Biological sex and social setting affects pain intensity and observational coding of other people's pain behaviors.

This experiment examines the impact of biological sex and audience composition on laboratory-induced ischemic pain intensity and observational coding of other people's pain behaviors. Situational context was manipulated by varying the sex and number of audience stimuli in the laboratory setting during the pain task and during observational evaluations of other people's pain suffering. The analyses revealed sex differences in felt pain intensity and observable pain behaviors, with male subjects reporting lower pain intensity and evidencing fewer pain behaviors than female subjects on average. Follow-up analyses revealed that, after controlling for social anxiety, audience composition was linked to felt pain intensity, and this relation was moderated by participant sex and audience sex, such that only male subjects showed decreased pain intensity with increasing number of female audience members. Sex differences were also found in the rating of other people's pain behaviors, with male observers rating the pain of others lower than female observers. Composition of the audience influenced observers' pain ratings such that the presence of more male subjects in the audience correlated with lower observer ratings, whereas the presence of more female subjects correlated with higher observer ratings. This is the first study to show that the sex and the composition of the social context in which pain is experienced affects the intensity of felt pain and the evaluation of other people's pain suffering. Implications of the findings for measuring and interpreting pain suffering in male and female patients by male and female treatment providers in health care settings are discussed. Published by Elsevier B.V.