Patients who display protective pain behaviors are viewed as less likable, less dependable, and less likely to return to work

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SummaryThe expression of protective pain behaviors might contribute to the development and maintenance of occupational disability by influencing clinicians’ judgments about patients’ readiness to work.In the present study, participants (ie, observers) watched video sequences of patients with chronic back pain performing a physically demanding lifting task. Participants were asked to make judgments about patients’ levels of pain and readiness to work. For each patient, observers were also asked to make judgments about personality traits relevant to work performance and employment. The primary objective of this study was to examine the differential influence of communicative and protective pain behaviors on observers’ judgments about patients’ pain intensity and readiness to work. Consistent with previous research, analyses indicated that patients displaying either communicative (eg, facial expressions) or protective (eg, guarding) pain behaviors were perceived as having significantly more pain than patients displaying no pain behavior. Analyses also revealed that patients displaying protective pain behaviors were perceived as being significantly less likable, less dependable, and less ready to work than patients displaying other forms of pain behavior. Discussion addresses the processes by which pain behaviors might influence observers’ judgments about patients’ personality traits and readiness to work. Implications of the present findings for clinical practice and the management of patients presenting with pain conditions are also discussed.

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