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A Popular Pain Reliever Can Alter Risk Perception

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Past research has shown that Tylenol’s active ingredient, acetaminophen, can sway emotions and relieve hurt feelings. But Baldwin Way, associate professor of psychology at The Ohio State University, and his colleagues have now shown that it might subtly nudge people to take risks.

It’s not surprising to scientists that acetaminophen might have effects beyond fever and pain reduction. “You take it for headaches, so obviously it gets to the brain,” said Jean Golding, emeritus professor of pediatric and perinatal epidemiology at the University of Bristol, who has studied the cognitive effects of acetaminophen in children after fetal exposure.

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Scientists have conducted studies showing that acetaminophen can reduce emotional pain and blunt positive and negative emotions. Way’s team thought that it might also drive behavioral changes, like risk-taking, in people taking the medication.

In a study published in the journal Social Cognitive and Affective Neuroscience, Way and his team showed taking acetaminophen affected risk perception and made people more likely to take risks in a balloon-popping lab task.

During the experiment, 142 undergraduate participants were randomly assigned to take a standard extra-strength acetaminophen dose (i.e. Tylenol) or a placebo. The participants then completed questionnaires that measured how risky or beneficial they tended to judge activities or technologies for American society.

Way and his colleagues then tested risk-taking tendencies with a task commonly used in psychology experiments, the balloon analogue risk task. The undergrads began with an deflated balloon on a computer screen. They could inflate the balloon, earning five cents with each pump, but the balloon could pop at any time. If it popped before the participant decided to collect their imaginary earnings, they would lose the money. This task also manipulates emotions by employing a dramatic visual burst and popping sound if the participant inflates it too much. This makes negative outcomes much more salient to participants than when they win five cents.

The acetaminophen group didn’t judge circumstances as less risky or beneficial than the placebo group, but they did take more risks with the balloon tasks, pumping the balloon more than those who didn’t take acetaminophen.

In a second experiment, a different group of 189 undergraduates completed the same balloon task, but this time they had to judge the risks and benefits of more personal, emotional situations, like betting a day’s pay on a sporting event. In this case, the acetaminophen group did judge situations as less risky, which suggests to Way that acetaminophen blunted the effects of negative emotions, leading the undergrads to rate situations as less risky.

C. Nathan DeWall, a professor of psychology at the University of Kentucky not involved in the study, thinks this offers evidence that taking risks can be emotionally painful, and reducing that pain might make people less risk-averse. “What these findings indicate is that people are processing the [risk-taking] situation in the same way you would the prospect of getting physically injured,” said. “Risk-taking is actually painful.”

But the effects Way found were small. “It’s not taking you from zero to 100,” said Way. “These are subtle effects, pushing people 5-10% more [toward risk-taking].” On an individual basis, acetaminophen won’t turn you from risk-averse to thrill-seeker. But acetaminophen is in hundreds of medications, taken by millions of people each day.

“When you put that into a large society of many, many people, if it’s moving just a few people a few [percentage points] over the line, it could be having behavioral effects,” Way said.

While it’s unknown whether sick people, or people outside of the undergraduate population, would respond to acetaminophen the same way as those in Way’s study, a slight increase in risk-taking might have notable consequences. In the context of Covid-19, it might influence how well people adhere to public health advice. After someone takes Tylenol, it’s possible that while the drug is in their system, getting together with a few friends or forgetting a mask at home won’t seem all that risky.

“The caveat to that is if you have Covid-19 and you have the symptoms, you might be at a higher inflammatory state,” said Way. The body is more inflamed during illness, which could influence the way acetaminophen affects the brain and behavior. Way only tested people who weren’t sick.

DeWall thinks Way’s results could have positive implications. “Risk-taking gets a bad rap,” he said. “When you look at the people who most of us want to emulate, those are people who took tremendous risks.”

But DeWall doesn’t think this means that someone should take acetaminophen before they need to make a risky decision. He thinks these findings add to the idea that there are different ways to reduce the perception of pain, including the painful idea of risk. “For me, the findings give a lot of hope.”

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