Biological sex and social setting affects pain intensity and observational coding of other people’s pain behaviors

Abstract

This experiment examines the impact of biological sex and audience composition on laboratory-induced ischemic pain intensity and observational coding of other people's pain behaviors. Situational context was manipulated by varying the sex and number of audience stimuli in the laboratory setting during the pain task and during observational evaluations of other people's pain suffering. The analyses revealed sex differences in felt pain intensity and observable pain behaviors, with male subjects reporting lower pain intensity and evidencing fewer pain behaviors than female subjects on average. Follow-up analyses revealed that, after controlling for social anxiety, audience composition was linked to felt pain intensity, and this relation was moderated by participant sex and audience sex, such that only male subjects showed decreased pain intensity with increasing number of female audience members. Sex differences were also found in the rating of other people's pain behaviors, with male observers rating the pain of others lower than female observers. Composition of the audience influenced observers' pain ratings such that the presence of more male subjects in the audience correlated with lower observer ratings, whereas the presence of more female subjects correlated with higher observer ratings. This is the first study to show that the sex and the composition of the social context in which pain is experienced affects the intensity of felt pain and the evaluation of other people's pain suffering. Implications of the findings for measuring and interpreting pain suffering in male and female patients by male and female treatment providers in health care settings are discussed.

The Curse of Curves

“…People that endorse stronger gender roles may also involuntarily or voluntarily engage in activities (e.g., pain concealment and increased bodybuilding, which may result in higher SHRs) that may partially explain the current findings (e.g., see McCreary et al 2007). Such possibilities are still consistent with the socialsignaling perspective of pain expression and the general thesis that males and females utilize pain behaviors in somewhat specialized and selective ways for regulating their peer relationships (Vigil 2009b(Vigil , 2011Vigil and Coulombe 2011;Vigil and Strenth 2014). Future research will benefit from investigations of sex differences in pain expression in relation to individual differences in gonadal gender profiles, attentional regulation, and nociceptive processes involved in pain expression (e.g., Park et al 2012).…”

“…Sex differences in the expression of pain and pain empathizing behaviors (i.e., displays of vulnerability and appeasement) fit this pattern and the general hypothesis that females are more sensitive to interchange trustworthiness cues for maintaining their more consolidated and intimate network structures (Vigil 2008(Vigil , 2009bVigil and Coulombe 2011;Vigil and Strenth 2014). This hypothesis is consistent with recent findings that people express pain differently to male and female audiences (e.g., medical staff and experimenters), and men and women share distinct associations between core elements of their social experiences (e.g., quantity and quality of intimate relationships) and experimental pain reporting (Vigil 2011;Vigil and Alcock 2014;Vigil and Coulombe 2011;Vigil et al 2014a, c;2014d).…”

“…The participant then carried out the CPT without a researcher present, and the researcher observed the participant through a live video feed from the next room to ensure adherence to the cold pressor procedure. This protocol enabled researchers to collect CPT data without being physically present during the CPT, which has been shown to influence experimental pain reporting (Kállai et al 2004;Levine and De Simone 1991;Vigil and Coulombe 2011). Following the cold pressor task individuals were debriefed.…”

“…Recent social-signaling models from evolutionary psychology instead purport that gender differences in many heuristically expressive gestures, including reacting to and empathizing with others' pain, are likely the result of intrasexual selection pressures associated with how ancestral males and females interacted with their peers (Vigil 2007(Vigil , 2008(Vigil , 2009a(Vigil , b, 2011Vigil and Coulombe 2011;Vigil and Strenth 2014). According to Vigil's socio-relational framework of expressive behaviors (SRFB; Vigil 2009a), humans evolved the behavioral heuristics to selectively demonstrate "submissive" gestures such as pain expression and pain empathizing (costly altruism signals) in order to signal vulnerability and appeasement and, ultimately, trustworthiness cues toward intimate and familiar confidantes (Vigil 2007(Vigil , 2009aVigil and Strenth 2014).…”

“…Lower levels of pain behaviors (e.g., lower reported pain intensity and higher reported pain threshold and tolerance) in males would then be interpretable as an example of the varied heuristic tendencies they evolved to demonstrate capacity cues for maintaining their less intimate and more fluid relationships. Thus, from this social-signaling perspective of pain behaviors, the sexually selected tendencies for males and females to form different types of peer network structures and to utilize specialized expressive styles for interacting with peers may also have driven contemporary gender differences in the heuristic expression of pain, distinctions that are undoubtedly reinforced by social learning (Vigil 2007(Vigil , 2008(Vigil , 2009a(Vigil , b, 2011Vigil and Coulombe 2011;Vigil and Strenth 2014).…”