Social conflict imagery induces stress, social and physical pain: sex differences in autonomic and affective responses and pathways to resilience and wellbeing.

Introduction: This study investigated how viewing images depicting male-female conflict influences emotional distress, autonomic regulation, and pain. Methods: Sixty-five adults completed pre-experiment questionnaires and were exposed to a plus sign (baseline condition) and conflict images (conflict condition). Emotional responses and heart rate variability (HRV) were assessed during the experiment, and pain was evaluated following each condition. HRV analyses included absolute and normalized spectral measures. High-frequency HRV (HF-HRV) primarily reflected parasympathetic activity, whereas low-frequency (LF)-related indices reflected mixed and relative autonomic influences rather than pure sympathetic activity. Results: Exposure to conflict images produced psychological distress and physiological dysregulation, characterized by increased stress, anxiety, fear, state loneliness, negative societal perceptions, and pain, accompanied by reduced happiness, empathy, and positive societal perceptions. Conflict exposure significantly reduced absolute parasympathetic activity, as indicated by lower HF and lnHF, whereas absolute LF power remained unchanged. Thus, the principal autonomic response to conflict reflected selective parasympathetic withdrawal rather than increased absolute LF activity. Age-adjusted analyses revealed sex-specific patterns of autonomic and emotional responses. Women exhibited higher normalized HF-HRV (HF norm), happiness, empathy, and positive societal perceptions, together with lower negative societal perceptions. In contrast, men exhibited higher normalized LF-HRV (LF norm) and LF/HF ratios, reflecting greater relative LF predominance and differences in autonomic quality rather than increased sympathetic activation. Significant sex × age interactions were observed for stress, happiness, and empathy, indicating divergent age-related trajectories between men and women, with women showing declines in these variables with increasing age. Regression analyses further showed that conflict-related stress was positively associated with trait loneliness, depression, anxiety, and LF-related indices, whereas higher root mean square of successive differences (RMSSD), reflecting better parasympathetic regulation, was associated with lower stress. Post-conflict pain was positively associated with female sex, stress, and LF-related indices and negatively associated with emotional resources. Discussion: Social conflict imagery elicited selective parasympathetic withdrawal, autonomic spectral redistribution, psychological distress, and increased pain, particularly among psychologically vulnerable individuals. Conversely, adaptive autonomic regulation, emotional resources, and social support promoted resilience and enhanced wellbeing. These findings highlight psychophysiological and psychosocial pathways through which vulnerability and resilience shape stress, wellbeing, and pain-related outcomes under social conflict. The ecological validity of these findings warrants further investigation.