Neural Mechanisms of Interpersonal Expectations on Negative Affect

The study employs a within-subject, crossover factorial design, consisting of two experiments. Experiment 1 In Experiment 1, 30 participants ('patients') will complete all combinations of two independent variables-stimulation type (active vs. sham tTIS) and placebo manipulation (positive vs. negative placebo messaging)-resulting in four sessions: * Session A: Positive Placebo + Active tTIS * Session B: Positive Placebo + Sham tTIS * Session C: Negative Placebo + Active tTIS * Session D: Negative Placebo + Sham tTIS Participants complete three multimodal negative affect tasks (MNAT) before and after each stimulation session. Active tTIS delivers two signals at 2000 Hz and 2080 Hz, generating an 80 Hz interference beat targeted at the anterior/mid-cingulate cortex (aMCC) at 2 mA for 20 minutes. Sham tTIS uses identical frequencies (2000 Hz and 2000 Hz) with no effective interference. Sessions are administered in a counterbalanced order based on a Balanced Latin Square to minimize order effects, with at least 48 hours between sessions. Participants thus serve as their own controls. Experiment 2 Experiment 2 includes 160 participants divided into two groups: 120 'patients' and 40 'doctors'. A within-subject crossover design is employed, focusing specifically on placebo manipulation effects. Patients complete two experimental sessions involving sham tTIS only: * Session E: On-Placebo + Sham tTIS (with social placebo intervention) * Session F: Off-Placebo + Sham tTIS (without placebo intervention) In both sessions, patients complete the same MNAT tasks before and after stimulation. Sham tTIS involves a brief 15-second stimulation followed by no current for the remainder of the session, preserving the illusion of active stimulation. 'Doctors' are trained to administer the sham stimulation and deliver the placebo manipulation. During placebo induction sessions, providers simulate a "personalization" procedure, adjusting sham parameters while covertly reducing pain stimulus intensity to enhance placebo effects. Providers also monitor patients' nonverbal behavior and reported affect, offering feedback to enhance engagement and perceived treatment quality. Participants undergo MRI scanning, physiological monitoring, and behavioral assessments during Experiment 2. Multimodal physiological data-including ECG, respiration, skin conductance, photoplethysmography (PPG), and trans-radial electrical bioimpedance velocimetry (TRVE)-are collected using the BIOPAC 160 system.