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Researchers have found that when male and female patients expressed the same amount of pain, observers viewed female patients' pain as less intense and more likely to benefit from psychotherapy versus medication as compared to men's pain.
The results also indicated a significant patient gender bias that could also prompt disparities in treatments.
This research was published in the Journal of Pain, which is co-authored by Elizabeth Losin, assistant professor of psychology and director of the Social and Cultural Neuroscience lab at the University of Miami.
The study comprised two experiments for arriving at the results.
In the first experiment, 50 participants were asked to view various videos of male and female patients who suffered from shoulder pain performing a series of range of motion exercises using their injured and uninjured shoulders.
Researchers used the videos from a database that contains various videos of actual shoulder injury patients, each experiencing a range of different degrees of pain. The database, from where the videos were taken, included patients' self-reported level of discomfort when moving their shoulders, reported Hindustan Times.
The study provides results that are more applicable to patients in clinical settings compared to previous studies that used posed actors in their stimuli videos, according to Losin.
Losin said that one of the advantages of using these videos of patients who are actually experiencing pain from an injury is that they have the patients' ratings of their own pain."
She added that the study had a ground truth to work with, which they can't have if it's a stimulus with an actor pretending to be in pain.
The patients' facial expressions were analyzed through the Facial Action Coding System (FACS). It is a comprehensive, anatomically based system for describing all visually discernible facial movements.
For arriving at the conclusions, the researchers used these FACS values in a formula to provide an objective score of the intensity of the patients' pain facial expressions.
The study participants were asked to rate the amount of pain they thought the patients in the videos experienced on a scale from zero to a hundred. The scale of zero was labelled as "absolutely no pain," and 100, labelled as "worst pain possible."
In the second experiment, researchers replicated the first portion of this study with 200 participants.
After viewing the videos in the second experiment, perceivers were asked to complete the Gender Role Expectation of Pain questionnaire, which measures gender-related stereotypes about pain sensitivity, the endurance of pain, and willingness to report pain.
The perceivers also shared their inputs on how much medication and psychotherapy they would prescribe to each patient and which of these treatments they believed would be more effective in treating each patient.
After completing both the experiments, the researchers analysed the results of the participant's responses to the videos compared to the patient's self-reported level of pain and the facial expression intensity data.
Losin explained that the ability to analyse observers' perceptions relative to these two ground truth measures of the patients' pain in the videos allowed the researchers to measure bias more accurately.
Overall, the study found out that female patients were perceived to be in less pain than male patients, who exhibited the same intensity of pain.
The additional analyses using participants' responses to the questionnaire about gender-related pain stereotypes allowed researchers to arrive at the conclusion that these perceptions were partially explained by these stereotypes.
"If the stereotype is to think women are more expressive than men, perhaps 'overly' expressive, then the tendency will be to discount women's pain behaviours," said Losin.
Losin further added that the flip side of this stereotype is that men are perceived to be stoic, so when a man makes an intense pain facial expression.
Losin explained that the result of this gender stereotype about pain expression is that each unit of increased pain expression from a man is thought to represent a higher increase in his pain experience than that same increase in pain expression by a woman.
Apart from this, the study concluded that the gender of the perceivers did not influence pain estimation. Both men and women participating in the experiment interpreted women's pain to be less intense.
Losin also said that the idea to study disparities in the perception of pain based on a patient's gender was derived from previous research that stated women are often prescribed less treatment than men and wait longer to receive that treatment as well.
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