Threat of pain influences social context effects on verbal pain report and facial expression

• Published in: Behaviour research and therapy Vol. 47; no. 9; pp. 774 - 782
• Main Authors: Vlaeyen, Johan W.S., Hanssen, Marjolein, Goubert, Liesbet, Vervoort, Tine, Peters, Madelon, van Breukelen, Gerard, Sullivan, Michael J.L., Morley, Stephen
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.09.2009; Elsevier; Elsevier Science Ltd
• Subjects: Adult; Behavior; Biological and medical sciences; Catastrophization; Cognition. Intelligence; Cognitive appraisal model; Communal coping model; Discriminant analysis; Emotions; Face; Facial Expression; Female; Fundamental and applied biological sciences. Psychology; Humans; Male; Miscellaneous; Pain; Pain - psychology; Pain behavior; Pain catastrophizing; Pain Measurement - methods; Perceived threats; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Recovery; Safety behaviors social context; Self Report; Social context; Social Environment; Threat of pain; Validation studies; Safety behaviors social context; Pain catastrophizing; Communal coping model; Threat of pain; Pain behavior; Cognitive appraisal model; Social environment; Affect affectivity; Social influence; Cognition; Catastrophic thinking; Social behavior; Pain; Theoretical model; Language; Coping; Face; Verbalization; Cognitive appraisal; Human; Healthy subject; Emotion emotionality; Experimental study; Cognitive theory; Facial expression
• ISSN: 0005-7967; 1873-622X; 1873-622X
• DOI: 10.1016/j.brat.2009.05.008

Current theoretical models of pain catastrophizing have diverging predictions regarding the role of social context and perceived threat on pain expression. The communal coping model of catastrophizing predicts that high pain catastrophizers display more pain expression in the presence of another, regardless of the threat value of the pain, while a cognitive appraisal model predicts high pain catastrophizers to express more pain when pain has increased threat value, regardless of social context. A 2 × 2 factorial design was used to test the validity of both predictions. Healthy participants with varying levels of pain catastrophizing were exposed to a cold pressor task, consisting of a 60 s immersion and 60 s recovery period. Interestingly, the immersion results revealed that beyond and independent from the effects of pain catastrophizing, the effect of threat on verbal pain report and facial expression was dependent on social context and vice versa. In a threatening context, perceived threat of pain mediated the inhibitory effect of social presence on pain expression, suggesting that the observer acted as a safety signal. In the recovery period, social presence enhanced facial expression, but only when no threat was induced. The results are discussed in terms of the dynamic interaction between social context and threat appraisals.