SUMMARY The subjective nature of pain renders its perception in others a challenge for clinicians and informal caregivers responsible for its assessment and relief. Adequate perception of others' pain relies on different behavioral and neurophysiological mechanisms. Several individual, relational and contextual factors can influence the way the brain reacts to others' pain and the perception and assessment of this pain. This article focuses on recent neurophysiological and psychological evidence that characterizes these factors, and discusses their potential impact on the perception of others' pain in a caregiving context. Factors influencing the perception of pain in others are divided into factors related to the self (caregiver), factors related to the other (patient), and factors related to the relationship between those individuals and the context in which the pain is perceived. We propose that the perception of others' pain plays a crucial role in the treatment provided by clinicians and informal caregivers, and that further research could lead to improving decision-making regarding pain management.
Pain perceived in others can be a stressful signal that elicits personal distress and discomfort that can interfere with prosocial behaviors. Healthcare providers (HCPs) have to be able to regulate these self-oriented feelings to offer optimal help to patients in pain. However, previous studies have documented a tendency in HCPs to underestimate the pain of patients that could interfere with optimal help to these patients. The aim of this study was to compare HCP and control (CTL) participants' prosocial behavior towards persons in pain and their associated brain responses. HCPs and CTL participants took part in a newly developed prosocial task during which they were asked to choose how much time they wanted to offer to help patients in pain. It was shown that compared to CTL participants, HCPs offered more help to persons in pain and reported less trait personal distress when facing suffering in others. Additional evidence was provided by the fMRI results, which indicated that compared to CTL participants, HCP participants showed different pattern of activity in the dorsolateral prefrontal cortex, bilateral precuneus and the posterior cingulate cortex during the prosocial task, suggesting that the underlying mechanisms of the difference in prosocial behaviors could vary according to the degree to which processes such as mentalizing and cognitive control are solicited.
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