We Discount the Pain of Others When Pain Has No Medical Explanation

Abstract

and PerspectiveThe present studies investigated the impact of medical and psychosocial information upon observer"s estimations of pain, emotional responses and behavioral tendencies towards another person in pain. Participants were recruited from the community (study 1: N = 39; 10 men; study 2: N = 41; 12 men), and viewed videos of 4 patients expressing pain, paired with vignettes describing absence or presence of a) medical evidence for the pain and b) psychosocial influences upon the pain experience. A similar methodology was used for study 1 and 2, except for the explicit manipulation of the presence/absence of psychosocial influences in study 2. For each patient video, participant estimations of the patient"s pain, their own distress, sympathy and inclination to help (VAS) were assessed. In both studies, results indicated lower ratings on all measures when medical evidence for pain was absent.Overall, no effect of psychosocial influences was found, except in study 2 where participants indicated to feel less distress when psychosocial influences were present. The findings suggest that pain is taken less seriously when there is no medical evidence for the pain. The findings are discussed in terms of potential mechanisms underlying pain estimations as well as implications for caregiving behavior.Perspective: The present studies indicate that observers take the pain of others less seriously in the absence of clear medical evidence for the pain. These findings are important to further understand the social context in which pain for which there is no clear medical explanation is experienced.

Health Care Professionals' Reactions to Patient Pain: Impact of Knowledge About Medical Evidence and Psychosocial Influences

“…These results are in line with findings of several vignette studies indicating that the absence of medical evidence relates to lower pain estimates in lay observers 8,9,54 , medical students 10 , internal medicine physicians 55 and nurses. 57 Further, the results are consistent with recent findings 16,17 indicating that lay observers attribute lower pain, feel less sympathy for the patient, and are less inclined to help the patient when a medical explanation for the pain is lacking. Next, the results extend the findings of Taylor and colleagues 57 that show that nurses are less willing to undertake pain relief actions when medical evidence for pain is absent.…”

“…Previous research into the influence of contextual information on observer responses has largely relied on short written stories about fictitious patients, 55,57 or on videos displaying only the patients" facial pain expressions. 17 Our approach using videotaped full body pain behaviors of actual patients in pain is more akin to clinician assessment in natural settings, and therefore, more ecologically valid. Finally, in our study, participants were general practitioners and physiotherapists who have a pre-eminent role in the care of patients with pain.…”

“…17 Further, according to Williams 65 , visual analogue scales are considered valid measures of observers" estimates of others" pain.…”

Examining Affective-Motivational Dynamics and Behavioral Implications Within The Interpersonal Context of Pain

“…By identifying mechanisms of action and targets for change, future research is expected to make major strides toward the ultimate goal of enhancing adjustment for both persons in pain and observers or caregivers in their environment. 20 …”

“…), and potential mechanisms of action. unfairness of the pain experience, and prejudicial/discriminatory beliefs or attitudes [3,18,19,20,40,87]. Type of relationship between pain observer and sufferer is likely important here.…”