Evaluating Differential Effects of Specific Pain Dismissal Interactions with Physicians

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Abstract

Objectives:

Over 40% of adolescents with chronic pain report experiencing pain dismissal, which is a response from another individual that is perceived as diminishing, denying, or disbelieving an individual’s report of pain. Pain dismissal by physicians often leaves patients feeling discredited, which may discourage them from seeking and receiving proper treatment for their pain. The purpose of this study was to investigate how the four most commonly reported types of physician pain dismissal differentially affect individuals’ reactions.

Methods:

Emerging adults, age 18- to 25-years-old (N=352, 60% female), were randomly assigned to read one of four vignettes describing the most commonly reported types of physician pain dismissal identified by previous research: denial/disbelief, minimizing, faking for secondary gain, and psychogenic. Participants answered questions regarding their reactions to one of the pain dismissal vignettes.

Results:

All four vignettes were perceived as dismissive and problematic by the majority of participants, but participants who read the psychogenic pain dismissal vignette were less dissatisfied overall with the hypothetical medical appointment than participants who read the other three vignettes.

Discussion:

All four types of physician pain dismissal were broadly perceived negatively, suggesting that the experience of pain dismissal is likely not due to patient hypersensitivity but to physician behavior. Discussion of the psychological factors associated with pain was less likely to be perceived as dismissive. Psychologists and physicians should collaborate to develop recommended language that validates patients’ experiences of pain, communicates appropriate levels of empathy, and reduces the frequency of perceived physician pain dismissal.

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