Abstract: Previous research showing that swearing alleviates pain is extended by addressing emotion arousal and distraction as possible mechanisms. We assessed the effects of a conventional swear word (“fuck”) and two new “swear” words identified as both emotion-arousing and distracting: “fouch” and “twizpipe.” A mixed sex group of participants (N = 92) completed a repeated measures experimental design augmented by mediation analysis. The independent variable was repeating one of four different words: “fuck” vs. “fouch” vs. “twizpipe” vs. a neutral word. The dependent variables were emotion rating, humor rating, distraction rating, cold pressor pain threshold, cold pressor pain tolerance, pain perception score, and change from resting heart rate. Mediation analyses were conducted for emotion, humor, and distraction ratings. For conventional swearing (“fuck”), confirmatory analyses found a 32% increase in pain threshold and a 33% increase in pain tolerance, accompanied by increased ratings for emotion, humor, and distraction, relative to the neutral word condition. The new “swear” words, “fouch” and “twizpipe,” were rated as more emotional and humorous than the neutral word but did not affect pain threshold or tolerance. Changes in heart rate and pain perception were absent. Our data replicate previous findings that repeating a swear word at a steady pace and volume benefits pain tolerance, extending this finding to pain threshold. Mediation analyses did not identify a pathway via which such effects manifest. Distraction appears to be of little importance but emotion arousal is worthy of future study.
Discussion
This study contributes to the psychology literature on swearing in the context of pain (Stephens et al., 2009; Stephens and Umland, 2011; Philipp and Lombardo, 2017; Robertson et al., 2017) as the first attempt to create new “swear” words and assess some of their psychological properties. Our experiment assessed the effects of repeating three different words – a conventional swear word (“fuck”) and two new “swear” words (“fouch” and “twizpipe”) - on pain perception and tolerance, compared with a neutral word control condition (a word to describe a table). We ran a well-powered experiment with a sample consisting of 92 native English speakers. We used an ice-cold water hand immersion task known as the cold pressor procedure. This provides a controlled stimulus that is painful but not harmful and yields scores for pain threshold (time at which pain is reported) and pain tolerance (time at which the hand is removed). We also recorded heart rate as well as ratings of pain perception, emotion, humor, and distraction. The order in which participants completed the conditions (“fuck,” “fouch,” “twizpipe,” and neutral word) was randomized to guard against order effects. Pain Catastrophizing and Fear of Pain scores were gathered to help understand sample characteristics. The scores were similar to our previous data (Stephens and Umland, 2011) in which the overall mean score for Pain Catastrophizing was 25.30 (SD = 9.64) and for Fear of Pain was 87.45 (SD = 16.43). This indicates that our sample may be considered typical for these variables and, as such, that these variables are unlikely to have unduly influenced the pain outcomes.
Hypotheses (i) to (iii) were put forward as manipulation checks to ensure that the made-up “swear” words had the desired properties in terms of the emotion, humor, and distraction ratings. Hypothesis (i) that emotion ratings would be greater for “fouch” vs. neutral word was supported, and hypothesis (ii) that humor and distraction ratings would be greater for “twizpipe” vs. neutral word was partially supported in that the humor rating was greater for “twizpipe.” Interestingly, both made-up “swear” words showed higher ratings for emotion and humor compared with the neutral word. Hypothesis (iii) that emotion, humor, and distraction ratings would be greater for “fuck” vs. neutral word was supported. Our tests of hypotheses (i) to (iii) demonstrate that our manipulation of creating new “swear” words was successful in that “fouch” and “twizpipe” were able to evoke some of the properties of swearing, in terms of emotion rating and humor. This was not the case for distraction, however, since only “fuck” was found to have a raised distraction rating compared with the neutral word. Given that both new “swear” words had demonstrated potential to influence pain perception via increased emotion ratings and/or distracting a person from the pain via increased humor ratings, it seemed appropriate to continue with the analyses and test whether the new “swear” words had any effect on the pain outcomes. We also note that “fuck” was rated as humorous in this context, consistent with the findings of Engelthaler and Hills (2018), who found the word “fuck” was rated in the top 1% of funniest words when 5000 English words were presented one at a time.
Hypotheses (iv) to (vii) were put forward as tests of whether the conventional swear word and the new “swear” words would show hypoalgesic effects and associated changes in heart rate, as found previously. Hypothesis (iv), that cold pressor pain onset latency (pain threshold) would be increased for “fuck,” “fouch,” and “twizpipe” vs. neutral word, was supported for “fuck” but not for “fouch” or “twizpipe.” Hypothesis (v), that cold pressor pain tolerance latency would be increased for “fuck,” “fouch,” and “twizpipe” vs. neutral word, was also supported for “fuck” but not for “fouch” or “twizpipe”. Together, these findings extend previous research on swearing and pain by replicating, in a pre-registered study, the beneficial effect of swearing on pain tolerance and showing that swearing has an additional beneficial effect on pain threshold (onset latency), a behavioral pain measure that has not previously been assessed.
Regarding the new “swear” words, our confirmatory analyses showed no beneficial effects for pain threshold and tolerance. On the suggestion of a peer reviewer, we ran exploratory equivalence tests assessing whether the effect sizes for these words were within a range considered to be negligible. These analyses confirmed the absence of a beneficial effect for pain threshold and tolerance beyond a smallest effect size of interest based on the conservatively small estimate of dz = 0.3 entered into the power calculation. That these new “swear” words had no effect on pain threshold and tolerance is not altogether surprising. While it is not properly understood how swear words gain their power, it has been suggested that swearing is learned during childhood and that aversive classical conditioning contributes to the emotionally arousing aspects of swear word use (Jay, 2009; Tomash and Reed, 2013). This suggests that how and when we learn conventional swear words is an important aspect of how they function. Clearly, the new “swear” words utilized in the present study were not learned during childhood and so there was no possibility that this aspect could have had an influence. On the other hand, “fouch” and “twizpipe” were chosen because they had potential to mirror some properties of conventional swearing. Like the swear word, these words were rated as more emotion-evoking and humorous than the neutral word control condition. Nevertheless, these properties did not facilitate pain alleviation effects, suggesting that surface properties of swear words (such as how they sound) do not explain the hypoalgesic effects of swearing. An overall absence of pain alleviation effects for the new “swear” words in the present study would be expected based on Jay’s (2009) childhood aversive classical conditioning theory. There is little evidence for this theory other than a low powered experiment (N = 26) finding that participants reporting a higher frequency of punishment for swearing as children showed an increased skin conductance response when reading swear words, compared with participants reporting a lower frequency of punishment for swearing (Tomash and Reed, 2013). To investigate this theory further, future research should aim to verify the frequency with which such aversive classical conditioning events occur in childhood and assess the relationship between prior punishment for swearing and autonomic arousal in an adequately powered design.
Hypothesis (vi), that pain perception would be decreased for “fuck,” “fouch,” and “twizpipe” vs. neutral word, was not supported. We should not be surprised at the lack of differences for pain perception as this may indicate that participants base behavioral decisions of reporting pain onset and removing the hand on similar perceived pain levels, albeit levels that have been modified by repeating a swear word. On that basis we suggest that measuring subjective pain perception is of limited usefulness in future studies assessing hypoalgesic effects of swearing where behavioral measures such as the cold pressor procedure are employed.
Hypothesis (vii), that change from resting heart rate would be increased for “fuck” and “fouch” vs. neutral word, was not supported. The lack of heart rate differences across conditions is at odds with previous studies which have shown elevated heart rate for swearing versus a neutral word (Stephens et al., 2009; Stephens and Umland, 2011). This may be due to the design of the present study in which participants completed four consecutive word repetition/cold pressor immersion conditions rather than two, as previously. Repeated presentations of similar tasks, as well as repeated exposure to aversive stimuli, have been found to result in blunted cardiovascular stress reactivity (Hughes et al., 2018). Blunted cardiovascular stress reactivity refers to the reduction in cardiovascular response to acute physiological or psychological stress (Brindle et al., 2017). It seems reasonable to suggest that repeated exposure to cold pressor-mediated acute pain may have induced cardiovascular blunting.
In the absence of clear autonomic responses to swearing, we assessed the exploratory hypothesis (viii) that the effects of swearing on pain tolerance would be mediated by one or more psychological variables, in the form of the emotion, humor, or distraction rating scores. However, none of the ratings showed evidence of mediation, with 95% confidence intervals for humor and distraction being approximately symmetrically balanced across the origin. The latter effect is of interest because swearing in the context of pain is often characterized as a deliberate strategy for distraction, and distraction is recognized as being an effective psychological means of influencing descending pain inhibitory pathways (Edwards et al., 2009). While swearing was rated as distracting (more so than the other words) the level of distraction was not related to the pain alleviation effects. Thus, based on our evidence, distraction may not be important in explaining how swearing produces hypoalgesic effects. The analysis assessing whether emotion ratings mediate the effect of swearing on extending pain tolerance also showed no effect, although here the 95% confidence interval only narrowly crossed the origin. While offering no evidential support for a mediation effect, further study assessing mediation of hypoalgesic effects of swearing via emotional arousal, in the absence of changes in heart rate, might fruitfully demonstrate this as a viable mechanism. Such an effect would be in keeping with previous research finding pain relieving effects of emotional arousal (Stephens and Allsop, 2012).
However, there is a caveat to this. At the study outset we theorized that swearing may increase emotional arousal without specifying the valence of that arousal. During peer review we were directed to literature linking emotion elicitation and pain modulation, and in particular, research by Lefebvre and Jensen (2019) who report that inducing a state of negative affect by asking participants to recall a time when they experienced a high degree of worry led to increased ratings of pain from pressure applied to the finger, relative to baseline. In addition, the same study found that inducing a state of positive affect by asking participants to recall a happy memory led to decreased ratings of pain. It is apparent that emotional modulation of pain can be explained by the two-factor behavioral inhibition system-behavioral activation system (BIS-BAS) model of pain (Jensen et al., 2016). According to the BIS-BAS model, negative affect contributes toward pain-related avoidance behaviors and associated negative cognitions, thereby increasing the subjective experience of pain. Conversely, positive affect contributes toward approach behaviors and positive cognitions, thus decreasing the subjective experience of pain. One limitation of the present study is that the measure of emotion elicitation was not valenced. This may explain why emotion was not shown to be a mediating variable in the link between swearing and hypoalgesia. Future research should assess both positive and negative emotion arousal due to swearing.
A further limitation might have been that participants did not consider themselves to be swearing when repeating the novel “swear” words. This remains unknown as we did not carry out a manipulation check asking participants whether they considered using these words was swearing. On the other hand, the novel “swear” words were selected by a panel of experts and laypeople briefed to choose words that could be used in similar ways to swear words, and which shared properties of swear words including emotional resonance and humor potential. It is also worth noting that “Fouch” begins with a fricative, defined as a sound created by forcing air through a narrow channel (here the lower teeth and upper lip) which some have associated with swearing, although other contest such a link (Stack Exchange, 2014).
Additionally, maintaining the ice water temperature in the range 3–5°C might be considered too wide a variation, such that the physical intensity of the pain stimulus was not consistent across participants. In mitigation there was no systematic variation of the temperature across the four word conditions. As shown in Table 1, the starting temperatures for each immersion were fairly consistent, with means ranging from 3.91 to 3.98 (SDs 0.50 to 0.53). This indicates that approximately 65% of immersions had starting temperatures within a 1°C range of 3.5–4.5°. Therefore, variation in temperature is unlikely to have biased the results.
A final limitation is that participants may have guessed the aims of the study and consequently demand characteristics may have influenced the results. In advertising the study as “psychological effects of vocal expressions, including swearing, while immersing the hand in ice water” we aimed to hide our predictions. Nevertheless, due to widespread media exposure for findings of previous studies conducted in the Keele Swear Lab we cannot rule out, nor quantify the extent to which, participant behavior was influenced by expectations of participants.
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