If a patient is not likeable, will he or she be taken less seriously when exhibiting or complaining about pain? Reporting in the October 2011 issue of Pain®, researchers have found that observers of patients estimate lower pain intensity and are perceptually less sympathetic to the patients’ pain when the patients are not liked.

40 study participants (17 men and 23 women) were preconditioned by viewing pictures of six different patients tagged with simple descriptions that ranged from negative (egoistic, hypocritical, or arrogant) to neutral (true to tradition, reserved, or conventional) to positive (faithful, honest, or friendly). After this preconditioning process, participants observed short videos of the patients undergoing a standardized physiotherapy assessment. The six patients observed were experiencing shoulder pain and eight short video fragments (2 seconds in duration) of each were selected, resulting in 48 different fragments. After each video fragment, the participants were asked to rate the severity of pain of the patients on a scale of “no pain” to “pain as bad as could be.” Afterwards, the participants were also asked to judge the patients to be negative or positive, disagreeable or agreeable, and unsympathetic or sympathetic.

Investigators found that participants rated patients associated with negative traits as less likeable than patients associated with neutral traits. They rated patients associated with neutral traits as less likable than patients associated with positive traits. Further, pain of disliked patients expressing high intensity pain was estimated as less intense than pain of liked patients expressing high intensity pain. Furthermore, observers were less perceptually sensitive toward pain of negatively evaluated patients than to pain of positively evaluated patients, i.e. they were less able to discriminate between different levels of pain expressed by the disliked patients.

“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,” commented lead investigator 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. “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.”

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The article is “When you dislike patients, pain is taken less seriously” by Lies De Ruddere, Liesbet Goubert, Ken Martin Prkachin, Michael André Louis Stevens, Dimitri Marcel Leon Van Ryckeghem, and Geert Crombez (DOI: 10.1016/j.pain.2011.06.028). It appears in Pain®, Volume 152, Issue 10 (October 2011) published by Elsevier.

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