In some cases of chronic pain, the complaints seem out of
proportion to pathophysiological findings. Several models of
pain have been forwarded to account for such cases, but no one
explanation can account for the underlying processes involved in
the genesis of chronic pain in all cases. The present analysis
offers the additional factor of self—deception, defined as a
contradiction between one’s words or attitude and behavior. By
attempting to demonstrate subjective pain to observers, a pain
patient convinces him- or herself of the displayed painfulness
through a process of self—deception. Several psychological
phenomena are included in the model of self—deception, including
coping strategies, cognitive dissonance, self-perception,
impression management, and attentional and memory biases.
To explore the self—deception model of chronic pain, a
laboratory analogue study was devised using female student
volunteers who rated the painfulness of shock—induced stimuli
under conditions designed to foster self—deception. Painfulness
was measured 1) verbally by means of two visual analogue scales
which reflected the pain intensity and affective unpleasantness
and 2) nonverbally by means of quantified facial muscle
movements. For each subject, individual pain threshold and
tolerance levels were established. She then underwent a pretest
comprising five random shocks from her threshold to tolerance
range. Next, in the manipulation phase the subject was asked to
display more, less or the same degree of pain while undergoing
another random series of shocks. A final posttest was identical to the pretest and provided a measure of the durability of the
altered pain display effect. In the first of two studies, the
altered pain display was nonverbal: subjects exaggerated,
diminished or did not change their facial expressiveness while
undergoing the pain stimuli. In the second study, the altered
pain display was verbal: subjects were told that at the end of
the series they would be required to tell a fellow student (via
videotape) that the shocks hurt more, less or about the same as
what they had expected. Half of all subjects were further told
that their deceptive communication would have negative
consequences for viewers.
Misleading fellow students about the pain experienced was
expected to make the subjects feel badly, motivating them to
change their attitude or beliefs about the pain experienced.
They were expected to change their pain reports in keeping with
the deceptive communication. That is, other deception was
expected to foster self-deception. This effect was expected to
endure and it was expected to be greatest for those in the
negative consequences condition.
The first study showed that exaggerated facial expressions
of pain appear to be an amplification of normal pain expression.
However, changes in facial expression did not bring about changes
in verbal report of pain perceived, calling into question the
facial feedback hypothesis.
The results of the second study suggested that pain was
altered only for subjects who prepared to state that their pain
felt less painful than expected. This effect reached significance on the pain intensity visual analogue scale for low
intensity shocks. This effect did not carry over into the
posttest phase, nor were negative consequences effective in
amplifying the manipulation, leaving the theoretical mechanism
underlying the change in pain unclear. Moreover, the effect did
not vary amongst subjects who scored differently on
questionnaires measuring self—deception as a trait, present
anxiety, or adaptive coping strategies.
The self—report measure of self—deception was related to
factors found to predict adaptive coping or good functioning in
chronic pain patients, namely a sense of control over pain and
the absence of catastrophizing thoughts.
One particular facial movement (brow lowerer) was
consistently related to the verbal pain reports, attesting to the
validity of facial expression as a measure of pain.
The results are discussed with implications and suggestions
for future research. One major problem with research involving
subject deception is that subjects may appear to comply with
experimental instructions to deceive others while avoiding
personal responsibility through a variety of mechanisms yet to be
determined.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/3295 |
| Date | 05 1900 |
| Creators | Swalm, Delphin Marlene |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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