Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada Department of Psychology, York University, Toronto, Ontario, Canada.
Pain. 2013 Apr;154(4):525-533. doi: 10.1016/j.pain.2012.12.015. Epub 2012 Dec 28.
Facial expressions provide a primary source of inference about a child's pain. Although facial expressions typically appear spontaneous, children have some capacity to fake or suppress displays of pain, thereby potentially misleading caregiver judgments. The present study was designed to compare accuracy of different groups of caregivers in detecting deception in children's facial expressions of pain when voluntarily controlled. Caregivers (15 pediatricians, 15 pediatric nurses, and 15 parents) viewed 48 video clips of children, 12 in each of 4 conditions (genuine pain, faked pain, suppressed pain, neutral baseline), and judged which condition was apparent to them. A 3 (group: pediatrician vs pediatric nurse vs parent)×4 (condition: genuine vs faked vs suppressed vs neutral) mixed analysis of variance (ANOVA) of judgment accuracies revealed a significant main effect of group, with nurses demonstrating higher overall accuracy scores than parents, and pediatricians not differing from either group. As well, all caregivers, regardless of group, demonstrated the lowest accuracy when viewing the genuine condition, relative to the faked and suppressed conditions, with accuracy for the neutral condition not differing significantly from the other conditions. Overall, caregivers were more successful at identifying faked and suppressed than genuine expressions of pain in children, and pediatric nurses fared better overall in judgment accuracy than parents.
面部表情是推断儿童疼痛的主要依据。尽管面部表情通常看起来是自发的，但儿童有一定的能力来伪装或抑制疼痛的表现，从而可能误导照顾者的判断。本研究旨在比较不同组别的照顾者在自愿控制的情况下，检测儿童疼痛面部表情欺骗时的准确性。照顾者（15 名儿科医生、15 名儿科护士和 15 名家长）观看了 48 个儿童视频片段，每个条件有 12 个片段（真实疼痛、伪装疼痛、抑制疼痛、中性基线），并判断他们看到的是哪种情况。对判断准确性进行的 3（组：儿科医生与儿科护士与家长）×4（条件：真实与伪装与抑制与中性）混合方差分析（ANOVA）显示，判断准确性存在显著的组间主效应，护士的总体准确性得分高于家长，而儿科医生与任何一组均无差异。此外，无论组别如何，所有照顾者在观看真实情况时的准确性最低，与伪装和抑制情况相比，中性情况的准确性与其他情况无显著差异。总体而言，照顾者在识别儿童疼痛的伪装和抑制表情方面比真实表情更成功，儿科护士在判断准确性方面总体上优于家长。
