Can images of pain enhance patient-clinician rapport in pain consultations?

A variety of treatment outcomes in chronic pain are influenced by patient-clinician rapport. Patients often report finding it difficult to explain their pain, and this potential obstacle to mutual understanding may impede patient-clinician rapport. Previous research has argued that the communication of both patients and clinicians is facilitated by the use of pain-related images in pain assessments. This study investigated whether introducing pain-related images into pain assessments would strengthen various components of patient-clinician rapport, including relative levels of affiliation and dominance, and interpersonal coordination between patient and clinician behaviour. Videos of 35 pain assessments in which pain images were present or absent were used to code behavioural displays of patient and clinician rapport at fixed intervals across the course of the assessment. Mixed modelling was used to examine patterns of patient and clinician affiliation and dominance with consultation type (Image vs Control) as a moderator. When pain images were present, clinicians showed more affiliation behaviour over the course of the consultation and there was greater correspondence between the affiliation behaviour of patient and clinician. However, relative levels of patient and clinician dominance were unaffected by the presence of pain images in consultations. Additional analyses revealed that clinicians responded directly to patients' use of pain images with displays of affiliation. Based on the results of this study, we recommend further investigation into the utility and feasibility of incorporating pain images into pain assessments to enhance patient-clinician communication.

Impact of pain behaviors on evaluations of warmth and competence.

This study investigated the social judgments that are made about people who appear to be in pain. Fifty-six participants viewed 2 video clips of human figures exercising. The videos were created by a motion tracking system, and showed dots that had been placed at various points on the body, so that body motion was the only visible cue. One of the figures displayed pain behaviors (eg, rubbing, holding, hesitating), while the other did not. Without any other information about the person in each video, participants evaluated each person on a variety of attributes associated with interpersonal warmth, competence, mood, and physical fitness. As well as judging them to be in more pain, participants evaluated the person who displayed pain behavior as less warm and less competent than the person who did not display pain behavior. In addition, the person who displayed pain behavior was perceived to be in a more negative mood and to have poorer physical fitness than the person who did not, and these perceptions contributed to the impact of pain behaviors on evaluations of warmth and competence, respectively. The implications of these negative social evaluations for social relationships, well-being, and pain assessment in persons in chronic pain are discussed.

Warriors and peacekeepers: testing a biosocial implicit leadership hypothesis of intergroup relations using masculine and feminine faces.

This paper examines the impact of facial cues on leadership emergence. Using evolutionary social psychology, we expand upon implicit and contingent theories of leadership and propose that different types of intergroup relations elicit different implicit cognitive leadership prototypes. It is argued that a biologically based hormonal connection between behavior and corresponding facial characteristics interacts with evolutionarily consistent social dynamics to influence leadership emergence. We predict that masculine-looking leaders are selected during intergroup conflict (war) and feminine-looking leaders during intergroup cooperation (peace). Across two experiments we show that a general categorization of leader versus nonleader is an initial implicit requirement for emergence, and at a context-specific level facial cues of masculinity and femininity contingently affect war versus peace leadership emergence in the predicted direction. In addition, we replicate our findings in Experiment 1 across culture using Western and East Asian samples. In Experiment 2, we also show that masculine-feminine facial cues are better predictors of leadership than male-female cues. Collectively, our results indicate a multi-level classification of context-specific leadership based on visual cues imbedded in the human face and challenge traditional distinctions of male and female leadership.