Stopyn Rhonda J N, Hadjistavropoulos Thomas, Loucks Jeff
Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada.
J Nonverbal Behav. 2021;45(1):31-52. doi: 10.1007/s10919-020-00344-0. Epub 2020 Oct 11.
Nonverbal pain cues such as facial expressions, are useful in the systematic assessment of pain in people with dementia who have severe limitations in their ability to communicate. Nonetheless, the extent to which observers rely on specific pain-related facial responses (e.g., eye movements, frowning) when judging pain remains unclear. Observers viewed three types of videos of patients expressing pain (younger patients, older patients without dementia, older patients with dementia) while wearing an eye tracker device that recorded their viewing behaviors. They provided pain ratings for each patient in the videos. These observers assigned higher pain ratings to older adults compared to younger adults and the highest pain ratings to patients with dementia. Pain ratings assigned to younger adults showed greater correspondence to objectively coded facial reactions compared to older adults. The correspondence of observer ratings was not affected by the cognitive status of target patients as there were no differences between the ratings assigned to older adults with and without dementia. Observers' percentage of total dwell time (amount of time that an observer glances or fixates within a defined visual area of interest) across specific facial areas did not predict the correspondence of observers' pain ratings to objective coding of facial responses. Our results demonstrate that patient characteristics such as age and cognitive status impact the pain decoding process by observers when viewing facial expressions of pain in others.
非言语疼痛线索，如面部表情，在对沟通能力严重受限的痴呆症患者进行疼痛的系统评估中很有用。尽管如此，观察者在判断疼痛时依赖特定疼痛相关面部反应（如眼球运动、皱眉）的程度仍不明确。观察者观看了三类患者表达疼痛的视频（年轻患者、无痴呆症的老年患者、患有痴呆症的老年患者），同时佩戴眼动追踪设备记录他们的观看行为。他们为视频中的每位患者给出疼痛评分。与年轻成年人相比，这些观察者给老年人的疼痛评分更高，给患有痴呆症的患者的疼痛评分最高。与老年人相比，给年轻成年人的疼痛评分与客观编码的面部反应更相符。观察者评分的相符程度不受目标患者认知状态的影响，因为给有痴呆症和无痴呆症的老年人的评分没有差异。观察者在特定面部区域的总注视时间百分比（观察者在定义的感兴趣视觉区域内扫视或注视的时间量）并不能预测观察者的疼痛评分与面部反应客观编码的相符程度。我们的结果表明，年龄和认知状态等患者特征会影响观察者在观察他人疼痛面部表情时的疼痛解码过程。
