 23 ]. The target stimulus itself also contained conflicting elements (an attractive face in pain versus an unattractive face in pain). As suggested by our results, the affective incongruence of the presented stimuli is a significant factor influencing affective evaluation, constituting a crucial component of the early empathic response. These findings support our hypothesis regarding the important role of affect in attractiveness research. It is important to remember that any study of empathy is analyzed in a social context, where empathy is understood as the observer's response to the emotional state of the observed person. As a result, researchers are more likely to focus on the social aspects of the reaction than on the emotional stimulus itself and whether this stimulus elicits responses in the brain similar to those that occur during the experience of pain. A meta-analysis by Coll et al. [ 10 ] indicates that the emergence of the N2 component in studies on empathy for pain requires careful interpretation. It cannot be automatically assumed that the presence of this component means the full experience of empathy. As recommended by Coll and colleagues [ 31 ], the results regarding the recognition of others' emotions should not be overextended to the entire process of empathy. The third Hypothesis (H3) concerned the P3 component, in which categorization features and facilitated processing were emphasized [ 15 , 16 , 17 ]. According to our assumptions, the amplitude of the P3 component was significantly larger for painful compared to non-painful stimulation within the block with unattractive primed stimuli. Research on empathy for pain indicates that the amplitude of this component is insensitive to experimental manipulations of the stimulus appearance [e.g., 32]. Therefore, we predicted that the target's attractiveness would not affect the P3. Nevertheless, the congruence of the prime’s valence with the target stimulus and the task of the participant focusing attention on painful stimuli could lead to faster classification and greater engagement of cognitive resources. Finally, consistent with behavioural results, participants consistently rated painful stimuli as more painful than non-painful ones, confirming the accuracy of stimulus perception. Our assumptions regarding the influence of the prime on pain assessment were partially confirmed. Regardless of the primed stimulus, higher scores on the pain intensity scale were obtained for unattractive models rather than attractive ones, which aligns with the observations of Kopiś and Meng [ 18 , 19 ]. In the context of priming, participants’ ratings were significantly lower when the face of a less attractive model in a painful situation preceded a prime showing an attractive face. Conversely, when the primed stimulus and the subsequent photo of the model in a painful situation were congruent in terms of valence (prime and target stimulus: less attractive model), pain intensity ratings were significantly higher. This result may indicate important implications related to affective preparation, visible both in the amplitude of ERP components and in the behavioural ratings of participants. The results of this study indicate a significant role of affective conflict in modulating early empathic processing (N2), which may modify the selectivity of attention and prepare the cognitive system for further classification of the stimulus. In turn, the results for the late P3 component and the results of the behavioural response fit into the model of top-down processes in the context of empathy, where the congruence of valence between the anticipatory and target stimuli promotes more effective affective processing and faster integration of emotional information [ 2 , 27 ]. Several limitations of this study warrant consideration. First, masked priming may limit conclusions about conscious empathy modulation. Thus, perhaps it would be better to use the neural adaptation procedure. Second, static faces with syringe-related pain cues may not fully capture real-world empathy dynamics. This kind of stimulus may be associated with aesthetic medicine treatments. Third, the N2 component showed unexpected effects that conflicted with empathy-specific interpretations, suggesting broader affective processing rather than empathy-specific mechanisms [ 10 , 9 ]. Finally, although we reported statistically significant results, the partial effect size is unsatisfactory. Although this is the norm in EEG studies [ 33 ], the results should be interpreted cautiously. Methods Participants The study involved 60 participants. To estimate the required sample size, we relied on previous studies on the relationship between attractiveness and pain with an analogous experimental procedure [ 18 ]. Based on the results of the mean amplitude values ​​for the individual conditions from the study, the required sample size for the stimulus x attractiveness interaction was estimated using the GLIMMPSE (General Linear Mixed Model Power and Sample Size) software [ 34 ] for the N2 component. Assuming a standard deviation of the results at the level of 0.166 microvolts and homogeneous variance between conditions, it was estimated that the required sample size should be 33 participants. Without more specific data from other studies and considering the EEG method, we decided to increase the sample size to a minimum of 50 participants. Consequently, data from 53 participants (28 females, M age =21.43, SD age =2.91, age range: 19–29; 25 males, M age =22.08, SD age =2.94, age range: 18–28) were analysed; considering artefacts in the EEG signal, the data from seven participants were removed from the analysis. All participants were right-handed, had normal or corrected-to-normal vision, and none of them had any neurological diseases in the past or suffered from chronic pain caused by an illness. Further exclusion criteria were past or present substance abuse or use of psychopharmaceuticals within the last three months. Participants were recruited via advertisements posted on the university website, so most participants were students. Written consent was obtained at the outset of the study. Participants were informed that their participation was voluntary and that they may end the procedure anytime. All participants were volunteers and received 100 PLN (~ 24 $ ). Stimuli The stimuli were taken from the Chicago Face Database [ 35 ] http://faculty.chicagobooth.edu/bernd.wittenbrink/cfd/index.html , website: https://figshare.com/search?q=faces ; and also face bases available: [ 36 ]). Faces were controlled for attractiveness. At first, 50 participants (25 females; M = 22.14; SD = 3.71) evaluated 439 pictures of faces on a 1–9 scale (1 - very unattractive person; 9 - very attractive person). The procedure contain instructions and one testing trial. Participants saw the fixation cross (1 sec.) after that, face for one second, which they evaluated on a scale. The total procedure took approximately 30 minutes, and there were three breaks. Then, we selected ten attractive faces (5 females M = 5,89; SD = 0,13; 5 males M = 5,78; SD = 0,18) and ten unattractive faces (5 females M = 1,99; SD = 0,12; 5 males M = 1.96; SD = 0.11) as a priming stimulus. Additionally, we selected 30 other attractive faces (15 females M = 5,91; SD = 0,26; 15 males M = 5,47; SD = 0,27) and 30 unattractive faces (15 females M = 2,25; SD = 0,07; 15 males M = 2,23; SD = 0,09). To evoke the empathic response, we added to those 60 faces a syringe (painful) or cotton tip (non-painful), as in Meng et al. [ 19 ] and Kopiś et al. [ 18 ] study. There were two versions of the syringe and cotton tip, and the objects were placed on the left and right sides of the cheek. Thus, in the whole procedure (for both groups), there were 480 stimuli (60*2 (painful/non-painful)*2 (versions of the objects)*2 (left/ right side)). Instruments and Materials To control for trait empathy, participants completed the Interpersonal Reactivity Index (IRI) developed by Davis [37; Polish version: 38] The Polish version of the IRI has three subscales: Empathic Concern, Personal Distress and Perspective Taking [ 38 ]. The IRI contains 28 statements rated on a 5-point Likert-type scale (1 - completely disagree; 5 - strongly agree). Reliability was measured using Cronbach's alpha = 0.78 for the Empathic Concern dimension, Cronbach's alpha = 0.78 for the Personal Distress dimension, and Cronbach's alpha = 0.74 for the Perspective Taking dimension [38 p. 15]. The empathy dimensions were assessed using the Interpersonal Reactivity Index [IRI; 39, 38] (see Table 3 ). Table 3 Interpersonal Reactivity Index (IRI) results. Interpersonal Reactivity Index M/SD Range Empathic Concern 40.26/5.99 24–55 Perspective Taking 35.26/4.34 25–43 Personal Distress 22.87/6.97 10–38 EEG Acquisition Brain bioelectrical activity was recorded using 64 Ag/AgCl actiCap active electrodes (Brain Products, GmbH, Germany). The electrodes were connected to an actiCHamp amplifier (Brain Products, GmbH, Germany). A digital recording of the brain's bioelectrical activity was carried out with BrainVision Recorder 1.22.0001. software. The electrode locations were based on the extended international 10–20 system [ 40 ]. The EEG was referenced to an FCz electrode online digitised at a sample rate of 250 Hz. Electrode impedance was kept below 10 kΩ. EEGLAB toolbox for MATLAB was used for data processing and analyses [ 41 ]. EEG Analysis Data were filtered using a Sinc FIR filter (0.1–45 Hz). After that, the automatic procedure for rejecting and correcting "non-stationary" artifacts and bad channels (ASR) was used [ 42 ]. After, common average reference and signal decomposition using the Independent Component Analysis (ICA) methods were applied. We removed artifactual ICA components, and data were segmented − 600 to 1000 ms from the onset of the experimental stimulus, with pre-stimulus level correction: -550 to -350 ms. The average value of the segments per experimental condition was calculated. Mean N2 and P3 and component amplitudes were measured at frontal (N2: F3, Fz, F4; time-windows 200–280 ms), and parietal (P3: P3, Pz, P4; time-windows P3: 300–500 ms) electrode sites based on a visual inspection and similar as in studies [ 18 , 9 ], locked to the onset of the face stimuli, respectively. Statistical analysis The three-way repeated measures ANOVA was applied for the pain intensity ratings for behavioural data. The PRIME (unattractive model vs attractive model), ATTRACTIVENESS (unattractive presented model vs attractive presented model) and STIMULUS (painful vs non-painful) factors were included in the model as within-subjects factors. The simple effects analysis was calculated using Bonferroni adjustment. The effect size was calculated as the partial eta square ( η p 2 ). For electroencephalography data, the three-way repeated measures ANOVA with PRIME (unattractive model vs. attractive model), ATTRACTIVENESS (unattractive presented model vs. attractive presented model) and STIMULUS (painful vs. non-painful) as within-subjects factors were used for every mean event-related potential components such as N2 and P3. The simple effects were analysed using Bonferroni adjustment. The partial eta square ( η p 2 ) was used to assess effect size. Priming Procedure The research was conducted under standardised conditions at [masked for the reviewers]. A computer and an electroencephalograph were used in the experiment. The PsychoPy 2023.2.3 software was used to design the experimental procedure. Brain bioelectrical activity was recorded using 64 Ag/AgCl actiCap active electrodes (Brain Products, GmbH, Germany). Instructions and tasks for all participants were displayed on a 24-inch monitor. Participants read the instructions containing general information about the experiment's goal. The participants' main task was to evaluate the pain observed in the pictures. The one trial started with a presentation of the fixation point in the middle of the computer screen for 500 ms then, for ~ 50 ms, a mask with white noise was presented, after the prime picture was presented for ~ 17 ms (attractive or unattractive face), again there was a mask for ~ 50 ms after that blank screen for 200 ms and then an attractive or unattractive face with painful or non-painful stimulation for 1000 ms. After that, participants were asked to rate the level of pain felt by the person in the photo. Participants gave their responses on a 1 (lack of pain) to 5 (very painful) scale. It is worth adding that the experiment was divided into two blocks (unattractive face prime and attractive face prime) and presented in random order. The primed face and the face in the painful/non-painful condition were the same sex. The whole experiment procedure took about 45 minutes (Fig. 3 ). The study was conducted following the Declaration of Helsinki and approved by the research team's university [masked for reviewers] ethics committee (No: KEBN_13/2023). All participants gave written informed consent to participate in the study. Declarations Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and approved by the research team's The John Paul II Catholic University of Lublin ethics committee (No: KEBN_13/2023.). All participants gave written informed consent to participate in the study. Consent for publication: Not applicable Data Availability: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests: The authors declare that they have no competing interests Funding: This study was funded by the National Science Centre, Poland (Grant No.UMO-2021/41/N/HS6/01044). Authors' contributions: NKP– Software, Validation, Investigation, Resources, Data Curation, Writing - Original Draft, Visualization, Project administration AC – Methodology, Formal analysis, Writing - Original Draft, Writing - Review & Editing, Supervision EZM– Methodology, Writing - Original Draft, Writing - Review & Editing, Supervision MSz - Writing - Review & Editing, Data Curation. Acknowledgements: We would like to thank Tomasz Jankowski for his help in project coordination. References Decety, J. & Jackson, P. L. The functional architecture of human empathy. Behav. Cogn. Neurosci. Rev. 3 , 71–100 (2004). Fan, Y. & Han, S. Temporal dynamic of neural mechanisms involved in empathy for pain: an event-related brain potential study. Neuropsychologia 46 , 160–173 (2008). Singer, T. et al. 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Kopiś-Posiej, N. & Cudo, A. Empathic response or affective response: a study on the affective cue in the empathy for pain paradigm. Adv. Cogn. Psychol. 20 , 167–177 (2024). Coll, M. P. Meta-analysis of ERP investigations of pain empathy underlines methodological issues in ERP research. Soc. Cogn. Affect. Neurosci. 13 , 1003–1017 (2018). Kolańczyk, A. Stany uwagi sprzyjające wpływom afektu na ocenianie [States of attention fostering influences of affect on judgments]. Stud. Psychol. 42 , 93–109 (2004). Rottenberg, J. & James, J. G. When emotion goes wrong: Realizing the promise of affective science. Clin. Psych . 10 (2), 227–232 (2003). Pan, F., Shi, L., Zhang, L., Lu, Q. & Xue, S. Different stages, different signals: the modulating effect of cognitive conflict on subsequent processing. PLoS One . 11 , e0163263 (2016). Peng, W. et al. Reduced empathic pain processing in patients with somatoform pain disorder: evidence from behavioral and neurophysiological measures. Int. J. Psychophysiol. 139 , 40–47 (2019). Marzouki, Y., Midgley, K. J., Holcomb, P. J. & Grainger, J. An ERP investigation of the modulation of subliminal priming by exogenous cues. Brain Res. 1231 , 86–92 (2008). Sessa, P., Meconi, F. & Han, S. Double dissociation of neural responses supporting perceptual and cognitive components of social cognition: evidence from processing of others' pain. Sci. Rep. 4 , 6584 (2014). Sessa, P., Meconi, F., Castelli, L. & Dell’Acqua, R. Taking one’s time in feeling other-race pain: an event-related potential investigation on the time-course of cross-racial empathy. Soc. Cogn. Affect. Neurosci. 9 , 454–463 (2014). Kopiś, N., Francuz, P., Zabielska-Mendyk, E. & Augustynowicz, P. Feeling other people's pain: an event-related potential study on facial attractiveness and emotional empathy. Adv. Cogn. Psychol. 16 , 169–179 (2020). Meng, J., Hu, L., Shen, L., Yang, Z. & Chen, H. The interaction between pain and attractiveness perception in others. Sci. Rep. 10 , 2038 (2020). Lan, M., Peng, M., Zhao, X., Li, H. & Yang, J. Neural processing of the physical attractiveness stereotype: ugliness is bad vs. beauty is good. Neuropsychologia 155 , 107824 (2021). Rellecke, J., Palazova, M., Sommer, W. & Schacht, A. Automaticity in attractive face processing: brain potentials from a dual task. Neuroreport 22 , 706–710 (2011). Henson, R. N., Mouchlianitis, E., Matthews, W. J. & Kouider, S. Electrophysiological correlates of masked face priming. Neuroimage 40 , 884–895 (2008). Xu, M., Lauwereyns, J. & Iramina, K. Dissociation of category versus item priming in face processing: an event-related potential study. Cogn. Neurodyn. 6 , 155–167 (2012). Murphy, S. T. & Zajonc, R. B. Affect, cognition, and awareness: affective priming with optimal and suboptimal stimulus exposures. J. Pers. Soc. Psychol. 64 , 723–739 (1993). Shtudiner, Z. E., Siniver, E., Tobol, Y. & Yaniv, G. Gender and priming of facial attractiveness: a lab-in-the-field experiment on dishonesty. SSRN 4196049 (2022). Ma, Q. & Hu, Y. Beauty matters: social preferences in a three-person ultimatum game. PLoS One . 10 , e0125806 (2015). Rohr, M. & Wentura, D. Degree and complexity of non-conscious emotional information processing – a review of masked priming studies. Front. Hum. Neurosci. 15 , 689369 (2021). Yong, L., Wei-Na, Z. & De-Li, S. Subliminal affective priming effect by faces with different valence: an ERP study. Acta Psychol. Sin (2010). Comesaña, M. et al. ERP correlates of masked affective priming with emoticons. Comput. Hum. Behav. 29 , 588–595 (2013). Vecchio, A. & De Pascalis, V. ERP indicators of situational empathy pain. Behav. Brain Res. 439 , 114224 (2023). Coll, M. P. et al. Are we really measuring empathy? Proposal for a new measurement framework. Neurosci. Biobehav Rev. 83 , 132–139 (2017). Contreras-Huerta, L. S., Hielscher, E., Sherwell, C. S., Rens, N. & Cunnington, R. Intergroup relationships do not reduce racial bias in empathic neural responses to pain. Neuropsychologia 64 , 263–270 (2014). Luck, S. J. & Gaspelin, N. How to get statistically significant effects in any ERP experiment (and why you shouldn't). Psychophysiology 54 , 146–157 (2017). Kreidler, S. M. et al. GLIMMPSE: online power computation for linear models with and without a baseline covariate. J. Stat. Softw. 54 , 1–26 (2013). Ma, D. S., Correll, J. & Wittenbrink, B. The Chicago face database: a free stimulus set of faces and norming data. Behav. Res. Methods . 47 , 1122–1135 (2015). Strohminger, N. et al. The MR2: a multi-racial, mega-resolution database of facial stimuli. Behav. Res. Methods . 48 , 1197–1204 (2016). Davis, M. H. A multidimensional approach to individual differences in empathy. JSAS Cat Sel. Doc. Psychol. 10 , 85 (1980). Kaźmierczak, M., Plopa, M. & Retowski, S. Skala wrażliwości empatycznej. Przegl Psychol. 50 , 9–24 (2007). Davis, M. H. Measuring individual differences in empathy: evidence for a multidimensional approach. J. Pers. Soc. Psychol. 44 , 113–126 (1983). Jasper, H. H. The ten-twenty electrode system of the international federation. Electroencephalogr. Clin. Neurophysiol. 10 , 371–375 (1958). Delorme, A. & Martin, A. J. IEEE,. Automated data cleaning for the Muse EEG. In Proc. IEEE Int. Conf. Bioinform. Biomed. (BIBM) , 1–4 (2021). Mullen, T. R. et al. Real-time neuroimaging and cognitive monitoring using wearable dry EEG. IEEE Trans. Biomed. Eng. 62 , 2553–2567 (2015). Additional Declarations No competing interests reported. Supplementary Files SM1.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6683265","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":467458082,"identity":"94b3fd78-7186-4435-b332-22225e26f15c","order_by":0,"name":"Natalia Kopiś-Posiej","email":"data:image/png;base64,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","orcid":"","institution":"The John Paul II Catholic University of Lublin","correspondingAuthor":true,"prefix":"","firstName":"Natalia","middleName":"","lastName":"Kopiś-Posiej","suffix":""},{"id":467458084,"identity":"63f752fc-7128-4c32-be3e-cdb664082f17","order_by":1,"name":"Andrzej Cudo","email":"","orcid":"","institution":"The John Paul II Catholic University of Lublin","correspondingAuthor":false,"prefix":"","firstName":"Andrzej","middleName":"","lastName":"Cudo","suffix":""},{"id":467458086,"identity":"f535bd4e-5e0c-4c3a-850b-c3d8ec6a4165","order_by":2,"name":"Emilia Zabielska-Mendyk","email":"","orcid":"","institution":"The John Paul II Catholic University of Lublin","correspondingAuthor":false,"prefix":"","firstName":"Emilia","middleName":"","lastName":"Zabielska-Mendyk","suffix":""},{"id":467458087,"identity":"283b1348-6994-4321-aff8-66fb6bf836a6","order_by":3,"name":"Magdalena Szwed","email":"","orcid":"","institution":"Maria Curie-Sklodowska University in Lublin","correspondingAuthor":false,"prefix":"","firstName":"Magdalena","middleName":"","lastName":"Szwed","suffix":""}],"badges":[],"createdAt":"2025-05-16 20:08:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6683265/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6683265/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84305238,"identity":"d35746f4-3f75-483f-9216-95241680b39a","added_by":"auto","created_at":"2025-06-10 11:24:03","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":2029214,"visible":true,"origin":"","legend":"\u003cp\u003eSignificant interaction effect of the STIMULUS × ATTRACTIVENESS × PRIME in N2 ERP component. Only when an attractive face was primed, the amplitude was more negative for the attractive model than for the unattractive model presented in painful condition\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6683265/v1/fbeabacc9a1ac469ee62cc4e.jpeg"},{"id":84305340,"identity":"3c771c74-d256-45ef-940b-a2cfb9213b0b","added_by":"auto","created_at":"2025-06-10 11:24:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":214107,"visible":true,"origin":"","legend":"\u003cp\u003eSignificant interaction effect of the STIMULUS × PRIME in P3 ERP component\u003c/p\u003e","description":"","filename":"floatimage222.png","url":"https://assets-eu.researchsquare.com/files/rs-6683265/v1/ddc86be345c32797d1e34f07.png"},{"id":84305475,"identity":"9126b9bc-774b-4fe0-b2a5-80ff5d1a481c","added_by":"auto","created_at":"2025-06-10 11:24:14","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":202297,"visible":true,"origin":"","legend":"\u003cp\u003eIllustration of the experimental procedure. The procedure was divided into two blocks: in one block, only attractive faces were primed, and in the other block, only unattractive faces were primed.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-6683265/v1/f2c93e57df1dde8adbc6deaa.png"},{"id":85533320,"identity":"48beec79-2ee9-410b-b23d-fd1eff3b6087","added_by":"auto","created_at":"2025-06-27 03:46:54","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3231558,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6683265/v1/a0939334-aaa3-409b-a6f9-f6e56652f9b5.pdf"},{"id":84305436,"identity":"2946773e-258c-4ebb-b012-b35989f03571","added_by":"auto","created_at":"2025-06-10 11:24:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":80214,"visible":true,"origin":"","legend":"","description":"","filename":"SM1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6683265/v1/d9a7ea1029f51071e9bbd8d2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Primed by Beauty or Not? How Facial Attractiveness Influences Neural and Behavioral Empathy for Pain","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEmpathy as a theoretical construct is usually described through its two main aspects: the affective experience of the other's present or inferred emotional state, referred to as emotional empathy, and at least some recognition and understanding of other people's state known as cognitive empathy [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Empathy is frequently operationalised in research through the psychophysiological reaction elicited by observing stimuli related to other people's pain [e.g., 2]. For humans, pain is a stimulus that engages and focuses attention; this applies to stimuli from the external environment and those originating from the body. Based on the results of neuroimaging studies [see 4,5,6,7] it can be indicated that when observing stimuli showing painful situations, specific brain structures like: insular cortex and cingulate cortex, ventral medial prefrontal cortex, superior temporal cortex, and temporo-parietal junction, are active. Activation of these areas may be associated with personal suffering [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], perceived unpleasantness [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], and perceived intensity of pain [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn electroencephalographic (EEG) studies, there were differences in the amplitude of event-related potentials (ERP) components registered between painful and non-painful stimuli in time windows corresponding to the N1, N2, P2 and P3 components [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In previous research [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], this difference was interpreted as an occurrence of early process of the empathic reaction to the perception of painful social stimuli in contrast to non-painful social stimuli. Nevertheless, it is worth mentioning that, according to recent studies, the interpretation of early ERP results should also consider general affective processes rather than just affective empathy [see 9, 10]. Affect encompasses an emotional state strongly connected with valence [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Affect depends on the presence of specific stimuli [e.g., 12]. This implies that exposure to a stimulus associated with pain (e.g., a needle or a knife) may elicit in the participant a response linked to an affective reaction characterized by negative valence.\u003c/p\u003e \u003cp\u003eThus, the N2 ERP component was considered a \"semiautomatic\" component (after early automatic processing, reflected in the N1 and P2) that is often interpreted as early conflict detection [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Additionally, the N2 amplitude may be connected with processes related to affective arousal in response to the observed stimulus [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. On the other hand, the amplitude of the P3 ERP component is sensitive to categorizing the target stimulus [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Also, according to Sessa et al. [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], higher P3 amplitudes have been linked to greater empathy levels, indicating that individuals are more engaged in evaluating the emotional context of the observed pain. This may suggest that when individuals see situations in which others perceive pain, their cognitive resources are mobilized to process the emotional and social implications of that pain. In this context, the general affective processes may be connected with the early process of the empathic reaction.\u003c/p\u003e \u003cp\u003eStudies on early process of empathic response have focused on bias in empathy [e.g. 17 \u0026ndash; racial bias in empathy]. However, differences in ERP empathic response emerge not only due to the participant's ethnic group status. Kopiś et al. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and Meng et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] found that the early process of empathic reaction decreases when the participants see a physically attractive model compared to a less attractive model. In components such as N2 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and P3 [during pain judgment; 19], the difference between the painful and the non-painful stimulus occurred only when the participants look at less attractive models. It was found that looking at faces perceived as highly attractive may have a weakening effect on the early process of empathic response [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] and, at the same time, distract the attention of participants from pain [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUndoubtedly, facial physical attractiveness is strongly associated with the well-documented stereotype \"what is beautiful is good\" [e.g. 20]. However, within the specific context of empathy for pain as examined through EEG/ERP paradigms, physical attractiveness appears to exert a paradoxically adverse effect on pain perception. This raises important questions regarding the underlying factors that modulate these outcomes. In the present study, we aimed to investigate whether the affective valence linked to facial attractiveness influences early process of empathic responses.\u003c/p\u003e \u003cp\u003ePrior research [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] has demonstrated that physically attractive faces typically elicit positive valence, whereas less attractive faces tend to evoke negative valence. Possibly, the simultaneous presentation of a highly attractive face alongside a negative, pain-related stimulus (e.g., a needle stuck in the cheek of the model) may induce affective conflict, thereby complicating the unambiguous evaluation of the affective valence content. To explore these dynamics, we used a \u0026lsquo;sandwich-masked faces\u0026rsquo; paradigm. This paradigm is used to study unconscious visual processing, particularly of faces where the prime and probe belong to the same or different category \u0026mdash;used, for example, to judge fame [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Our procedure involved presenting, in a very brief time, a face stimulus (the \"prime\" \u0026minus;\u0026thinsp;17 ms) that is preceded and followed by visual masks and subsequent probe stimuli. The prime stimuli were pictures of attractive (one block) or unattractive faces (another block). The probe stimuli that occurred after priming were attractive and unattractive faces in painful or non-painful situations [see. 18, 19]. The prime and target faces were different to demonstrate that the affective features of masked primes are processed.\u003c/p\u003e \u003cp\u003eIt has been shown that behavioural and neural responses are modulated by pre-exposure to a face from the same category [e.g., 23]. These effects suggest that category priming enhances processing efficiency for faces sharing categorical features even when the exact identity differs. Additionally, previous studies have shown that priming with faces of varying attractiveness can modulate the evaluation of subsequent stimuli [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and influence social behaviours, including honesty [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], or altruism [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWithin the framework of unconscious affective processing, it is posited that automatic processing of the primed stimulus activates its evaluative connotation, thereby \u0026ldquo;preparing\u0026rdquo; the cognitive and affective system for the response to the target stimulus despite the stimulus\u0026rsquo; task irrelevance and masking [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Thus, our procedure was designed to isolate the influence of valence and to understand affective conflicts in the pain empathy paradigm. Considering previous research [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], it should be noted that attractive and unattractive model faces as a stimulus with opposite valance may lead to affective conflict in painful situations. Considering the ERP components relevant to affective priming research [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] and to research on empathy for pain [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], we decided to measure the amplitude of the N2 and P3 components.\u003c/p\u003e \u003cp\u003eThe N2 component is recognized as an index of early attentional allocation and the detection of cognitive or affective conflict; we hypothesize that the amplitude of the N2 will differ significantly under conditions of attractive faces as prime in painful situations. Specifically, we predict that the N2 amplitude will be significantly lower for painful stimuli compared to non-painful within the block with attractive primed stimuli (H1). Furthermore, we predict that the physical attractiveness of the target faces presented after priming will modulate the affective processing reflected in the N2 component. Accordingly, we expect a significant interaction effect whereby the N2 amplitude in the pain condition will differ between attractive and unattractive target faces, particularly in the context of priming with attractive faces as positive valence stimuli (H2).\u003c/p\u003e \u003cp\u003eAdditionally, we assumed that a masked prime related to the target image would enhance the P3 amplitude of the target, reflecting facilitated processing and easier target classification. Thus, the amplitude of the P3 component will be significantly larger for painful compared to non-painful stimulation within the block with unattractive primed stimuli (H3).\u003c/p\u003e \u003cp\u003eFinally, in masked priming tasks, the participant's task is to classify the viewed stimulus into categories related to the prime. Still, in pain empathy studies, the tasks focus on pain assessment. Since the study aims to measure empathic response, the participant's task is to assess the intensity of pain experienced by the model in the picture, which is considered an appropriate approach in empathy research [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Thus, we assume that similarly to the hypotheses regarding ERP components, the assessment of the intensity of pain experienced by others will be lower when the target stimuli (faces in painful situations) are primed with an attractive face, compared to conditions primed with an unattractive face (H4). Moreover, this effect will be particularly visible when both the prime and the target stimulus are attractive (H5).\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eBehavioural results\u003c/h2\u003e \u003cp\u003eFor the pain intensity ratings, there was a statistically significant main effect of the ATTRACTIVENESS, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;24.87, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.32 (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Specifically, when unattractive models (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.30, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.06) were presented, the pain intensity rating was higher than when attractive models (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.10, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.07) were presented. Additionally, there was a main effect of the STIMULUS, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;98.24, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.65. In this context, the painful stimuli were rated higher (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.93, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.12) than the non-painful stimuli (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.47, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.06) in the pain intensity rating scale.\u003c/p\u003e \u003cp\u003eThere was also a statistically significant interaction effect of the ATTRACTIVENESS \u0026times; PRIME, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;5.89, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.019, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.10 (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The simple effects analysis showed differences between attractiveness conditions in the conditions related to priming by the unattractive-model (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and the attractive model (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). For the unattractive model prime, the pain intensity ratings were higher when unattractive models (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.32, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.06) were presented than when attractive models (M\u0026thinsp;=\u0026thinsp;2.08, SE\u0026thinsp;=\u0026thinsp;0.07) were presented. Similarly, for the attractive-model prime, the pain intensity ratings were higher when unattractive models (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.29, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.06) were presented than when attractive models (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.11, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.07) were presented. Additionally, no significant differences between priming conditions were observed in the unattractive and attractive presented model conditions, separately.\u003c/p\u003e \u003cp\u003eThe STIMULUS \u0026times; ATTRACTIVENESS \u0026times; PRIME interaction effect was statistically significant, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;13.06, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.20 (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The simple effects analysis showed differences between the painful and non-painful stimuli in the unattractive presented model condition (p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and attractive presented model condition (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) among priming condition related to presented unattractive models. Analogously, there were statistically significant differences between stimulus conditions in the unattractive presented model (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and attractive presented model (p\u0026thinsp;\u0026lt;\u0026thinsp;.001) among priming condition related to presented attractive models. More specifically, painful stimuli were rated as more painful than non-painful stimuli at the level of the other conditions. The simple effects analysis showed differences between the unattractive presented model and the attractive presented model in the painful stimuli condition (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and non-painful stimuli condition (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) among priming condition related to presented unattractive models. Analogously, there were statistically significant differences between attractiveness conditions in the painful stimuli condition (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.008) and non-painful stimuli condition (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) among priming condition related to presented attractive models. Specifically, when unattractive models were presented the pain intensity rating was higher than when attractive models were presented at the level of the other conditions (see supplementary materials).\u003c/p\u003e \u003cp\u003eMoreover, the simple effects analysis showed differences between the priming condition in painful stimuli condition among unattractive presented model condition (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.007). More precisely, the pain intensity ratings were higher when unattractive model primes were presented (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.10, SE\u0026thinsp;=\u0026thinsp;0.11) than when attractive model primes were presented (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.98, SE\u0026thinsp;=\u0026thinsp;0.11) in painful stimuli among unattractive presented model condition. Other analogous comparisons were statistically insignificant (\u003cem\u003eps\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;.219). The means and standard errors of the pain intensity rating scores for each condition are shown in supplementary materials.\u003c/p\u003e \u003cp\u003eOther main effects and interaction effects were statistically insignificant (\u003cem\u003eFs\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;2.38, \u003cem\u003eps\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;.129).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBehavioural results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEffects\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eηp2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eATTRACTIVENESS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e27.55\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.330\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSTIMULUS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e102.89\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.65\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePRIMING x ATTRACTIVENESS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e4.89\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.031\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.08\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING x STIMULUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eATTRACTIVENESS x STIMULUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePRIMING x ATTRACTIVENESS x STIMULUS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e14.606\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.21\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cem\u003eNote: Statistically significant results were bolded.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eElectroencephalography results\u003c/h3\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eN2 component\u003c/h2\u003e \u003cp\u003eFor the N2 component, the STIMULUS \u0026times; ATTRACTIVENESS \u0026times; PRIME interaction effect was statistically significant, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;4.45, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.040, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.08. The simple effects analysis showed differences only in the attractiveness prime condition between attractive and unattractive models in the pain (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.004). Only when an attractive face was primed, the N2 component amplitude was more negative for the attractive model (\u003cem\u003eM\u003c/em\u003e=-2.66\u0026micro;V, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.40\u0026micro;V) than for the unattractive model (\u003cem\u003eM\u003c/em\u003e=-2.10\u0026micro;V, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.35\u0026micro;V) presented in painful condition (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNo analogous statistically significant differences were found between attractiveness conditions in the non-painful condition. The simple effects analysis showed no differences between the painful vs non-painful stimulus in unattractive and attractive presented model conditions, separately. The main effects and other interaction effects were statistically insignificant (see Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eP3 component\u003c/h3\u003e\n\u003cp\u003eThere was a statistically significant main effect of the ATTRACTIVENESS, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;15.05, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.22. More specifically, the amplitude of the P3 component was more positive in the attractive presented model condition (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.18\u003cem\u003e\u0026micro;V\u003c/em\u003e, SE\u0026thinsp;=\u0026thinsp;0.3\u003cem\u003e\u0026micro;V\u003c/em\u003e) than the unattractive presented model condition (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.96\u003cem\u003e\u0026micro;V\u003c/em\u003e, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.28\u003cem\u003e\u0026micro;V\u003c/em\u003e). Additionally, there was a main effect of the STIMULUS, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;9.12, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.004, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.15. More precisely, the amplitude of the P3 component was more positive in painful condition (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.21\u003cem\u003e\u0026micro;V\u003c/em\u003e, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.31\u003cem\u003e\u0026micro;V\u003c/em\u003e) than in non-painful condition (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.93\u003cem\u003e\u0026micro;V\u003c/em\u003e, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.28\u003cem\u003e\u0026micro;V\u003c/em\u003e).\u003c/p\u003e \u003cp\u003eMoreover, there was a statistically significant interaction effect of the STIMULUS \u0026times; PRIME, \u003cem\u003eF\u003c/em\u003e (1, 52)\u0026thinsp;=\u0026thinsp;5.63, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.021, \u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.98. The simple effects analysis showed differences between stimulus conditions in the unattractive model condition (p\u0026thinsp;=\u0026thinsp;.003). For the unattractive model condition, the P3 component amplitude was more positive in the painful condition (M\u0026thinsp;=\u0026thinsp;3.32\u0026micro;V, SE\u0026thinsp;=\u0026thinsp;0.33\u0026micro;V) than in the non-painful condition (M\u0026thinsp;=\u0026thinsp;2.84\u0026micro;V, SE\u0026thinsp;=\u0026thinsp;0.28\u0026micro;V) (see Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). There were no significant differences between stimulus conditions in the attractive model condition. Additionally, no significant differences between prime conditions (unattractive presented model vs. attractive presented model) were observed in the painful and non-painful condition, separately. Other main effects and interaction effects were statistically insignificant (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eElectroencephalography results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eN2 component\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEffects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eηp2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.774\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eATTRACTIVENESS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTIMULUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.900\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING x ATTRACTIVENESS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING x STIMULUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eATTRACTIVENESS x STIMULUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.547\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePRIMING x ATTRACTIVENESS x STIMULUS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e4.45\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.040\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.079\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eP3 component\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEffects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eηp2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.883\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eATTRACTIVENESS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e15.05\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.224\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSTIMULUS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e9.12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.149\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING x ATTRACTIVENESS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.495\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePRIMING x STIMULUS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e5.63\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.021\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.098\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eATTRACTIVENESS x STIMULUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.853\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePRIMING x ATTRACTIVENESS x STIMULUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNote: Statistically significant results were bolded.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study aimed to check whether affective valence associated with faces of different attractiveness influences early processes of empathy for pain. Previous studies have reported changes in the empathetic response for attractive vs. less attractive people. More precisely, no significant differences in the amplitude of ERP components were for physically attractive models. This effect was explained by processes related to attention or the lack of similarity between the participant and the model in the photo [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Nevertheless, an important issue that should be considered is the valence of the stimulus. Physically attractive faces are rated more positively than unattractive faces [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Combining attractive faces with a stimulus associated with pain (negative valence) may make the final assessment of the seen stimulus difficult. Therefore, in our study, we decided to use the sandwich-masked face priming paradigm. In our hypotheses, we assumed that the N2 component would register effects related to affective conflict.\u003c/p\u003e \u003cp\u003eThe first hypothesis (H1) concerning the interaction between prime and painful/non-painful stimuli was not confirmed. However, the second hypothesis (H2), which more particularly underlined the conflict related to the stimulus's valence, was confirmed. We registered a significant difference in the amplitude of the N2 component between the attractive and unattractive faces in the pain condition when the prime was also an attractive face.\u003c/p\u003e \u003cp\u003eWe noted that the N2 component may register conflict in the context of stimulus valence [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Specifically, we observed that stimuli depicting attractive individuals in situations of suffering could evoke conflict related to the ultimate evaluation and classification of the stimulus. We propose that the primed stimulus (i.e., an attractive face) influenced the overall evaluative connotation, thereby \"preparing\" the cognitive and affective systems to respond to the target stimulus [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The target stimulus itself also contained conflicting elements (an attractive face in pain versus an unattractive face in pain). As suggested by our results, the affective incongruence of the presented stimuli is a significant factor influencing affective evaluation, constituting a crucial component of the early empathic response. These findings support our hypothesis regarding the important role of affect in attractiveness research.\u003c/p\u003e \u003cp\u003eIt is important to remember that any study of empathy is analyzed in a social context, where empathy is understood as the observer's response to the emotional state of the observed person. As a result, researchers are more likely to focus on the social aspects of the reaction than on the emotional stimulus itself and whether this stimulus elicits responses in the brain similar to those that occur during the experience of pain. A meta-analysis by Coll et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] indicates that the emergence of the N2 component in studies on empathy for pain requires careful interpretation. It cannot be automatically assumed that the presence of this component means the full experience of empathy. As recommended by Coll and colleagues [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], the results regarding the recognition of others' emotions should not be overextended to the entire process of empathy.\u003c/p\u003e \u003cp\u003eThe third Hypothesis (H3) concerned the P3 component, in which categorization features and facilitated processing were emphasized [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. According to our assumptions, the amplitude of the P3 component was significantly larger for painful compared to non-painful stimulation within the block with unattractive primed stimuli. Research on empathy for pain indicates that the amplitude of this component is insensitive to experimental manipulations of the stimulus appearance [e.g., 32]. Therefore, we predicted that the target's attractiveness would not affect the P3. Nevertheless, the congruence of the prime’s valence with the target stimulus and the task of the participant focusing attention on painful stimuli could lead to faster classification and greater engagement of cognitive resources.\u003c/p\u003e \u003cp\u003eFinally, consistent with behavioural results, participants consistently rated painful stimuli as more painful than non-painful ones, confirming the accuracy of stimulus perception. Our assumptions regarding the influence of the prime on pain assessment were partially confirmed. Regardless of the primed stimulus, higher scores on the pain intensity scale were obtained for unattractive models rather than attractive ones, which aligns with the observations of Kopiś and Meng [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In the context of priming, participants’ ratings were significantly lower when the face of a less attractive model in a painful situation preceded a prime showing an attractive face. Conversely, when the primed stimulus and the subsequent photo of the model in a painful situation were congruent in terms of valence (prime and target stimulus: less attractive model), pain intensity ratings were significantly higher. This result may indicate important implications related to affective preparation, visible both in the amplitude of ERP components and in the behavioural ratings of participants.\u003c/p\u003e \u003cp\u003eThe results of this study indicate a significant role of affective conflict in modulating early empathic processing (N2), which may modify the selectivity of attention and prepare the cognitive system for further classification of the stimulus. In turn, the results for the late P3 component and the results of the behavioural response fit into the model of top-down processes in the context of empathy, where the congruence of valence between the anticipatory and target stimuli promotes more effective affective processing and faster integration of emotional information [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral limitations of this study warrant consideration. First, masked priming may limit conclusions about conscious empathy modulation. Thus, perhaps it would be better to use the neural adaptation procedure. Second, static faces with syringe-related pain cues may not fully capture real-world empathy dynamics. This kind of stimulus may be associated with aesthetic medicine treatments. Third, the N2 component showed unexpected effects that conflicted with empathy-specific interpretations, suggesting broader affective processing rather than empathy-specific mechanisms [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Finally, although we reported statistically significant results, the partial effect size is unsatisfactory. Although this is the norm in EEG studies [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], the results should be interpreted cautiously.\u003c/p\u003e "},{"header":"Methods","content":"\u003ch2\u003eParticipants\u003c/h2\u003e\u003cp\u003eThe study involved 60 participants. To estimate the required sample size, we relied on previous studies on the relationship between attractiveness and pain with an analogous experimental procedure [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Based on the results of the mean amplitude values ​​for the individual conditions from the study, the required sample size for the stimulus x attractiveness interaction was estimated using the GLIMMPSE (General Linear Mixed Model Power and Sample Size) software [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] for the N2 component. Assuming a standard deviation of the results at the level of 0.166 microvolts and homogeneous variance between conditions, it was estimated that the required sample size should be 33 participants. Without more specific data from other studies and considering the EEG method, we decided to increase the sample size to a minimum of 50 participants.\u003c/p\u003e\u003cp\u003eConsequently, data from 53 participants (28 females, M\u003csub\u003eage\u003c/sub\u003e=21.43, SD\u003csub\u003eage\u003c/sub\u003e=2.91, age range: 19–29; 25 males, M\u003csub\u003eage\u003c/sub\u003e=22.08, SD\u003csub\u003eage\u003c/sub\u003e=2.94, age range: 18–28) were analysed; considering artefacts in the EEG signal, the data from seven participants were removed from the analysis. All participants were right-handed, had normal or corrected-to-normal vision, and none of them had any neurological diseases in the past or suffered from chronic pain caused by an illness. Further exclusion criteria were past or present substance abuse or use of psychopharmaceuticals within the last three months. Participants were recruited via advertisements posted on the university website, so most participants were students. Written consent was obtained at the outset of the study. Participants were informed that their participation was voluntary and that they may end the procedure anytime. All participants were volunteers and received 100 PLN (~ 24 \u003cspan\u003e$\u003c/span\u003e).\u003c/p\u003e\u003ch3\u003eStimuli\u003c/h3\u003e\u003cp\u003eThe stimuli were taken from the Chicago Face Database [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://faculty.chicagobooth.edu/bernd.wittenbrink/cfd/index.html\u003c/span\u003e\u003cspan address=\"http://faculty.chicagobooth.edu/bernd.wittenbrink/cfd/index.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, website: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://figshare.com/search?q=faces\u003c/span\u003e\u003cspan address=\"https://figshare.com/search?q=faces\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e; and also face bases available: [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]). Faces were controlled for attractiveness. At first, 50 participants (25 females; M = 22.14; SD = 3.71) evaluated 439 pictures of faces on a 1–9 scale (1 - very unattractive person; 9 - very attractive person). The procedure contain instructions and one testing trial. Participants saw the fixation cross (1 sec.) after that, face for one second, which they evaluated on a scale. The total procedure took approximately 30 minutes, and there were three breaks.\u003c/p\u003e\u003cp\u003eThen, we selected ten attractive faces (5 females M = 5,89; SD = 0,13; 5 males M = 5,78; SD = 0,18) and ten unattractive faces (5 females M = 1,99; SD = 0,12; 5 males M = 1.96; SD = 0.11) as a priming stimulus. Additionally, we selected 30 other attractive faces (15 females M = 5,91; SD = 0,26; 15 males M = 5,47; SD = 0,27) and 30 unattractive faces (15 females M = 2,25; SD = 0,07; 15 males M = 2,23; SD = 0,09). To evoke the empathic response, we added to those 60 faces a syringe (painful) or cotton tip (non-painful), as in Meng et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] and Kopiś et al. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] study. There were two versions of the syringe and cotton tip, and the objects were placed on the left and right sides of the cheek. Thus, in the whole procedure (for both groups), there were 480 stimuli (60*2 (painful/non-painful)*2 (versions of the objects)*2 (left/ right side)).\u003c/p\u003e\u003ch2\u003eInstruments and Materials\u003c/h2\u003e\u003cp\u003eTo control for trait empathy, participants completed the Interpersonal Reactivity Index (IRI) developed by Davis [37; Polish version: 38] The Polish version of the IRI has three subscales: Empathic Concern, Personal Distress and Perspective Taking [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The IRI contains 28 statements rated on a 5-point Likert-type scale (1 - completely disagree; 5 - strongly agree). Reliability was measured using Cronbach's alpha = 0.78 for the Empathic Concern dimension, Cronbach's alpha = 0.78 for the Personal Distress dimension, and Cronbach's alpha = 0.74 for the Perspective Taking dimension [38 p. 15]. The empathy dimensions were assessed using the Interpersonal Reactivity Index [IRI; 39, 38] (see Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInterpersonal Reactivity Index (IRI) results.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterpersonal Reactivity Index\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM/SD\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRange\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmpathic Concern\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40.26/5.99\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24–55\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerspective Taking\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.26/4.34\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25–43\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal Distress\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22.87/6.97\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10–38\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003ch2\u003eEEG Acquisition\u003c/h2\u003e\u003cp\u003eBrain bioelectrical activity was recorded using 64 Ag/AgCl actiCap active electrodes (Brain Products, GmbH, Germany). The electrodes were connected to an actiCHamp amplifier (Brain Products, GmbH, Germany). A digital recording of the brain's bioelectrical activity was carried out with BrainVision Recorder 1.22.0001. software. The electrode locations were based on the extended international 10–20 system [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. The EEG was referenced to an FCz electrode online digitised at a sample rate of 250 Hz. Electrode impedance was kept below 10 kΩ. EEGLAB toolbox for MATLAB was used for data processing and analyses [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e\u003ch2\u003eEEG Analysis\u003c/h2\u003e\u003cp\u003eData were filtered using a Sinc FIR filter (0.1–45 Hz). After that, the automatic procedure for rejecting and correcting \"non-stationary\" artifacts and bad channels (ASR) was used [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. After, common average reference and signal decomposition using the Independent Component Analysis (ICA) methods were applied. We removed artifactual ICA components, and data were segmented − 600 to 1000 ms from the onset of the experimental stimulus, with pre-stimulus level correction: -550 to -350 ms. The average value of the segments per experimental condition was calculated. Mean N2 and P3 and component amplitudes were measured at frontal (N2: F3, Fz, F4; time-windows 200–280 ms), and parietal (P3: P3, Pz, P4; time-windows P3: 300–500 ms) electrode sites based on a visual inspection and similar as in studies [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], locked to the onset of the face stimuli, respectively.\u003c/p\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eThe three-way repeated measures ANOVA was applied for the pain intensity ratings for behavioural data. The PRIME (unattractive model vs attractive model), ATTRACTIVENESS (unattractive presented model vs attractive presented model) and STIMULUS (painful vs non-painful) factors were included in the model as within-subjects factors. The simple effects analysis was calculated using Bonferroni adjustment. The effect size was calculated as the partial eta square (\u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e).\u003c/p\u003e\u003cp\u003eFor electroencephalography data, the three-way repeated measures ANOVA with PRIME (unattractive model vs. attractive model), ATTRACTIVENESS (unattractive presented model vs. attractive presented model) and STIMULUS (painful vs. non-painful) as within-subjects factors were used for every mean event-related potential components such as N2 and P3. The \u003cem\u003esimple effects\u003c/em\u003e were analysed using Bonferroni adjustment. The partial eta square (\u003cem\u003eη\u003c/em\u003e\u003csub\u003e\u003cem\u003ep\u003c/em\u003e\u003c/sub\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e) was used to assess effect size.\u003c/p\u003e\u003ch2\u003ePriming Procedure\u003c/h2\u003e\u003cp\u003e The research was conducted under standardised conditions at [masked for the reviewers]. A computer and an electroencephalograph were used in the experiment. The PsychoPy 2023.2.3 software was used to design the experimental procedure. Brain bioelectrical activity was recorded using 64 Ag/AgCl actiCap active electrodes (Brain Products, GmbH, Germany). Instructions and tasks for all participants were displayed on a 24-inch monitor.\u003c/p\u003e\u003cp\u003eParticipants read the instructions containing general information about the experiment's goal. The participants' main task was to evaluate the pain observed in the pictures. The one trial started with a presentation of the fixation point in the middle of the computer screen for 500 ms then, for ~ 50 ms, a mask with white noise was presented, after the prime picture was presented for ~ 17 ms (attractive or unattractive face), again there was a mask for ~ 50 ms after that blank screen for 200 ms and then an attractive or unattractive face with painful or non-painful stimulation for 1000 ms. After that, participants were asked to rate the level of pain felt by the person in the photo. Participants gave their responses on a 1 (lack of pain) to 5 (very painful) scale.\u003c/p\u003e\u003cp\u003eIt is worth adding that the experiment was divided into two blocks (unattractive face prime and attractive face prime) and presented in random order. The primed face and the face in the painful/non-painful condition were the same sex. The whole experiment procedure took about 45 minutes (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e The study was conducted following the Declaration of Helsinki and approved by the research team's university [masked for reviewers] ethics committee (No: KEBN_13/2023). All participants gave written informed consent to participate in the study.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate:\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and approved by the research team\u0026apos;s The John Paul II Catholic University of Lublin ethics committee (No: KEBN_13/2023.). All participants gave written informed consent to participate in the study.\u003c/p\u003e\n\u003cp\u003eConsent for publication:\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003eData Availability:\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests:\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003eFunding:\u003c/p\u003e\n\u003cp\u003eThis study was funded by the National Science Centre, Poland (Grant No.UMO-2021/41/N/HS6/01044).\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions:\u003c/p\u003e\n\u003cp\u003eNKP\u0026ndash; \u0026nbsp; Software, Validation, Investigation, Resources, Data Curation, \u0026nbsp; \u0026nbsp;Writing - Original Draft, Visualization, Project administration AC \u0026ndash; Methodology, Formal analysis, Writing - Original Draft, Writing - Review \u0026amp; Editing, Supervision EZM\u0026ndash; Methodology, Writing - Original Draft, Writing - Review \u0026amp; Editing, Supervision MSz - \u0026nbsp; \u0026nbsp; \u0026nbsp; Writing - Review \u0026amp; Editing, Data Curation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcknowledgements:\u003c/p\u003e\n\u003cp\u003eWe would like to thank Tomasz Jankowski for his help in project coordination.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDecety, J. \u0026amp; Jackson, P. 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R. et al. Real-time neuroimaging and cognitive monitoring using wearable dry EEG. \u003cem\u003eIEEE Trans. Biomed. Eng.\u003c/em\u003e \u003cb\u003e62\u003c/b\u003e, 2553\u0026ndash;2567 (2015).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Empathy, ERP, priming, attractiveness, pain","lastPublishedDoi":"10.21203/rs.3.rs-6683265/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6683265/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eEmpathy for pain is a multifaceted process influenced by both affective and cognitive factors. The present study investigated whether priming faces of varying physical attractiveness modulates early empathic responses to pain, as measured by event-related potentials (ERPs). To explore these dynamics, the \u0026lsquo;sandwich-masked faces\u0026rsquo; paradigm was used. Fifty-three healthy adults viewed photographs of faces rated as highly attractive or unattractive (prime), followed by target images depicting either painful or non-painful situations. Results revealed that attractive facial primes, when paired with painful target stimuli, elicited enhanced N2 amplitudes, indicative of affective conflict during early empathic processing. Additionally, P3 amplitude was higher for painful stimuli following unattractive primes, suggesting facilitated categorization and increased cognitive engagement. Behavioral data showed that pain intensity ratings were generally higher for unattractive models, especially when prime and target valence were congruent. These findings demonstrate that facial attractiveness and affective priming modulate both early and late stages of neural empathic processing, highlighting the complex role of unconscious affective cues in empathy for pain.\u003c/p\u003e","manuscriptTitle":"Primed by Beauty or Not? How Facial Attractiveness Influences Neural and Behavioral Empathy for Pain","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-10 11:23:21","doi":"10.21203/rs.3.rs-6683265/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e363a2be-1126-4fb2-a8a6-4861d9a00870","owner":[],"postedDate":"June 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":49632003,"name":"Biological sciences/Psychology"},{"id":49632004,"name":"Biological sciences/Psychology/Human behaviour"}],"tags":[],"updatedAt":"2025-06-27T03:38:36+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-10 11:23:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6683265","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6683265","identity":"rs-6683265","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}