Statistical learning shapes pain perception and prediction independently of external cues.

The placebo and nocebo effects highlight the importance of expectations in modulating pain perception, but in everyday life we don't need an external source of information to form expectations about pain. The brain can learn to predict pain in a more fundamental way, simply by experiencing fluctuating, non-random streams of noxious inputs, and extracting their temporal regularities. This process is called statistical learning. Here, we address a key open question: does statistical learning modulate pain perception? We asked 27 participants to both rate and predict pain intensity levels in sequences of fluctuating heat pain. Using a computational approach, we show that probabilistic expectations and confidence were used to weigh pain perception and prediction. As such, this study goes beyond well-established conditioning paradigms associating non-pain cues with pain outcomes, and shows that statistical learning itself shapes pain experience. This finding opens a new path of research into the brain mechanisms of pain regulation, with relevance to chronic pain where it may be dysfunctional.

Social uncertainty in the digital world.

The social world is inherently uncertain. We present a computational framework for thinking about how increasingly popular online environments modulate the social uncertainty we experience, depending on the type of social inferences we make. This framework draws on Bayesian inference, which involves combining multiple informational sources to update our beliefs.

"Quite simply they don't communicate": a case study of a National Health Service response to staff suicide.

Workplace suicide can have significant knock-on effects within an organisation, yet research has shown within the healthcare profession, not all staff receive suicide prevention training, and few employers take the time to reflect on the need to change workplace policies or practices following the death of a staff member to suicide. How staff suicide is communicated across an organisation and to family members is important. Effective crisis communication is critical for effective management for a timely and sensitive response to a staff suicide within an organisation. By doing so, workplaces can help to reduce the significant emotional trauma suicide can have on an employee, and support good mental health across its workforce. This study aimed to explore and understand the communication processes around staff suicide across a National Health Service (NHS) Trust and to provide recommendations based on these findings. Semi-structured interviews were conducted with 29 participants, each lasting approximately 90 min. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed. Thematic analysis was used to analyse the data, resulting in seven themes being identified based on communication. Findings indicated that the Trust had no clear communication strategy in place for tackling staff suicide. Each suicide was handled differently, training across staff roles was lacking and operational procedures were deemed insensitive. This paper aimed to provide insight into the communication strategies used in the aftermath of a staff suicide. These findings highlight the inconsistency of the communication, lack of clear policy and guidance and the negative impact this had on staff. Further research is needed across NHS Trusts nationwide to gain insight into the current communication strategies in place to develop a national approach to clear communication following the death of an NHS worker to suicide. Tweetable abstract: Effective communication is critical in the aftermath of an NHS staff suicide. By doing so, NHS Trusts can help to reduce the trauma suicide can have on an employee and support good mental health across its workforce @stann2.

Prior Expectations of Motion Direction Modulate Early Sensory Processing.

Perception is a process of inference, integrating sensory inputs with prior expectations. However, little is known regarding the temporal dynamics of this integration. It has been proposed that expectation plays a role early in the perceptual process, biasing sensory processing. Alternatively, others suggest that expectations are integrated only at later, postperceptual decision-making stages. The current study aimed to dissociate between these hypotheses. We exposed human participants (male and female) to auditory cues predicting the likely direction of upcoming moving dot patterns, while recording neural activity using magnetoencephalography (MEG). Participants' reports of the moving dot directions were biased toward the direction predicted by the cues. To investigate when expectations affected sensory representations, we used inverted encoding models to decode the direction represented in early sensory signals. Strikingly, the cues modulated the direction represented in the MEG signal as early as 150 ms after visual stimulus onset. While this may not reflect a modulation of the initial feedforward sweep, it does reveal a modulation of early sensory representations. Exploratory analyses showed that the neural modulation was related to perceptual expectation effects: participants with a stronger perceptual bias toward the predicted direction also revealed a stronger reflection of the predicted direction in the MEG signal. For participants with this perceptual bias, a correlation between decoded and perceived direction already emerged before visual stimulus onset, suggesting that the prestimulus state of the visual cortex influences sensory processing. Together, these results suggest that expectations play an integral role in the neural computations underlying perception.SIGNIFICANCE STATEMENT Perception can be thought of as an inferential process in which our brains integrate sensory inputs with prior expectations to make sense of the world. This study investigated whether this integration occurs early or late in the process of perception. We exposed human participants to auditory cues that predicted the likely direction of visual moving dots, while recording neural activity with millisecond resolution using magnetoencephalography. Participants' perceptual reports of the direction of the moving dots were biased toward the predicted direction. Additionally, the predicted direction modulated the neural representation of the moving dots just 150 ms after they appeared. This suggests that prior expectations affected sensory processing at early stages, playing an integral role in the perceptual process.