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Psychosocial Contributions to Sex-Correlated Differences in Pain

Myers, Cynthia D. PhD*; Riley, Joseph L. III PhD†,‡; Robinson, Michael E. PhD

The Clinical Journal of Pain: July 2003 - Volume 19 - Issue 4 - p 225–232

Abstract: Sex-correlated differences in pain perception and behavior have been reported in several studies. Where such differences are found, they are most often in the direction of girls and women reporting more pain than is reported by boys and men. Although biologic, psychologic, and sociocultural factors act interdependently to influence pain responding, most efforts to explain sex-correlated differences in pain have focused on first-order biologic differences between the sexes. The current paper discusses empirical and theoretical literature addressing gender role socialization, cognitive factors, and affective factors associated with sex-correlated differences in pain. We affirm that there is convincing evidence that such psychosocial factors must be taken into account in research on sex-correlated differences in pain. We contend that the use of the dichotomous variable sex as a proxy for presumed biologic aspects of being female or male may obscure the contribution to sex-correlated differences that could be ascribed to the ways in which women and men are socialized with respect to pain perception and pain reporting.

*Department of Pediatrics, University of California, Los Angeles, California; and Departments of †Operative Dentistry and ‡Clinical and Health Psychology, University of Florida, Gainesville, Florida

Received June 17, 2002; accepted June 17, 2002.

Supported by National Institute of Dental and Craniofacial Research grant DE007283, National Institute of Dental and Craniofacial Research grants DE 13208-01A2, and National Institute of Mental Health grant R15MH57131.

Corresponding author: Cynthia D. Myers, PhD, Pediatric Pain Program, UCLA School of Medicine, 10833 LeConte Avenue #22-464 MDCC, Los Angeles, CA 90095-1752. E-mail:

© 2003 Lippincott Williams & Wilkins, Inc.