Hide your pain: Social threat increases pain reports and aggression, but reduces facial pain expression and empathy

Kai Karos*, Ann Meulders, Liesbet Goubert, Johan W.S. Vlaeyen

*Corresponding author for this work

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Earlier research studying the effects of social threat on the experience and expression of pain led to mixed results. In this study, female participants (N = 32) came to the lab with two confederates. Both confederates administered a total of 10 painful electrocutaneous stimuli to the participant. The framing of the administration was manipulated in a within-subjects design: In the low social threat condition the participant was told that the confederate could choose between 10 to 20 pain stimuli, thus they believed that this confederate chose to administer the minimum allowed number of pain stimuli. In the high social threat condition the confederate had a choice between 1 and 10 stimuli, thus they believed that this confederate chose to administer the maximum allowed number of stimuli. Participants reported on the intensity, unpleasantness, and threat value of the painful stimuli, and their facial expression was recorded. Moreover, aggression and empathy towards the confederates were assessed. As hypothesized, participants reported increased pain intensity, unpleasantness, and threat in the high social threat condition compared to the low social threat condition, but showed less facial pain expression. Finally, participants exhibited increased aggression and reduced empathy towards the confederate in the high social threat condition. PERSPECTIVE: Social threat reduces painful facial expression, but simultaneously increases pain reports, leading to a double burden of the person in pain. Additionally, social threat affected social relationships by increasing aggression and reducing empathy for the other.

Original languageEnglish
Pages (from-to)334-346
Number of pages13
JournalThe Journal of Pain
Issue number3-4
Early online date25 Jul 2019
Publication statusPublished - 2020


  • Social threat
  • pain expression
  • self-report
  • aggression
  • communication
  • retribution
  • empathy
  • SEX

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