Pain judgements of patients’ relatives: examining the use of social contract theory as theoretical framework
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Observer underestimation of others’ pain was studied using a concept from evolutionary psychology: a cheater detection mechanism from social contract theory, applied to relatives and friends of chronic pain patients. 127 participants estimated characters’ pain intensity and fairness of behaviour after reading four vignettes describing characters suffering from pain. Four cues were systematically varied: the character continuing or stopping liked tasks; continuing or stopping disliked tasks; availability of medical evidence; and pain intensity as rated by characters. Results revealed that pain intensity and the two behavioural variables had an effect on pain estimates: high pain self-reports and stopping all tasks led to high pain estimates; pain was estimated to be lowest when characters stopped disliked but continued with liked tasks. This combination was also rated least fair. Results support the use of social contract theory as a theoretical framework to explore pain judgements.
KeywordsPain underestimation Pain judgements Significant others Vignettes Social contract theory Cheating detection mechanism
This study is part of the first author’s PhD funded by the National German Merit Foundation. Authors wish to thank all participants, patients and staff at INPUT Pain Management Programme for their help and support, as well as to thank Raymond Tait for kindly providing original materials of vignette studies by himself and his colleagues.
- Cosmides, L., & Tooby, J. (1992). Cognitive adaptations for social exchange. In J. H. Barkow, L. Cosmides, & J. Tooby (Eds.), The adapted mind: Evolutionary psychology and the generation of culture (pp. 163–228). Oxford: Oxford University Press.Google Scholar
- Cosmides, L., & Tooby, J. (2004). Knowing thyself: the evolutionary psychology of moral reasoning and moral sentiments. In R. E. Freeman, & P. Warhane (Eds.), Business, science, and ethics: The Ruffing series (pp. 91–127). Charlottesville, VA: Society for Business Ethics.Google Scholar
- Craig, K. D., Hill, M. L., & McMurtry, B. W. (1999). Detecting deception and malingering. In A. R. Block, & E. F. Kremer (Eds.), Handbook of pain syndromes: biopsychosocial perspectives (pp. 41–58). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
- Craig, K. D., Prkachin, K. M., & Grunau, R. E. (2001). The facial expression of pain. In D. C. Turk, & R. Melzack (Eds.), Handbook of pain assessment (pp. 153–169). New York: Guilford Press.Google Scholar
- Gigerenzer, G. (2000). Adaptive thinking. Rationality in the real world. New York: Oxford University Press.Google Scholar
- Halligan, P., Bass, C., & Oakley, D. (2003). Malingering and illness deception. Oxford: Oxford University Press.Google Scholar
- Hamers, J. P. H., van den Hout, M. A., Halfens, R. J. G., Huijer Abu-Saad, H., & Heijltjes, A. E. G. (1997). Differences in pain assessment and decisions regarding the administration of analgesics between novices, intermediates and experts in pediatric nursing. International Journal of Nursing Studies, 34, 325–334. doi: 10.1016/S0020-7489(97)00024-2.PubMedCrossRefGoogle Scholar
- Jensen, M. P., & Karoly, P. (2001). Self-report scales and procedures for assessing pain in adults. In D. C. Turk, & R. Melzack (Eds.), Handbook of pain assessment (pp. 15–34). New York: Guilford Press.Google Scholar
- Krokosky, N. J., & Reardon, R. C. (1989). The accuracy of nurses’ and doctors’ perceptions of patient pain. In S. G. Funk, E. M. Tornquist, M. T. Champagne, L. A. Cropp, & R. A. Wiese (Eds.), Key aspects of comfort: management of pain, fatigue and nausea (pp. 127–134). New York: Springer.Google Scholar
- Oberst, M. T. (1978). Nurses’ inferences of suffering: the effects of nurse-patient similarity and verbalisations of distress. In M. J. Nelson (Ed.), Clinical perspectives in nursing research (pp. 38–60). New York: Teachers College Press.Google Scholar
- Riemsma, R. P., Taal, E., & Rasker, J. J. (2000). Perceptions about perceived functional disabilities and pain of people with rheumatoid arthritis: differences between patients and their spouses and correlates with well-being. Arthritis Care Research, 13, 255–261. doi: 10.1002/1529-0131(200010)13:5≤255::AID-ANR3≥3.0.CO;2-3.CrossRefGoogle Scholar