Pain and satisfaction: healthcare providers’ facial appearance matters

Mattarozzi, Katia; Caponera, Elisa; Russo, Paolo Maria; Colonnello, Valentina; Bassetti, Margherita; Farolfi, Elena; Todorov, Alexander

doi:10.1007/s00426-020-01330-3

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…Social factors may also influence expectations and health outcomes even before interactions. Recent work indicates that first impressions of healthcare providers based on facial features alone can influence pain and expectations about pain [55,56].…”

Section: Social Influences On Placebo Analgesiamentioning

confidence: 99%

A social affective neuroscience lens on placebo analgesia

Atlas

2021

Trends in Cognitive Sciences

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Pain is a fundamental experience that promotes survival. In humans, pain stands at the intersection of multiple health crises: chronic pain, the opioid epidemic, and health disparities. The study of placebo analgesia highlights how social, cognitive, and affective processes can directly shape pain, and identifies potential paths for mitigating these crises. This review examines recent progress in the study of placebo analgesia through affective science. It focuses on how placebo effects are shaped by expectations, affect, and the social context surrounding treatment, and discusses neurobiological mechanisms of placebo, highlighting unanswered questions and implications for health. Collaborations between clinicians and social and affective scientists can address outstanding questions and leverage placebo to reduce pain and improve human health.Pain: a biopsychosocial phenomenon that requires integrative research Pain (see Glossary) lies at the core of multiple health crises. It is central to the opioid epidemic [1,2], there are substantial health disparities in pain [3][4][5], over 11% of American adults report experiencing daily pain [6], and chronic pain is highly comorbid with other central nervous system conditions, including mental health illnesses [7] and substance use disorders [8]. Healthcare practitioners have reduced opioid prescriptions in response to the opioid epidemic [9], but we lack effective alternatives, including nonaddictive and nonpharmacological therapies.Hope can be found in the progress the field has made in isolating the mechanisms that contribute to pain through animal models because the systems that process pain [10] and nociception are highly conserved across species. Nevertheless, pain in humans is ultimately a subjective, conscious experience that involves the integration of sensory processing, emotion, context, and decision making. Understanding human pain requires an integrative approach that draws on psychology, neuroscience, and medicine. In this review I focus on placebo analgesia, a phenomenon that lies at the intersection of these diverse fields. In the following sections I review the critical influences of expectations, affect, and the social context surrounding treatment (Figure 1, Key figure). I then discuss the brain mechanisms underlying placebo effects and the extent to which placebo analgesia provides insights into domains other than pain. Throughout, I emphasize that research on the placebo effect has important implications for the urgent crises surrounding opioid use disorder and health disparities in pain. HighlightsThe study of placebo analgesia provides insights into how pain and clinical outcomes are shaped by social, cognitive, and affective processes.

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Section: Social Influences On Placebo Analgesiamentioning

confidence: 99%

A social affective neuroscience lens on placebo analgesia

Atlas

2021

Trends in Cognitive Sciences

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“…Results suggested that people are indeed influenced by making automatic inferences about trustworthiness during intergroup interactions. This finding is not only theoretically important, but also holds real-world implications, as trustworthiness inferences from faces as well as gender biases have been demonstrated to have an impact on several social contexts (e.g., Bagnis et al, 2021 ; Bagnis, et al, 2020 ; Mattarozzi et al, 2017 , 2020 ; Pireddu et al, 2022 ; Todorov, 2005 ; Wilson & Rule, 2015 ). We showed that negative inferences from untrustworthy-looking faces reveal the own-gender bias and thus may contribute, for example, to systemic gender-based disparities in healthcare (Fitzgerald et al, 2019 ).…”

Section: Discussionmentioning

confidence: 65%

Facial trustworthiness dampens own-gender bias in emotion recognition

Bagnis

Colonnello

Russo

et al. 2023

Psychological Research

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Previous research suggests that emotion recognition is influenced by social categories derived by invariant facial features such as gender and inferences of trustworthiness from facial appearance. The current study sought to replicate and extend these findings by examining the intersection of these social categories on recognition of emotional facial expressions. We used a dynamic emotion recognition task to assess accuracy and response times in the happiness and anger categorization displayed by female and male faces that differed in the degree of facial trustworthiness (i.e., trustworthy- vs. untrustworthy-looking faces). We found that facial trustworthiness was able to modulate the own-gender bias on emotion recognition, as responses to untrustworthy-looking faces revealed a bias towards ingroup members. Conversely, when faces look trustworthy, no differences on emotion recognition between female and male faces were found. In addition, positive inferences of trustworthiness lead to faster recognition of happiness in females and anger in males, showing that facial appearance was able to influence also the intersection between social categories and specific emotional expressions. Together, these results suggest that facial appearance, probably due to the activation of approach or avoidance motivational systems, is able to modulate the own-gender bias on emotion recognition.

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“…It is somewhat surprising, especially given this context, that appearing caring seems to decrease the probability to be hired, but noteworthily, the low odd ratio suggests that its influence, although significant, is a minor matter. In a previous study (Mattarozzi et al, 2020), it has been found that patients were more satisfied after receiving care from nurses who appeared more caring. Indeed, patients, when judging healthcare professionals' skills and their satisfaction about healthcare service, tend to rely more on facial appearance, since they have limited knowledge on specific clinical competences (Ruben, 2016).…”

Section: Discussionmentioning

confidence: 90%

“…Our results confirm that hiring in healthcare context is not an exception by showing that graduates with facial traits conveying feelings of familiarity are more likely to be hired as nurses. Crucially, inferences of familiarity from facial appearance have a great impact on our daily life, guiding our responses and decisions to unknown individuals (Dotsch, Hassin, & Todorov, 2017; Zebrowitz et al, 2007) and automatically enhancing positive feelings during social interactions (Coan, Schaefer, & Davidson, 2006; Krahé, Springer, Weinman, & Fotopoulou, 2013; Mattarozzi et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Facing up to bias in healthcare: The influence of familiarity appearance on hiring decisions

Bagnis

Cremonini

Pasi

et al. 2021

Applied Cognitive Psychology

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Associations between facial appearance and hiring decisions are well‐documented within job literature as a source of decision misjudgment with economic and human costs. Notwithstanding, this aspect is yet to be investigated in healthcare. We collected 90 pictures of new‐graduates nurses faces to be judged on different facial appearance‐based traits by an independent sample. Six months after graduation, the same new‐graduates were interviewed about their job situation. Binomial logistic regression was conducted to examine whether facial appearance ratings would predict the probability to be hired as nurse. Results showed that applicants with a face conveying a feeling of familiarity were more likely to be hired. Considering that people might be inclined to these biases during societal crises and the exceptional need to quickly recruit health professionals during COVID‐19 pandemic, our study recommends special attention to prevent the influence of facial appearance‐based evaluations not reflecting real skills to limit potentially adverse consequences.

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Pain and satisfaction: healthcare providers’ facial appearance matters

Cited by 8 publications

References 39 publications

A social affective neuroscience lens on placebo analgesia

A social affective neuroscience lens on placebo analgesia

Facial trustworthiness dampens own-gender bias in emotion recognition

Facing up to bias in healthcare: The influence of familiarity appearance on hiring decisions

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