The effect of disability claimants' coping styles on judgments of pain, disability, and compensation: A vignette study.

Abstract

Because insurance adjusters' decisions about whether to grant compensation to disability claimants are often based on subjective criteria, such decisions may be susceptible to the influence of factors irrelevant to the claimant's disabling condition. Objective: To examine whether judgments about compensation claimants are affected by the claimants' way of coping with pain and by claimant sex. Participants: Two hundred undergraduate students. Study Design: Participants made judgments about vignettes describing fictitious compensation claimants with differing strategies of coping with pain. The main analytic approach involved a multivariate analysis of variance with 5 within-subjects factors (i.e., coping style described in each of 5 vignettes) and 2 between-subjects factors (i.e., sex of claimant described in the vignettes). Results: Coping style was significantly related to perceptions of pain severity and disability and to beliefs about whether compensation should be awarded. Claimants who were described as engaging in catastrophizing or in praying and hoping were more likely than other claimants to be perceived as disabled and as deserving compensation for their injuries. Conclusions: Decisions about disability compensation could be influenced by claimant

Impact of being primed with social deception upon observer responses to others’ pain

“…For example, it would be interesting to examine whether the absence of medical evidence for the pain may function as a prime towards social cheating and whether the relation between the absence of medical evidence for the pain and lower ratings of pain [2,3,29,30] is mediated by observers' evaluation of the valence of the patient. Another example that may function as a cue for social cheating has been suggested by MacLeod and colleagues [20], who found that observers judge adaptive copers who claim compensation as less deserving compensation than patients with maladaptive coping styles. Third, behavioural measures (e.g., approach-avoidance behaviour measures) may complement our self-report measures and strengthen the validity of our results.…”

A biopsychosocial formulation of pain communication.

“…Observer characteristics, such as age and gender, have also been shown to affect observers' decoding of pain (Hadjistavropoulos, LaChapelle, Hale, & MacLeod, 2000a;Hadjistavropoulos, McMurtry, & Craig, 1996b;MacLeod, LaChapelle, Hadjistavropoulos, & Pfeifer, 2001). In addition, as the large double headed arrow in Figure 2 illustrates, the actions of the observer could then lead to the removal or reduction of the pain stimulus but could also affect the pain experience itself.…”

“…Additional research has indicated that others' responses to high catastrophizers may vary substantially; catastrophizing appears to elicit positive responses such as the provision of instrumental support MacLeod et al, 2001) at least initially, as well as negative responses such as criticizing the sufferer in pain or responding punitively (Boothby et al, 2004;Keefe et al, 2003). A persistent demanding style of high catastrophizing is likely to, over time, become a source of strain, burden, frustration and distress for caregivers (Cano, 2004).…”

Taking into account the observers’ uncertainty: a graduated approach to the credibility of the patient’s pain evaluation

“…The choice to use a sample of medical students was motivated by the preliminary nature of the study, whose generalizability may be tested in further researches. Moreover, some previous studies on similar topics recruited students as participants (e.g., undergraduate psychology students in Chibnall, 1994 andTait, 1995; first-year medical students in Chibnall et al, 1997; undergraduate students in MacLeod et al, 2001). Yet they provided an insightful basis for subsequent studies.…”

“…In particular, a vast range of studies point to the fact that there is a discrepancy between patients' self evaluations and judgments expressed by observers, often resulting in a phenomenon of "pain underestimation" (e.g., MacLeod et al, 2001;Marquié et al, 2003;Kappesser et al, 2004;Kappesser et al, 2006). This well-established tendency might bear major consequences.…”