Abstract
Individuals with pain-related concerns are likely to interpret ambiguous pain-related information in a threatening manner. It is unknown whether this interpretation bias also occurs for ambiguous pain-related facial expressions. This study examined whether individuals who habitually attach a catastrophic meaning to pain are characterized by negative interpretation bias for ambiguous pain-related facial expressions. Sixty-four female undergraduates completed an incidental learning task during which pictures of faces were presented, each followed by a visual target at one of two locations. Participants indicated target location by pressing one of two response keys. During the learning phase, happy and painful facial expressions predicted target location. During two test phases, morphed facial expressions of pain and happiness were added, equally often followed by a target at either location. Faster responses following morphs to targets at the location predicted by painful expressions compared to targets at the location predicted by happy expressions were taken to reflect pain-related interpretation bias. During one test phase, faces were preceded by either a safe or threatening context cue. High, but not low, pain-catastrophizers responded faster following morphs to targets at the location predicted by painful expressions than to targets at the other location (when participants were aware of the contingency between expression type and target location). When context cues were presented, there was no indication of interpretation bias. Participants were also asked to directly classify the facial expressions that were presented during the incidental learning task. Participants classified morphs more often as happy than as painful, independent of their level of pain catastrophizing. This observation is discussed in terms of differences between indirect and direct measures of interpretation bias.
Highlights
Pain-related behaviors, such as facial expressions, provide information about one’s current feelings and situation to others (Williams, 2002)
Mean RTs (Table 1, top rows) were subjected to an ANOVA with expression type (2: painful vs. happy) and target location (2: location predicted by painful expressions vs. location predicted by happy expressions) as within-subjects factors and Pain Catastrophizing Scale (PCS) group (2: high vs. low) as between-subjects factor
The primary objective of this study was to investigate whether healthy individuals, especially those with higher levels of pain catastrophizing, show a negative interpretation bias for ambiguous pain-related facial expressions
Summary
Pain-related behaviors, such as facial expressions, provide information about one’s current feelings and situation to others (Williams, 2002). Pain behavior can be ambiguous, not always providing a clear signal of pain or somatic threat (Pincus and Morley, 2001). Relevant to pain and maladaptive pain responding is whether negative interpretation bias of ambiguous pain behavior depends on the meaning attached to pain. Biased interpretation of ambiguous pain-related information, such as words related to pain and somatic threat, has found to be associated with individuals’ levels of pain-related anxiety, pain catastrophizing, and pain-related fear in healthy individuals (Pincus and Morley, 2001; Keogh and Cochrane, 2002; McKellar et al, 2003; Vancleef et al, 2009). We investigated biased interpretation of ambiguous pain-related facial expressions (i.e., morphed facial expressions of pain and happiness) in healthy volunteers, taking individual differences in level of pain catastrophizing into account
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