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Abstract

Psychological research on pain has highlighted the apparent plasticity of the experience and the substantial impact that social events have as determinants of its expression. For example, a wealth of evidence has demonstrated that exposure to social models displaying relative tolerance or intolerance for painful stimulation induces subjects to alter verbal reports of pain in tolerant and intolerant directions, respectively. Research on these effects, employing Signal Detection Theory (SDT) methods, suggests that these effects may be mediated by alterations in sensitivity to painful stimuli (Craig & Coren, 1975; Craig & Prkachin, 1978). Although the relevance of SDT methods to diagnostic decision-making processes has frequently been pointed out, relatively few studies have employed SDT methods to investigate diagnostic practices. The SDT perspective on diagnostic processes emphasizes the notion that a particular decision regarding the presence and severity of symptoms reflects the operation of two Factors: 1) evidence that a particular phenomenon is present in the patient, and 2) the diagnostician's readiness to accept weak or strong evidence as indicating the presence of the inferred phenomenon. In pain evaluations, variables such as background information about the patient are important in determining the diagnostician's criterion for accepting a particular set of evidence as indicative of pain. For the pain sufferer the diagnostician's criterion is critical. A bias to interpret expressive behavior as indicative that little pain is present may have drastic consequences on subsequent caretaking responses. The present study was an attempt to evaluate the impact of a priori pain-relevant information on observers' readiness to report the occurrence of pain in others. A second focus was to evaluate the influence of exposure to social models on discriminability of the overt behavior of subjects experiencing pain. SDT methods were employed for both purposes. Videotapes taken of subjects exposed to electric shocks of varying intensities were presented to 30 observers who attempted to determine the level of pain that observed "senders" were experiencing. Analyses of observers' judgments indicated that observers who were instructed that senders had had a pain-enhancing treatment were biased toward reporting pain in senders relative to observers instructed that senders had experienced a pain-reducing treatment and relative to controls. The behavior of senders exposed to a tolerant model was less discriminable and elicited lower average pain ratings relative to that of senders exposed to an intolerant model. Additional findings were that 1) males produced reliably higher discriminability ratings than females and 2) discriminability of pain expressions was inversely related to observer empathy. These results indicated that: 1) judgments of the presence and severity of pain experienced by others are substantially affected by background information, and 2) variations in social experience are capable of altering subjects' overt expressions of pain. Findings are discussed in relation to existing theories of social influences on pain, and in relation to diagnostic practices in the evaluation of pain in the natural setting.