Metacognition
Do we know how well we judge pain as well as we judge sight?
Open access · cc by · source: Europe PMC
People's confidence tracked the accuracy of their pain judgements just as well as for vision and warmth, but a person's skill at judging their own pain decisions was unrelated to their skill for vision.
Study at a glance
- Design
- Human experiment — Within-subject two-interval forced-choice intensity discrimination in three modalities (visual contrast, innocuous warmth, noxious heat), each followed by a 1-4 confidence rating, with staircases holding accuracy near 70.7%; two sessions on separate days.
- N
- N=36 · 36 healthy adults in the final sample, set by a sequential Bayes-factor stopping rule; incomplete or at-chance datasets were excluded and replaced.
- Population
- Healthy adult volunteers at University College London (18 female, aged 19-38) with normal vision and skin sensation
- Outcome
- Perceptual sensitivity (d'), metacognitive sensitivity (meta-d'), metacognitive efficiency (meta-d'/d') and mean confidence in each modality, and their correlations across modalities
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Key findings
Contrary to the authors' prediction, metacognitive efficiency did not differ between pain, warmth and vision; on average people were close to optimal, with efficiency near 1 in all three tasks. Average confidence also did not differ between modalities, and people who were generally confident in one task were confident in the others. However, individual differences in metacognitive efficiency correlated between vision and warmth (r = 0.42) but not between vision and pain (r = -0.04), suggesting that confidence about pain draws on something extra, perhaps its emotional or arousing quality.
Methodology
Thirty-six adults compared pairs of stimuli and said which was stronger: which of two striped patches had higher contrast, which of two warm touches on the hand was warmer, and which of two hot touches was more painful. After each choice they rated their confidence from 1 to 4. An adaptive staircase kept each task hard enough that people were right about 70.7% of the time, and signal detection theory was used to separate how well people perceived (d') from how well their confidence distinguished right from wrong answers (meta-d', and the ratio meta-d'/d', called metacognitive efficiency).
Limitations
With only 36 participants, estimates of correlations between tasks were imprecise; the warmth-pain correlation was inconclusive, and the authors say the pain-specific finding needs replication. Safety limits meant the warm and painful temperature ranges sat close together, so some 'warm' stimuli felt slightly painful and some 'painful' ones did not, and the warmth task ended up slightly harder than the others. The study measured experimentally induced heat pain in healthy young adults, so it says nothing directly about chronic pain, and the explanation that affect or arousal drives the pain-specific variance was not tested.
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