Pain assessment is subject to bias due to characteristics of the individual in pain and of the observing person. Few research studies have examined pain assessment biases in an experimental setting. The present study employs innovative virtual human technology to achieve greater experimental control. A lens model design was used to capture decision-making policies at the idiographic and nomothetic level. Seventy-five undergraduates viewed virtual humans (VH) that varied in sex, race, age, and pain expression. Participants provided computerized ratings with Visual Analogue Scales on the VH's pain intensity, pain unpleasantness, negative mood, coping, and need for medical treatment. Idiographic analyses revealed that individuals used pain expression most frequently as a significant cue. Nomothetic analyses showed that higher pain expression VH and female VH were viewed as having higher pain intensity, higher pain unpleasantness, greater negative mood, worse coping, and a greater need to seek medical treatment than lower pain expression VH and male VH, respectively. Older VH were viewed as having worse coping and a greater need to seek medical treatment than younger VH. This innovative paradigm involving VH technology and a lens model design was shown to be highly effective and could serve as a model for future studies investigating pain-related decision making in healthcare providers.

Pain assessment and treatment is challenging and can be influenced by patient demographic characteristics. Few research studies have been able to specifically examine these influences experimentally. The present study investigated the effects of patients' sex, race, age, and pain expression on healthcare students' assessment of pain and pain-related sequelae using virtual human (VH) technology. A lens model design was employed, which is an analogue method for capturing how individuals use environmental information to make judgments. In this study, decision-making policies were captured at the nomothetic and idiographic level. Participants included 107 healthcare students who viewed 32 VH patients that differed in sex, race, age, and pain expression in an online study. Participants provided ratings on a 100-point scale on the VH pain intensity, pain unpleasantness, negative mood, coping, and need for medical treatment. Nomothetic analyses revealed that female, African American, older, and high pain expression VH were rated higher than male, Caucasian, younger, and low pain expression VH, respectively, on most of the five ratings. Idiographic analyses revealed detailed findings for individuals' decision-making policies. VH technology and the lens model design were shown to be highly effective in examining individuals' decision making policies. Pain assessment often varied among individuals based on patient demographic and facial expression cues. This study could serve as a model for future investigations of pain assessment and treatment in healthcare students and providers.

BackgroundPatients’ sex, race, and age have been found to affect others’ perception of their pain. However, the influence of these characteristics on treatment recommendations from laypersons and healthcare providers is understudied.DesignTo address this issue, 75 undergraduates and 107 healthcare trainees (HTs) used a web-based delivery system to view video clips of virtual human (VH) patients presenting with different standardized levels of pain. Subjects then rated the VHs’ pain intensity and recommended the amount of medical treatment the VHs should receive.ResultsResults indicated that, compared with undergraduates, HTs perceived African Americans and older adults as having less pain but were more willing to recommend medical treatment for these patients than were undergraduate participants. HTs and undergraduates rated female, African American, older, and high-pain-expressing adults as having greater pain intensity than male, Caucasian, younger, and lower-pain-expressing adults. Moreover, they also recommended that female, older, and high-pain-expressing adults receive more medical treatment than male, younger, and lower-pain-expressing adults.ConclusionsThis study found that the characteristics of the VHs and whether the participants were undergraduates or HTs influenced the ratings of pain assessment and treatment recommendations. The findings are consistent with the previous VH literature showing that VH characteristics are important cues in the perception and treatment of pain. However, this is the first study to identify differences in pain-related decisions between individuals who are pursuing healthcare careers and those who are not. Finally, not only does this study serve as further evidence for the validity and potential of VH technology but also it confirms prior research that has shown that biases regarding patient sex, race, and age can affect pain assessment and treatment.

Young adult women are particularly vulnerable to body image problems and disordered eating. Instagram trends, such as fitspiration (fitness inspiration), promote the "thin ideal" and appearance-based diets and exercises. The present study investigated how fitspiration content impacts state body satisfaction and negative mood in female college students. Participants consisted of 283 female college students who were randomized into three groups of Instagram content: a fitspiration group (fitspiration images only), a half fitspiration and half travel group (fitspiration and travel images), and a control group (travel images). Participants completed visual analog scales on state body satisfaction and state negative mood before and after Instagram exposure. State body satisfaction significantly decreased and state negative mood increased in the fitspiration and half and half groups postexposure; on the other hand, state body satisfaction significantly increased and state negative mood decreased in the control group postexposure. Therefore, even partial exposure to fitspiration negatively impacted state body satisfaction and state negative mood. The fitspiration group also had significantly lower state body satisfaction and higher state negative mood than the control group postexposure. These results can inform education about the impact of fitspiration on the psychological health of female college students. Public Policy Relevance StatementThe present study found that even partial exposure to fitspiration negatively impacted body satisfaction and negative mood in young adult women, indicating the sensitivity of individuals to fitspiration messaging. There is a need for programming, such as the use of infographics, discussions and online messaging about the effects that these images can have on women.

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