Pain perception is a complex experience, influenced not only by physical stimuli but also by our anticipation of it. For autistic people, pain responses can differ from the norm, and this may be related to how they process pain anticipation. A deeper understanding of these processes can help develop more tailored support approaches for autistic people.

A new study examined these aspects in depth, focusing on the cognitive and emotional processes involved in pain anticipation, and also explored the effect of the hormone oxytocin on these processes.

Understanding Pain Anticipation Processes

The study, published in the journal Ann N Y Acad Sci in August 2026, included two experiments. In the first experiment, people with high autistic traits (HAT) participated alongside people with low autistic traits (LAT), performing a cue-based pain anticipation task. The researchers focused on two components of pain anticipation: processes related to decision-making and evaluation responses.

The findings of this experiment indicated significant differences:

  • In decision-making processes: Autistic people showed greater caution in uncertain situations and lower processing efficiency in high and certain pain conditions.
  • In evaluation responses: They exhibited more negative evaluation responses, which were found to be associated with a poorer psychological state.

These findings suggest that pain anticipation in autistic people involves partially separate components, some related to cognitive decisions and others to emotional evaluations.

The Effect of Oxytocin

In the second experiment, participants with high autistic traits received a dose of oxytocin (a hormone known to be involved in social bonding) or a placebo intranasally. The purpose of this part of the study was to examine whether oxytocin has an effect on pain anticipation processes.

The researchers report that oxytocin specifically affected decision-making processes in uncertain situations. It led to increased evidence accumulation and reduced non-decision processing time, while simultaneously increasing the tendency to choose high pain outcomes in ambiguous conditions. In contrast, the effect of oxytocin on evaluation measures was limited.

These findings indicate that oxytocin has unique and process-specific effects on how autistic people anticipate pain. A deeper understanding of these processes can help develop more tailored support approaches for autistic people, especially in coping with pain and uncertainty.

It is important to remember that this is an initial finding from a single study, and further research is needed to expand and confirm these understandings. Nevertheless, it provides a fascinating perspective on the complexity of pain perception and the potential effects of interventions.