Department of Medical Psychology and Sociology, University of Augsburg, Augsburg, Germany.
Bamberger Living Lab Dementia (BamLiD), University of Bamberg, Bamberg, Germany.
Pain. 2024 Aug 1;165(8):1784-1792. doi: 10.1097/j.pain.0000000000003180. Epub 2024 Feb 7.
Facial expressions of pain play an important role in pain diagnostics and social interactions. Given the prominent impact of sex on various aspects of pain, it is not surprising that sex differences have also been explored regarding facial expressions of pain; however, with inconclusive findings. We aim to further investigate sex differences in facial expressions of pain by using a large, combined sample to maximize statistical power. Data from 7 previous studies of our group were merged, combining in total the data of 392 participants (male: 192, female: 200). All participants received phasic heat pain, with intensities being tailored to the individual pain threshold. Pain intensity ratings were assessed, and facial responses were manually analyzed using the Facial Action Coding. To compare facial and subjective responses between sexes, linear mixed-effects models were used, with study ID as a random effect. We found significant sex differences in facial responses, with females showing elevated facial responses to pain, although they received lower physical heat intensities (women had lower pain thresholds). In contrast, pain intensity ratings did not differ between sexes. Additionally, facial and subjective responses to pain were significantly associated across sexes, with females showing slightly stronger associations. Although variations in facial expressions of pain are very large even within each sex, our findings demonstrate that women facially communicate pain more intensively and with a better match to their subjective experience compared with men. This indicates that women might be better in using facial communication of pain in an intensity-discriminative manner.
疼痛的面部表情在疼痛诊断和社会互动中起着重要作用。鉴于性别对疼痛的各个方面都有显著影响，因此，关于疼痛的面部表情也已经探索了性别差异，尽管这些发现并不一致。我们旨在通过使用一个大型的综合样本进一步研究疼痛的面部表情中的性别差异，以最大限度地提高统计效力。合并了我们团队的 7 项先前研究的数据，总共合并了 392 名参与者的数据（男性：192 名，女性：200 名）。所有参与者都接受了阶段性热痛刺激，强度根据个体疼痛阈值进行调整。评估了疼痛强度评分，并使用面部动作编码手动分析了面部反应。为了比较性别之间的面部和主观反应，使用线性混合效应模型，研究 ID 作为随机效应。我们发现面部反应存在显著的性别差异，女性对疼痛的面部反应更高，尽管她们接受的物理热强度较低（女性的疼痛阈值较低）。相比之下，性别之间的疼痛强度评分没有差异。此外，疼痛的面部和主观反应在性别之间具有显著的相关性，女性的相关性稍强。尽管即使在每个性别中，疼痛的面部表情变化也非常大，但我们的研究结果表明，女性比男性更强烈地表达疼痛，并且与主观体验更匹配。这表明女性在以强度为区分的方式使用面部疼痛沟通方面可能更有优势。
