Psychosocial mediators of sex differences in pain responsivity

Sanford, Stacy D.; Kersh, Brian C.; Thorn, Beverly E.; Rich, Martha Anne; Ward, L. Charles

doi:10.1054/jpai.2002.xb30066

Cited by 70 publications

(49 citation statements)

References 22 publications

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“…Sex difference is due to sociocultural differences between men and women, including differences in gender roles 111 and gender role expectations 84 .…”

Section: Socioculturalmentioning

confidence: 99%

Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon

2012

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| A clear majority of patients with chronic pain are women; however, it has been surprisingly difficult to determine whether this sex bias corresponds to actual sex differences in pain sensitivity. A survey of the currently available epidemiological and laboratory data indicates that the evidence for clinical and experimental sex differences in pain is overwhelming. Various explanations for this phenomenon have been given, ranging from experiential and sociocultural differences in pain experience between men and women to hormonally and genetically driven sex differences in brain neurochemistry. PERSPECTIVES NATURE REVIEWS | NEUROSCIENCE VOLUME 13 | DECEMBER 2012 | 859

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“…Sex difference is due to sociocultural differences between men and women, including differences in gender roles 111 and gender role expectations 84 .…”

Section: Socioculturalmentioning

confidence: 99%

Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon

2012

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“…Psychosocial factors contribute substantially to pain perception in humans and may differentially influence pain in men and women [64,101,159,167,172]. There are welldocumented sex differences in stress responses in both animals and humans [112], and sex differences in mechanisms of stress-induced analgesia have been reported in rodents [141].…”

Section: Future Directionsmentioning

confidence: 99%

“…For example, changes in spinal aromatase activity dramatically and immediately affected pain thresholds in the Japanese quail, without changes in plasma levels of gonadal steroids [56,57]. Future studies in which various steroidogenic enzyme inhibitors (or hormone agonists or antagonists) are locally infused would contribute to our understanding of how local changes in hormone action result in behavioral changes in sensitivity to pain and analgesia.How do psychological factors such as stress, mood, and conditioning (expectation) contribute to sex differences in pain/analgesia?Psychosocial factors contribute substantially to pain perception in humans and may differentially influence pain in men and women [64,101,159,167,172]. There are welldocumented sex differences in stress responses in both animals and humans [112], and sex differences in mechanisms of stress-induced analgesia have been reported in rodents [141].…”

mentioning

confidence: 99%

Studying sex and gender differences in pain and analgesia: A consensus report

Greenspan

Craft

LeResche

et al. 2007

Pain

859

633

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In September 2006, members of the Sex, Gender and Pain Special Interest Group of the International Association for the Study of Pain met to discuss the following: (1) what is known about sex and gender differences in pain and analgesia; (2) what are the "best practice" guidelines for pain research with respect to sex and gender; and (3) what are the crucial questions to address in the near future? The resulting consensus presented herein includes input from basic science, clinical and psychosocial pain researchers, as well as from recognized experts in sexual differentiation and reproductive endocrinology. We intend this document to serve as a utilitarian and thought-provoking guide for future research on sex and gender differences in pain and analgesia, both for those currently working in this field as well as those still wondering, "Do I really need to study females?" Keywords Sex differences; Gonadal hormones; Estrogens The case for studying sex and gender differences in pain and analgesiaThe pain field has moved from debating whether sex differences in pain exist to recognizing the importance of these differences. Attention is now directed toward understanding (1) what conditions lead to the expression of sex and gender differences in pain experience and reactivity, (2) what mechanisms underlie these differences, and (3) how these differences can inform clinical management of pain.As noted in a recent review, at least 79% of animal studies published in Pain over the preceding 10 years included male subjects only, with a mere 8% of studies on females only, and another 4% explicitly designed to test for sex differences (the rest did not specify) [142]. Given the substantially greater prevalence of many clinical pain conditions in women vs. men [20,199], and growing evidence for sex differences in sensitivity to experimental pain and to analgesics [21,41,213], we recommend that all pain researchers consider testing their hypotheses in both sexes, or if restricted by practical considerations, only in females. It is invalid to assume that data obtained in male subjects will generalize to females, and the best non-human model of the modal human pain sufferer -a woman -is a female animal. If only males are examined in a given study, it is important that a rationale for exclusion of females be provided and that the potential limitation in generalizability of the findings be addressed in the discussion, particularly when examining a pain phenomenon that occurs with greater prevalence or severity in females. In both preclinical and clinical studies, a comparison of both sexes will further our understanding of individual differences in sensitivity to pain and analgesia, thus improving our ability to treat and prevent pain in all people. General considerationsTwo issues of terminology are important. First, the term "sex" refers to biologically based differences, while the term "gender" refers to socially based phenomena. Although biological sex exerts a major influence on one's gender identity, sex and gender a...

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“…Three studies used the BSRI (Otto and Dougher, 1985;Myers et al, 2001), one study used the PAQ , two studies used the extended PAQ (EPAQ, Sanford et al, 2002;Thorn et al, 2004) and one study used the HyperMasculinity Index (HMI, Reidy et al, 2009). The BSRI is a 7-point scale measuring an individual's self-report of masculine or feminine characteristics based on sextyped social desirability traits (Bem, 1974).…”

Section: Masculine and Feminine Personality Trait Scalesmentioning

confidence: 99%

Gender role affects experimental pain responses: A systematic review with meta‐analysis

Alabas

Tashani

Tabasam

et al. 2012

European Journal of Pain

170

123

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Gender role refers to the culturally and socially constructed meanings that describe how women and men should behave in certain situations according to feminine and masculine roles learned throughout life. The aim of this meta-analysis was to evaluate the relationship between gender role and experimental pain responses in healthy human participants. We searched computerized databases for studies published between January 1950 and May 2011 that had measured gender role in healthy human adults and pain response to noxious stimuli. Studies were entered into a meta-analysis if they calculated a correlation coefficient (r) for gender role and experimental pain. Searches yielded 4465 'hits' and 13 studies were eligible for review. Sample sizes were 67-235 participants and the proportion of female participants was 45-67%. Eight types of gender role instrument were used. Meta-analysis of six studies (406 men and 539 women) found a significant positive correlation between masculine and feminine personality traits and pain threshold and tolerance, with a small effect size (r = 0.17, p = 0.01). Meta-analysis of four studies (263 men and 297 women) found a significant negative correlation between gender stereotypes specific to pain and pain threshold and tolerance, with a moderate effect size (r = -0.41, p < 0.001). In conclusion, individuals who considered themselves more masculine and less sensitive to pain than the typical man showed higher pain thresholds and tolerances. Gender stereotypes specific to pain scales showed stronger associations with sex differences in pain sensitivity response than masculine and feminine personality trait scales.

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Psychosocial mediators of sex differences in pain responsivity

Cited by 70 publications

References 22 publications

Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon

Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon

Studying sex and gender differences in pain and analgesia: A consensus report

Gender role affects experimental pain responses: A systematic review with meta‐analysis

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