A study found that when we observe patients we do not like, we tend to have a lower estimate of their pain intensity and are perceptually less sensitive to their pain, researchers reported in the journal Pain. The Belgian researchers explained that we tend to become less able to discriminate between varying pain levels when they are expressed by patients we dislike.

Liesbet Goubert, PhD, from Ghent University, Belgium, and team preconditioned 40 study participants by asking them to look at photographs of six different patients. Each patient was tagged with simple descriptions, ranging from:

  • Negative – e.g. egoistic, arrogant, or hypocritical
  • Neutral – e.g. reserved, true to tradition, or conventional
  • Positive – e.g. friendly, honest, or faithful

After being preconditioned, the volunteers watched short videos of each patient as they underwent standardized physiotherapy assessment. The six patients had shoulder pain. The participants watched 48 two-second video fragments; eight for each patient.

The participants had to rate pain severity after watching each 2-second video fragment – ratings varied from “no pain” to “pain as bad as could be”. At the end of the experiment, the participants had to decide whether the patients were negative/positive, agreeable/disagreeable, and sympathetic/unsympathetic.

As expected, the participants found that:

  • Patients with negative traits – participants found them to be the least likeable of all
  • Patients with neutral traits – participants found them more likeable than those with negative traits but less likeable than those with positive traits
  • Patents with positive traits – participants found these to be the most likeable patients of all

The participants rated the pain of the disliked patients who expressed high intensity pain as less intense when compared to high intensity pain expressed by the most likeable patients. They were also found to be less perceptually sensitive towards the pain of those with negative traits, compared to those with positive traits – in other words, they could not discriminate between different pain levels expressed by the disliked patients as well as they could among the liked patients.

Liesbet Goubert, PhD, assistant professor of Health Psychology and co-investigator Geert Crombez, PhD, head of the Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium, said:

“Identifying variables that influence pain estimation by others is relevant as pain estimation might influence crucial actions concerning pain management both in the professional context as well as in the everyday environment.

Our results suggest that pain of disliked patients who express high pain is taken less seriously by others.

This could imply less helping behavior by others as well as poorer health outcomes.”

Written by Christian Nordqvist