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Evaluating Differential Effects of Specific Pain Dismissal Interactions With Physicians

Lang, Amy, C., BS*; Igler, Eva, C., MA*; Defenderfer, Ellen, K., MS*; Uihlein, Julia, MA; Brimeyer, Chasity, T., PhD; Davies, W., Hobart, PhD*

The Clinical Journal of Pain: July 2018 - Volume 34 - Issue 7 - p 664–669
doi: 10.1097/AJP.0000000000000586
Original Articles

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 4 most commonly reported types of physician pain dismissal differentially affect individuals’ reactions.

Materials and Methods: Emerging adults, age 18- to 25-years old (N=352, 60% female), were randomly assigned to read 1 of 4 vignettes describing patient-provider interactions that included the most commonly reported types of pain dismissal identified by previous research: denial/disbelief, minimizing, faking for secondary gain, and psychogenic. Participants answered questions regarding their reactions to the pain dismissal vignettes.

Results: All 4 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 3 vignettes.

Discussion: All 4 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.

*Psychology Department, University of Wisconsin-Milwaukee

Center for Bioethics and Medical Humanities, Medical College of Wisconsin

Children’s Hospital of Wisconsin, Child and Adolescent Psychiatry Center, Milwaukee, WI

The authors declare no conflict of interest.

Reprints: Amy C. Lang, BS, Department of Psychology, University of Wisconsin-Milwaukee, 2441 E Hartford Ave., P.O. Box 413, Milwaukee, WI 53201 (e-mail: amyclang@uwm.edu).

Received April 6, 2017

Received in revised form November 24, 2017

Accepted December 27, 2017

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