A common cultural belief is that that others generally exaggerate their pain, contrary with the normative behavior of being as accurate as possible

Over-rating pain is overrated: A fundamental self-other bias in pain reporting behavior. Brandon L.Boring et al. The Journal of Pain, June 18 2022. https://doi.org/10.1016/j.jpain.2022.06.002

Highlights

• A common cultural belief is that that others generally exaggerate their pain.

• Normative pain reporting behavior is to be as accurate as possible.

• Counter-stereotypical patterns of reporting in populations with pain disparities.

• Fundamental pain bias: a false belief others exaggerate contrary to personal norms.

• Broader implications: cultural pain stigma, patient-provider trust, pain outcomes.

Abstract: Wide-spread cultural beliefs influence personal experiences and clinical treatment of pain, yet are often unexamined and unchallenged in the pain literature. The common cultural belief that people generally over-report or exaggerate pain is familiar, reflected in discordant patient-provider pain assessments, and compounded in the context of disparities in pain treatment. However, no studies have directly measured the prevalence of this belief among the general population, nor challenged the validity of this assumption by assessing normative pain reporting in clinical settings. Results of an initial and replication study suggest that reporting pain accurately “as-is” is the norm, yet most people still believe that others normatively over-report pain. We refer to the phenomenon by which most people report their pain as they experience it while paradoxically believing that others over-report their pain as the fundamental pain bias, and suggest this false perception may contribute to larger scale pain stigma and poor outcomes for people in pain. We also identify counter-stereotypical patterns of pain reporting among groups (i.e., women, Latinx Americans) that face more disparate care. Results reinforce the need for respecting patient pain reports, and suggest that distrust surrounding others’ pain experiences is prevalent in society.

Keywords: Pain ratingsStereotypesDisparitiesPain communicationCultural narratives