“When we dislike a person, we tend to underestimate the amount of pain they are in,” says University of Northern British Columbia psychology professor Ken Prkachin, whose research in the area of pain expression has been published in the latest edition of Pain, the official journal of the International Association for the Study of Pain. “This can include health professionals when they gauge pain in their patients. People who should be in a position to accurately gauge levels of pain are often poor at it.”

Dr. Prkachin co-wrote the article “When You Dislike Patients, Pain is Taken Less Seriously” with five other researchers from the University of Ghent in Belgium who set out to answer the question, “What are the impediments to a patient’s ability to communicate pain to their doctor?”

“We found that people associated with negative traits - egotism, arrogance, hypocrisy - had their level of pain consistently under-rated even when they were, in fact, in considerable pain,” says Dr. Prkachin. “If a clinician underestimates a patient’s pain, the course of action they take runs the risk of doing harm.”

The research involved showing photos of patients with corresponding descriptions of their personality traits to 40 study participants. The subjects were then shown recordings of the same patients in moderate pain, severe pain, and no pain at all. Participants were then asked to rate the pain level of each patient. The discomfort of disliked patients was consistently rated as less severe than that of “likable” patients.

“This is part of a huge public health epidemic of people in pain, chronic and otherwise, and patients with ‘invisible’ injuries are often doubly aggrieved,” says Dr. Prkachin. “If you break your leg, there is a visible sign such as a cast or a crutch. But if you have a bad back, people, including health professionals, are often skeptical and so treat the sufferer negatively, which can result in a second victimization. This is often affected by how much the person is liked.”

Dr. Prkachin adds that this line of research has already contributed to an increasing awareness among health professionals and policy makers. “Communications about pain have the potential to complicate and worsen an already complex clinical problem. Other findings suggest that surprisingly minimalist interventions, like encouraging people to view the world from the sufferer’s perspective, can diminish and even eliminate biases.”

Dr. Prkachin's research involves health and clinical psychology, pain expression, and the bio-behavioral determinants of heart disease. He is also Director of UNBC’s Psychophysiology Laboratory.