Acetaminophen
reduces
meaning
maintenance
1
Running
head:
Acetaminophen
reduces
meaning
maintenance
The
common
pain
of
surrealism
and
death:
Acetaminophen
reduces
compensatory
affirmation
following
meaning
threats
Key
words:
attitudes,
brain,
meaning,
threat.
Authors’ note:
This research was funded by a grant from the Social Sciences and Humanities Research
Council (410-2011-0409) to Heine and a Social Sciences and Humanities Research
Council Doctoral Fellowship to Randles.
Correspondence to: Steven J. Heine or Daniel Randles, Department of
Psychology, University of British Columbia, 2136 West Mall, Vancouver, B.C., V6T
1Z4, Canada. Email: heine@psych.ubc.ca or dan3791@psych.ubc.ca.
Acetaminophen
reduces
meaning
maintenance
2
ABSTRACT
The
meaning
maintenance
model
argues
that
any
violation
of
expectations
leads
to
an
affective
experience
that
motivates
compensatory
affirmation.
We
explore
whether
the
neural
mechanism
that
responds
to
meaning
threats
can
be
inhibited
by
acetaminophen,
in
the
same
way
that
it
inhibits
physical
pain,
or
the
distress
caused
by
social
rejection.
Across
two
studies,
participants
received
either
acetaminophen
or
a
placebo,
and
were
provided
with
either
an
unsettling
experience
or
a
control
experience.
In
Study
1,
participants
either
wrote
about
their
death
or
a
control
topic.
In
Study
2,
participants
either
watched
a
surrealist
film
clip
or
a
control
film
clip.
In
both
studies,
participants
in
the
meaning
threat
condition
who
had
taken
a
placebo
showed
typical
compensatory
affirmations
by
becoming
more
punitive
towards
law-‐breakers,
while
those
who
had
taken
acetaminophen,
and
those
in
the
control
conditions,
did
not.
Acetaminophen
reduces
meaning
maintenance
3
It does not take long after the opening credits of a David Lynch film for the
viewer to sense that something is awry. Whether it’s the nonlinear dream imagery,
the unsettling juxtaposition of the beautiful alongside the horrifying, or the surreal
disconnect between the events and characters’ reactions, Lynch’s films are
recognized for their ability to “disturb, offend or mystify” (Rodley, 2005, pg. 245).
Insofar as it “hurts” to watch some of Lynch’s films, as it arguably does whenever
we are assaulted by thoughts and experiences that are at odds with our
expectations and values, we might question how this uncomfortable feeling is
represented in the brain. In this paper we explore the common foundation that
underlies people's reactions to various kinds of events that cause anxiety, unease,
and pain.
The
meaning
maintenance
model
(MMM)
proposes
that
domain-‐general
arousal
is
triggered
by
any
experience
that
is
surprising,
confusing,
or
in
violation
of
expectations
(Heine,
Proulx,
&
Vohs,
2006).
In
this
article,
we
extend
recent
work
on
the
common
neural
pathway
for
physical
and
social
pain,
to
suggest
that
any
unexpected
event,
not
just
those
with
a
physical
or
social
component,
produces
the
same
initial
neural
and
subjective
experience
of
distress.
Based
on
this,
we
argue
that
acetaminophen,
shown
to
reduce
both
physical
and
social
pain,
will
also
prevent
typical
meaning
maintenance
responses.
Pain
and
rejection
Acetaminophen
reduces
meaning
maintenance
4
Both
physical
pain
and
social
rejection
share
a
neural
process
and
subjective
component
that
is
experienced
as
distress
(Eisenberger
&
Lieberman,
2004;
MacDonald,
&
Leary,
2005).
While
there
are
experiences
unique
to
each
event,
such
as
the
sensory
awareness
of
specific
pain,
there
are
many
subjective
and
neurological
similarities
that
lead
to
the
same
general
felt
unpleasantness
(Price,
2000).
For
instance,
there
is
evidence
that
experiencing
more
or
less
of
one
type
of
pain,
influences
sensitivity
to
the
other
(Asmundson,
Norton,
&
Jacobson,
1996;
MacDonald,
Kingsbury,
&
Shaw,
2005).
Likewise,
social
support
has
been
found
to
reduce
physical
pain
(Hoogendoorn,
van
Poppel,
Bongers,
Koes,
&
Bouter,
2000),
and
a
number
of
drugs
(including
opiate-‐based
drugs,
anti-‐depressants,
and
acetaminophen)
have
been
shown
to
reduce
both
physical
and
social
pain
(e.g.,
DeWall,
et
al.,
2010;
Panksepp,
2004).
One
brain
region
that
responds
to
both
events
is
the
dorsal
anterior
cingulate
cortex
(dACC).
The
dACC
responds
to
physical
and
social
pain
(Eisenberger,
Lieberman,
&
Williams,
2003)
and
its
activation
is
correlated
with
subjective
reports
of
felt
unpleasantness
after
physical
pain
(Tölle
et
al.,
1999)
and
exclusion
(Eisenberger,
et
al.,
2003).
However,
there
is
evidence
that
the
dACC
reacts
to
all
conflicts
and
errors
in
general
(Botvinick,
Cohen,
&
Carter,
2004).
The
dACC
has
been
described
as
a
cortical
alarm
system,
sensitive
to
any
discrepancy
in
the
environment,
not
just
to
those
that
relate
directly
to
physical
damage
or
social
rejection
(Eisenberger
&
Lieberman,
2004;
Inzlicht,
McGregor,
Hirsh,
&
Nash,
2009;
Shackman
et
al.,
2011).
While
it
is
true
then,
that
an
individual
will
likely
not
confuse
a
stubbed
toe
with
being
picked
last
for
a
soccer
team,
we
suggest
that
the
early-‐
Acetaminophen
reduces
meaning
maintenance
5
stage
neural
mechanisms
for
both
these
events,
or
for
any
perceived
anomaly,
share
much
in
common
and
require
additional
context
to
give
them
specificity.
The
Meaning
Maintenance
Model
The
MMM
focuses
on
people’s
compensatory
responses
to
violations
of
expectations,
termed
meaning
threats.
The
model
argues
that
any
perceived
meaning
threat
produces
unpleasant
arousal
that
often
lies
outside
of
awareness,
and
is
non-‐specific
to
the
causal
stimulus.
This
arousal
arguably
serves
to
prompt
people
to
identify
the
source
of
the
perceived
discrepancy
and,
if
time
and
cognitive
resources
are
sufficiently
available,
accommodate
to
the
unexpected
event.
For
example,
upon
observing
oneself
freely
choose
to
write
an
essay
in
favor
of
a
tuition
increase
at
one’s
university,
a
participant
might
accommodate
to
this
by
changing
their
attitudes
towards
tuition
increases.
In
many
cases,
however,
it
is
not
possible
to
resolve
the
violation,
either
because
the
problem
is
too
complex,
or
the
person
has
failed
to
correctly
identify
the
source
of
their
arousal.
When
this
occurs,
people
may
respond
to
the
arousal
by
affirming
any
available
unrelated
schema
to
which
they
are
committed.
These
affirmations
of
intact
meaning
frameworks
serve
to
dispel
the
unpleasant
sense
that
something
is
wrong.
Consequently,
disturbing
experiences
that
are
as
explicit
and
complex
as
writing
about
one’s
own
death
(Burke,
Martens,
&
Faucher,
2010)
or
dealing
with
social
rejection
(Nash,
McGregor,
&
Prentice,
2011),
down
to
experiences
that
are
relatively
implicit
and
benign,
such
as
subliminally
seeing
incoherent
word-‐pairs
(e.g.,
“quickly-‐blueberry”;
Randles,
Proulx,
&
Heine,
2011)
or
being
presented
with
a
change-‐blindness
manipulation
(Proulx
&
Heine,
2008),
all
lead
to
increased
motivation
to
affirm
unrelated
beliefs.
Acetaminophen
reduces
meaning
maintenance
6
These
kinds
of
affirmation
responses
have
been
identified
in
a
number
of
different
research
paradigms,
such
as
terror
management
theory,
self-‐affirmation,
and
uncertainty
management
(for
reviews
see
Heine
et
al.,
2006;
Proulx,
Inzlicht,
&
Harmon-‐Jones,
2012).
The
dACC
has
been
theorized
to
be
the
source
of
the
unpleasant
arousal
associated
with
uncertainty
and
violations
of
expectations
(McGregor,
Nash,
Mann,
&
Phills,
2010),
and
strong
adherence
to
belief
systems
that
serve
as
affirmations,
such
as
religion
and
political
conservatism,
inhibit
activity
throughout
the
ACC
(Amodio,
Jost,
Master,
&
Yee,
2007;
Inzlicht,
et
al.,
2009).
The
arousal
caused
by
meaning
threats
is
not
always
consciously
accessible,
which
is
a
clear
departure
from
pain
or
social
distress.
However,
when
participants
are
given
an
explanation
for
their
unpleasant
arousal
(e.g.,
being
told
that
it
is
due
to
a
supplement
they
have
taken)
they
attribute
their
distress
to
this
other
source
and
fail
to
show
compensatory
responses
(Kay,
Moscovitch,
&
Laurin,
2010;
Proulx
&
Heine,
2008;
Zanna
&
Cooper,
1974),
suggesting
that
they
are
in
fact
experiencing
some
form
of
distress
or
negative
affect.
Given
that
many
types
of
anomalous
experiences
can
elicit
the
same
affirmation
response,
and
that
the
resultant
arousal
can
be
misattributed,
it
suggests
that
the
distress
is
general
enough
that
the
source
of
arousal
can
be
confounded
in
the
person’s
mind.
The
present
research
is
predicated
on
four
key
findings
of
the
literature:
1)
both
physical
and
social
pain
are
associated
with
activation
in
the
dACC
(e.g.,
Eisenberger
et
al.,
2003);
2)
the
dACC
is
activated
in
response
to
anomalies
(e.g.,
Botvinick
et
al.,
2004);
3)
social
rejection
can
produce
the
same
compensatory
Acetaminophen
reduces
meaning
maintenance
7
affirmation
as
other
meaning
threats
(e.g.,
Nash
et
al.,
2011);
and,
4)
acetaminophen
has
been
shown
to
reduce
physical
and
social
pain
and
activation
in
the
dACC,
(DeWall
et
al.,
2010).
These
findings
led
us
to
predict
that
acetaminophen
may
also
inhibit
compensatory
affirmation
following
meaning
threats.
We
reasoned
that
participants
who
experienced
a
meaning
threat
after
having
consumed
acetaminophen
would
fail
to
detect
any
increase
in
arousal
and
thus
not
show
the
kinds
of
compensatory
affirmation
identified
in
previous
research.
Towards
this
end
we
conducted
two
studies
with
different
meaning
threats
and
affirmations.
METHOD
Participants
and
procedure
We
recruited
121
participants
(81
women).
The
sample
was
predominantly
of
East
Asian
(45%),
European
(29%),
and
South
Asian
(12%)
descent.
Participants
were
offered
$15
through
flyers
posted
on
campus,
or
partial
course
credit
in
psychology
classes.
The
study
was
advertised
as
a
general
assessment
of
the
cognitive
and
emotional
impacts
of
acetaminophen.
In
contrast
to
the
procedure
of
DeWall
et
al.
(2010;
in
which
participants
took
acetaminophen
multiple
times
a
day
for
three
weeks),
participants
in
the
present
study
received
a
single
acute
dose
of
acetaminophen,
which
was
active
in
their
system
while
they
experienced
the
threat.
Participants
were
randomly
assigned
to
receive
either
1000mg
of
Tylenol
brand
acetaminophen
(Rapid
ReleaseTM
formula)
or
1000mg
of
sugar
(a
placebo),
packed
in
two
opaque
gel
capsules.
The
researcher
was
blind
to
both
the
type
of
capsules
administered
(using
coded
bottles)
and
the
version
of
the
materials
that
participants
completed.
Acetaminophen
reduces
meaning
maintenance
8
The
effects
of
acetaminophen
are
difficult
to
detect
if
one
is
not
already
in
pain,
making
it
hard
to
identify
if
one
has
taken
a
drug
or
placebo.
When
taken
orally,
Tylenol’s
expected
time
to
reach
peak
absorption
is
45-‐60
minutes,
and
its
ceiling
effectiveness
in
adults
occurs
at
1000mg
(Bertolini
et
al.,
2006;
Gibb
&
Anderson,
2008);
this
is
also
the
maximum
recommended
single
dose.
After
receiving
the
capsules
to
ingest,
participants
were
given
free
time
for
30
minutes
prior
to
working
on
filler
tasks,
which
took
approximately
25
minutes
to
complete.
They
then
completed
the
mortality
salience
or
dental
pain
paragraphs,
followed
by
the
Positive
and
Negative
Affect
Schedule
(PANAS)
and
the
prostitution
bond
scenario
(all
materials
described
below).
Our
expectation
was
that
participants
in
the
placebo
condition
who
received
the
mortality
salience
manipulation
would
show
typical
compensatory
affirmation,
while
those
who
had
taken
Tylenol
would
not
show
this
reaction.
Materials
Filler
tasks.
We
asked
participants
to
complete
a
number
of
materials
not
relevant
to
the
task,
to
mask
our
specific
hypothesis
of
interest.
These
included
a
page
of
Sudoku
puzzles,
a
memory
task
matching
faces
of
individuals
to
their
biographies
and
a
series
of
personality
questionnaires
that
were
not
analyzed
as
part
of
the
study.
Mortality
salience
manipulation.
Participants
completed
the
standard
mortality
salience
manipulation:
they
either
wrote
two
paragraphs
about
what
will
happen
to
their
body
after
they
die
and
how
they
feel
about
it,
or
two
paragraphs
about
dental
pain
(Burke
et
al.,
2010).
Terror
management
theorists
have
argued
that
thoughts
Acetaminophen
reduces
meaning
maintenance
9
about
death
produced
a
unique
type
of
anxiety
(Greenberg,
Solomon,
&
Pyszczynski,
1997).
Recently
however,
a
number
of
other
theorists
have
argued
that
thinking
about
death
is
incompatible
with
everyday
thoughts
about
relationships,
plans,
and
ambitions
(Heine
et
al.,
2006;
McGregor,
Zanna,
Holmes,
&
Spencer,
2001;
Proulx
et
al.,
2012),
and
that
it
leads
to
the
same
anxiety
associated
with
other
violations
of
expectations,
such
as
frustrated
social
interactions,
or
perceived
incongruities.
These
arguments
have
been
supported
empirically,
where
mortality
salience
has
been
shown
to
lead
to
the
same
compensatory
affirmation
as
viewing
surreal
art
(Proulx,
Heine,
&
Vohs,
2010),
perceiving
a
visual
anomaly
(Proulx
&
Heine,
2008)
or
viewing
subliminally-‐presented
incongruous
word-‐pairs
(e.g.
role-‐fork;
Randles
et
al.,
2011).
The
rationale
behind
using
dental
pain
as
a
control
was
that
it
should
be
aversive,
but
should
not
create
an
experience
of
violated
expectations
or
uncertainty,
and
thus
should
not
lead
to
affirmation
responses
(McGregor,
et
al.,
1998).
This
control
condition
thus
helps
to
rule
out
negative
mood
as
an
explanation
for
the
compensatory
affirmation,
which
is
why
it
is
used
as
a
standard
control
group
in
mortality
salience
paradigms
(Burke
et
al.,
2010).
Positive
and
Negative
Affect
Schedule.
This
measure
identifies
the
state
of
affect
an
individual
is
experiencing,
based
on
twenty
different
affect
descriptors.
Participants
are
asked
how
they
are
feeling
at
the
moment
(Watson,
Clark,
&
Tellegen,
1988).
This
scale
is
often
used
as
a
delay
between
the
mortality
salience
manipulation
and
the
dependent
variable,
and
typically
reveals
that
the
manipulation
does
not
influence
either
positive
or
negative
affect
(Burke
et
al.,
2010).
Acetaminophen
reduces
meaning
maintenance
10
Social
judgment
survey.
Participants
read
a
hypothetical
arrest
report
about
a
prostitute
and
were
asked
to
set
the
amount
of
the
bail
(from
$0-‐$999).
This
measure
has
been
used
in
a
number
of
other
meaning-‐threat
studies
(Proulx
&
Heine,
2008;
Proulx
et
al., 2010; Randles
et
al.,
2011;
Rosenblatt,
Greenberg,
Solomon,
Pyszczynski
&
Lyon,
1989).
Participants
are
expected
to
increase
the
bond
value
after
a
threat,
because
trading
sex
for
money
is
both
at
odds
with
commonly
held
cultural
views
of
relationships,
as
well
as
being
against
the
law.
Increasing
the
bond
assessment
provides
participants
an
opportunity
to
affirm
their
belief
that
prostitution
is
wrong.
RESULTS
During
the
debriefing,
participants
were
asked
to
guess
which
capsules
they
had
consumed.
Fifty-‐five
percent
claimed
they
had
no
idea;
of
those
who
guessed,
57%
were
correct
(not
different
from
chance;
p=.17).
Five
participants
were
removed
for
not
completing
the
materials.
Planned
orthogonal
contrasts
were
used
to
test
our
hypothesis.
We
chose
this
analysis
because
we
were
expecting
one
particular
pattern
of
effects:
namely
that
the
threatened
group
that
received
a
placebo
would
show
higher
compensatory
affirmation
compared
to
the
other
three
groups.
As
predicted,
only
participants
who
had
experienced
a
meaning
threat
and
had
taken
the
placebo
showed
evidence
of
increased
affirmation.
Participants
in
the
threat/placebo
group
punished
the
norm
violator
by
a
significantly
larger
amount
than
the
other
three
groups,
t112=2.33,
Acetaminophen
reduces
meaning
maintenance
11
p=.02,
d=.52
±
.44
CI.975
(See
Figure
1)1.
Participants
in
the
threat/acetaminophen
group
showed
no
compensatory
affirmation
compared
to
the
two
control
groups,
t112<1,
d=.09
±
.45
CI.975.
The
two
control
groups
did
not
differ,
t112<1,
d=.09
±
.50
CI.975.
As
with
previous
meaning
threat
studies,
no
differences
between
conditions
emerged
for
self-‐reported
positive
or
negative
affect
(all
ts<1).
These
results
suggests
that
a
drug
that
can
alleviate
mild
pain,
headaches,
or
hurt
feelings
(DeWall
et
al.,
2010)
can
also
alleviate
the
affirmation
responses
that
are
incurred
when
people
consider
their
own
mortality,
which
some
have
argued
threatens
meaning
(Heine
et
al.,
2006;
Proulx
et
al.,
2012).
STUDY
2
In
Study
1,
we
employed
the
most
commonly
used
manipulation
of
existential
anxiety,
mortality
salience.
To
test
whether
acetaminophen
affects
uncertainty
more
broadly
defined,
we
turned
to
a
very
different
and
novel
manipulation
in
Study
2.
We
turned
to
an
artistic
tradition
which
is
known
precisely
for
its
ability
to
provoke
feelings
of
discomfort
and
unease:
surrealism.
The
surrealist
tradition
involves
the
juxtaposition
of
unfamiliar
elements
in
familiar
settings.
Past
research
has
found
that
surrealist
art
forms,
including
literature,
paintings,
and
humor,
lead
to
compensatory
responses
(Proulx
&
Heine,
2009;
Proulx
et
al.,
2010).
The
work
of
surrealist
filmmaker
David
Lynch
seemed
especially
apt
for
our
needs.
As
his
biographer
Rodley
(2005;
p.
x)
noted,
“the
1
Point
and
interval
estimates
for
Cohen’s
d
are
based
on
recommendations
in
Robey
(2004).
Acetaminophen
reduces
meaning
maintenance
12
indefinable
‘mood’
or
‘feeling’
Lynch
seeks
to
convey
is
linked
to
a
form
of
intellectual
uncertainty
–
what
he
calls
being
‘lost
in
darkness
and
confusion.’”
METHODS
Students
were
recruited
through
the
same
methods
as
Study
1.
Of
the
236
recruited,
8
failed
to
complete
the
study
because
of
technical
problems,
and
the
data
from
21
participants
were
removed
because
they
reported
during
an
open-‐ended
debriefing
that
they
had
participated
in
previous
MMM
experiments
or
guessed
that
we
were
interested
in
their
responses
to
the
Lynch
film.
The
key
effects
still
remain
significant
if
these
21
participants
are
included
in
the
analyses.
This
left
207
participants
(124
women),
who
were
predominantly
of
European
(52%),
East
Asian
(25%),
and
South
Asian
(7%)
descent.
The
paradigm
was
identical
to
Study
1,
with
two
differences.
First,
the
meaning
threat
was
changed.
Participants
in
the
meaning
threat
condition
watched
3
films.
First,
was
a
2-‐minute
clip
from
a
Donald
Duck
cartoon,
designed
to
ease
participants
into
the
task.
They
then
watched
a
4-‐minute
clip
from
the
short
film,
Rabbits,
created
by
David
Lynch.
The
film,
which
at
first
resembles
a
sit-‐com,
consists
of
a
series
of
non-‐sequiturs,
seemingly
random
laugh
and
applause
tracks
separated
by
long
portentous
pauses,
an
eerie
soundscape,
a
complete
absence
of
a
narrative,
and
characters
inexplicably
dressed
in
rabbit
costumes.
The
clip
is
ominous,
although
it
contains
no
reference
to
disturbing
or
unpleasant
topics.
After
the
Rabbits
clip,
participants
then
watched
a
2-‐minute
clip
from
Snoopy,
designed
to
serve
as
a
distraction/delay,
followed
by
the
PANAS.
As
we
were
concerned
that
participants
would
identify
Rabbits
as
critical
to
the
study,
adding
an
Acetaminophen
reduces
meaning
maintenance
13
additional
distractor
beyond
the
PANAS
was
expected
to
help
reduce
suspicion.
Participants
in
the
control
condition
saw
the
same
videos
except
the
Rabbits
clip
was
replaced
with
a
4-‐minute
clip
from
a
Simpsons
episode
(all
clips
available
upon
request).
We
also
changed
the
dependent
affirmation
measure.
This
study
was
conducted
3-‐6
months
after
a
well-‐publicized
local
riot
that
followed
the
loss
of
the
Vancouver
Canucks
bid
for
the
Stanley
Cup,
and
we
expected
that
most
students
held
a
negative
view
of
this
event.
Thus,
after
a
threat,
participants
should
affirm
this
view
by
calling
for
stronger
punishment
for
the
rioters.
Participants
were
informed
that
people
were
debating
whether
the
rioters
should
be
given
more
lenient
sentences
than
comparable
individual
acts
of
vandalism,
because
they
acted
impulsively,
or
stiffer
sentences
because
they
took
advantage
of
the
city
while
it
was
vulnerable.
Participants
then
marked
a
spot
on
a
line
connecting
the
endpoints,
indicating
that
rioters
should
not
be
fined
or
jailed
(0%)
to
a
doubled
fine
or
sentence
(200%),
with
a
normal
fine
or
sentence
(100%)
lying
at
the
midpoint.
(See
Appendix
A
in
the
Supplementary
Materials
online
for
measure).
RESULTS
Participants
were
unable
to
correctly
identify
whether
they
had
taken
acetaminophen
or
a
placebo:
53%
claimed
they
had
no
idea;
of
those
who
guessed,
45%
were
correct
(not
different
from
chance,
p=.29).
Participants
in
all
conditions
set
the
fine
for
the
rioter
at
a
higher
value
then
the
court
would
normally
set
(all
ps<.001),
which
confirms
our
expectations
that
most
students
in
our
sample
found
the
behaviors
unacceptable.
Acetaminophen
reduces
meaning
maintenance
14
As
in
Study
1
we
used
planned
orthogonal
contrasts
to
test
whether
the
placebo-‐threat
condition
showed
more
compensatory
affirmation
than
the
other
conditions.
Again,
only
participants
who
had
experienced
a
meaning
threat
and
had
taken
the
placebo
showed
evidence
of
increased
affirmation.
Participants
in
the
threat/placebo
group
punished
the
norm
violator
by
a
significantly
larger
amount
than
the
other
three
groups,
t203=2.64
p<.01,
d=.43
±
.32
CI.975
(See
Figure
2).
Participants
in
the
threat/acetaminophen
group
showed
no
compensatory
affirmation
compared
to
the
two
control
groups,
t203<1,
d=.05
±
.34
CI.975.
There
was
no
difference
between
the
acetaminophen
and
placebo
groups
for
the
control
manipulation,
t203<1,
d=.09
±
.35.
Again,
there
was
no
difference
between
the
groups
in
self-‐reported
positive
or
negative
affect
(all
ts<1.2,
ps>.23).
DISCUSSION
Two
studies
show
that
acetaminophen
interrupts
the
typical
compensatory
responses
to
meaning
threats.
In
the
first
study,
we
identified
a
typical
mortality
salience
reaction
in
the
placebo
group,
but
those
who
had
taken
acetaminophen
responded
in
ways
similar
to
those
who
did
not
contemplate
their
mortality.
In
the
second
study,
these
findings
were
replicated
using
a
surreal
video
clip
and
a
novel
dependent
measure,
showing
that
participants
who
watched
the
David
Lynch
clip
and
took
a
placebo
were
more
punitive
than
those
who
had
consumed
acetaminophen
or
who
had
watched
the
control
video.
In
neither
study
were
there
any
differences
in
self-‐reported
positive
or
negative
affect,
which
renders
it
unlikely
that
the
effects
were
simply
a
function
of
people
becoming
more
punitive
because
they
were
in
a
bad
mood.
Rather
we
argue
that
a
particular
type
of
distress
Acetaminophen
reduces
meaning
maintenance
15
associated
with
expectancy
violation
(originating
from
the
dACC)
and
a
failure
to
correctly
identify
or
be
able
to
accommodate
to
the
source
of
that
distress
lead
to
this
affirmation.
These
results
are
consistent
with
the
notion
of
a
domain-‐general
process
for
expectancy
violation.
Although
there
is
some
evidence
that
domain-‐specific
responses
to
certain
types
of
uncertainty
or
threat
can
occur
(e.g.
Burke
et
al.,
2010;
Rutjens
&
Loseman,
2010),
a
recent
review
of
the
threat
compensation
literature
underscored
how
similar
psychological
processes
are
implicated
across
different
threats
(Proulx
et
al.,
2012).
Our
findings
imply
that
the
similarities
between
physical
pain
and
belongingness
threats
may
not
be
specifically
due
to
them
both
triggering
something
akin
to
pain,
but
rather
that
they
both
typically
involve
a
violation
of
expectations.
This
is
not
to
say
that
uncertainty
is
a
necessary
feature
of
pain,
but
that
pain
(as
with
social
failures)
is
often
brought
about
by
unexpected
consequences
to
behaviors
or
actions.
In
reviewing
the
literature
on
the
ACC,
Shackman
et
al.
(2011)
argue
that
the
“the
core
function
common
to
negative
affect,
pain
and
cognitive
control
is
the
need
to
determine
an
optimal
course
of
action
in
the
face
of
uncertainty”
(p.
160).
However,
one
disconnect
between
the
present
findings
and
current
data
on
the
dACC
is
that
our
results,
and
many
manipulations
of
uncertainty
or
existential
anxiety
(e.g.,
Burke
et
al.,
2010),
do
not
lead
to
changes
in
self-‐reported
affect
as
measured
by
the
PANAS.
Studies
that
have
measured
dACC
activation
following
physical
pain,
social
pain,
and
frustration
have
produced
self-‐reported
negative
Acetaminophen
reduces
meaning
maintenance
16
affect
(e.g.
DeWall
et
al.
2010;
Eisenberger
&
Lieberman
2004;
Spunt,
Lieberman,
Cohen
&
Eisenberger,
2012),
and
a
recent
meta-‐analysis
of
brain
imaging
studies
found
that
the
dACC
was
activated
in
response
to
manipulations
that
induced
fear,
anger,
or
disgust
(Shackman
et
al.,
2011).
There
are
multiple
possibilities
for
this
disconnect.
It
could
be
that
a)
the
PANAS
does
not
tap
into
the
kinds
of
negative
affect
associated
with
expectancy
violations,
b)
asking
participants
about
how
they
feel
right
now
is
less
effective
than
asking
how
they
felt
about
the
threat
(as
Spunt
et
al.
(2012)
did),
or
c)
people
might
not
always
have
conscious
access
to
the
arousal
elicited
from
expectancy
violations.
These
studies
have
a
number
of
limitations
and
suggest
several
future
research
directions.
First,
it
is
unclear
how
well
our
findings
would
generalize
to
other
samples.
Research
on
terror
management
theory
finds
effects
of
the
same
direction
across
a
broad
array
of
samples,
although
Americans
and
college
students
show
stronger
effects
than
other
samples
(Burke
et
al.,
2010).
We
therefore
anticipate
that
the
findings
obtained
here
would
also
be
of
the
same
direction
yet
weaker
in
magnitude
in
other
samples.
A
second
limitation
is
that
acetaminophen
affects
a
number
of
brain
regions,
some
not
directly
related
to
physical
or
social
distress
(Toussaint
et
al.,
2010).
Thus,
there
are
several
possible
explanations
for
our
findings.
First,
acetaminophen
might
reduce
felt
arousal
upon
witnessing
violations.
Second,
participants
may
experience
the
same
arousal,
but
the
trigger
for
the
affirmational
response
may
be
interrupted
by
the
drug.
Third,
the
presence
of
the
drug
may
make
participants
less
attentive
so
they
never
notice
the
violation
to
begin
with.
Fourth,
acetaminophen
could
potentially
affect
some
of
the
cognitive
Acetaminophen
reduces
meaning
maintenance
17
processes
involved
in
completing
the
dependent
measures.
Although
our
studies
were
inspired
by
the
neurological
link
between
physical
pain,
social
pain,
and
expectancy
violation,
further
work
will
be
needed
to
confirm
that
overlapping
neurological
structures
are
involved.
We
also
do
not
know
whether
other
pain-‐relievers
would
have
the
same
kinds
of
inhibiting
effects.
Given
the
past
work
that
inspired
this
research
(see
introduction)
it
seems
possible
that
any
drug
that
inhibits
pain
via
the
central
nervous
system
might
be
effective,
but
this
has
yet
to
be
tested
(two
exceptions
being
that
marijuana
has
also
been
found
to
reduce
both
physical
pain
and
social
pain;
Deckman,
DeWall,
Way,
Gilman,
&
Richman,
2012,
and
that
the
tranquilizer
phenobarbital
reduces
attitude
change
following
induced
compliance;
Cooper,
Zanna,
&
Taves,
1978).
An
additional
hypothesis
that
emerges
from
these
findings
is
that
acetaminophen
may
not
only
reduce
felt
uncertainty
during
unexpected
negative
events,
but
also
positive
ones
(such
as
receiving
a
surprise
promotion
at
work).
Consistent
with
this
hypothesis
are
findings
that
fluid
compensation
also
emerges
from
positive
expectancy
violations,
such
as
participants
seeing
a
doctored
photo
of
themselves
that
makes
them
look
more
attractive
(Proulx
&
Randles,
2010)
and
evidence
that
the
ACC
does
respond
to
positive
feedback,
if
negative
feedback
was
expected
(Oliveira,
McDonald
&
Goodman,
2007)
The
findings
raise
several
questions,
and
a
fuller
understanding
could
be
achieved
through
employing
alternative
measures
of
distress
(e.g.,
psychophysiological
measures,
fMRI),
painkillers
(e.g.,
acetylsalicylic
acid),
kinds
of
Acetaminophen
reduces
meaning
maintenance
18
meaning
violations
(e.g.,
cognitive
dissonance),
compensatory
measures
(e.g.,
pattern
learning,
increased
beliefs
in
God),
and
samples
(e.g.,
young
children).
Despite
the
many
questions
that
these
findings
raise,
they
do
demonstrate
that
acetaminophen
has
far
more
reaching
psychological
consequences
than
previously
realized,
and
that
a
single
pill
can
serve
as
an
effective
manipulation
in
the
lab.
Acetaminophen
reduces
meaning
maintenance
19
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Figure
1
Bond
values
set
for
prostitute
described
in
the
social
judgment
survey
Note:
Scale
ranged
from
$0
–
$999.
Error
bars
represent
the
standard
error
for
each
group.
Acetaminophen
reduces
meaning
maintenance
26
Figure
2
Increased
penalty
percentage
(fine
or
jail
time)
for
someone
convicted
of
vandalism
or
theft
during
the
Vancouver
hockey
riot.
Note:
Scale
ranged
from
0%
(no
fine
or
jail
time
for
a
conviction,
through
100%
(a
normal
fine
or
jail
time
is
appropriate)
to
200%
(the
normal
penalty
should
be
doubled).
Bars
represent
the
standard
error
for
each
group.
