Feeling More Pain, Yet Showing Less: The Influence of Social Threat on Pain

The present study investigated the effects of social threat to physical integrity on reported pain and facial pain expression. Predictions of a cognitive appraisal model and a communicative perspective on pain expression were compared. Participants (N = 67) received 5 electric pain stimuli administered by a confederate. They were led to believe that 5 pain stimuli were the minimum, a fixed amount, or the maximum number of pain stimuli allowed, thereby varying the social threat posed by the confederate. Reported pain and facial pain expression were recorded during the delivery of pain stimuli. Increased perceived social threat led to an increase of reported pain, specifically for high pain catastrophizing participants, while it led to a reduction of facial pain expression. This is the first study to demonstrate that a social threat manipulation has opposite effects on reported pain and facial expression, suggesting differences in adaptive function for both forms of pain expression. Perspective: This is the first demonstration showing an increase in verbal pain report and a decrease in nonverbal pain expression at the same time during social threat. This knowledge may contribute to improving pain assessment in different contexts. (C) 2011 by the American Pain Society