National Institutes of Health -- Gender and Pain: Scientific Abstracts

GENDER, COPING, AND THE ARTHRITIS PAIN EXPERIENCE

Francis J. Keefe, Ph.D., Department of Psychology, Ohio University, Athens, Ohio

Pain is the most common complaint of persons with arthritis. The effects of arthritis pain, however, can vary substantially. For example, two people with the same level of disease activity can differ greatly in terms of the level of pain they report and the impact of pain on their lifestyle. One person may be overwhelmed by pain, depressed, and spend much of their day in a wheelchair. The other person may report little or no pain, feel confident about their ability to manage their disease, and lead an active lifestyle.

One factor that has been largely overlooked, but that may be particularly important in explaining such variations in the arthritis pain experience is gender. Research suggests that there can be substantial differences in the pain experience of men and women. Recent, preliminary studies conducted in our lab have examined gender differences in people having persistent arthritis pain. We have identified a number of gender differences in arthritis pain, pain coping, and pain behavior. All individuals participating in these studies have suffered from osteoarthritis. Osteoarthritis provides a particularly good model in which to study gender differences because it: 1) is a common age-related degenerative condition (affecting up to 70% of older adults), and 2) can lead to quite varied levels of pain and disability.

This presentation will highlight three of our recent studies, each of which uses a different experimental methodology to examine gender differences in the arthritis pain experience.

Study 1 used newly developed daily study methods to examine gender differences in daily coping with arthritis pain. One of the most interesting findings of this research was that, even when their greater pain was taken into account, women used more pain coping strategies, especially those that assist emotional regulation in the face of increasing pain. Further, men showed a much greater carry over effect of intensifying pain on negative mood the following day. These results suggest that while women may experience more intense pain, they may be better able to limit its emotional consequences than men.

Study 2 used direct observation methods to study gender differences in the behavior of patients and spouses during a structured patient-spouse interaction task. Patients and spouses were observed while they engaged in a series of routine household activities (e.g. picking clothes up off the floor.) A number of gender differences in the behavior of patients and spouses were found and the implications of these differences for involving spouses in arthritis pain management programs will be discussed.

Study 3 examined the effects of gender on the accuracy of spouses' judgements of their marital partners' pain. Each spouse viewed a videotape of the patient engaging in a series of daily activities and made ratings of the patient's pain using a computer controlled mouse. Ratings of pain provided by the spouse were directly compared to ratings of pain previously made by the patient. Interestingly, spouses varied considerably in their performance on this task. Women were much more accurate in making judgements of their partner's pain than men.

Taken together, the results of these studies suggest that there are a number of gender differences in the arthritis pain experience. Gender-related variations in pain, pain coping, and pain behavior are potentially quite important because they have implications for the management of arthritis pain. By taking into account gender differences, arthritis health professionals may be better able to understand and treat persistent arthritis pain.

Links for more information about the author(s):
web site:		Francis J. Keefe, Ph.D., Department of Psychology, Ohio University, Athens, Ohio