Gender differences in the perception of laboratory-induced noxious stimuli

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Gender differences in the perception of laboratory-induced noxious stimuli

 

Author: Soetanto, Lai-fong Angie
Title: Gender differences in the perception of laboratory-induced noxious stimuli
Degree: Ph.D.
Year: 2004
Subject: Hong Kong Polytechnic University -- Dissertations
Pain -- Physiological aspects -- Sex differences
Pain -- Psychological aspects -- Sex differences
Department: School of Nursing
Pages: xix, 209 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1762034
URI: http://theses.lib.polyu.edu.hk/handle/200/2528
Abstract: Introduction Studies conducted in North America suggest women report more bodily pain and are vulnerable to many more chronic pain conditions compared to men. However, whether this difference in pain report and pain experience is also observed in the Hong Kong culture, has not been investigated. Since gender differences in pain perception may have important implications for pain management, it is crucial the relationship between pain and gender in this culture be clarified. Method This thesis had two main objectives. First, the Traditional Threshold Theory method was used to explore gender differences in pain threshold and pain tolerance in Hong Kong men and women. Second, the method of Signal Detection Theory was used to quantify the sensory discriminability index [P(A)] and the pain report criterion [B] of pain perception. Results Study One showed significant gender differences in pressure pain threshold between men (M=453.69 grams, SD=145.75) and women (M=382.57 grams, SD=112.68), t(175)=3.63,p=0.001. Significant differences in pressure pain tolerance between men (M= 968.64 grams, SD = 153.15) and women (M=732.57 grams, SD=218.91), t(174)=8.27,p=0.001 were also found. Study Two showed significant gender differences in sensory discrimination [P(A)] between men (M=0.68, SD=0.03) and women (M=0.70, SD=0.03), t(124)=-2.90, p=0.004 although these differences are fairly small. Significant gender differences in pain report criterion (B) between men (M=4.92, SD=0.87) and women (M=4.58, SD=0.91), t(124) =2.19, p=0.03 were also found with men having fewer pain reports compared to women. Correlational analyses showed high trait anxiety scores is associated with higher pain ratings in men (r(89)=.22, p<0.05) and low state (r(62)=-.27, p<0.05) and trait (r(62)=-.37, p<0.01) anxiety scores were associated with fewer pain reports in women. Higher mean arterial pressure (MAP) was associated with lower sensory discriminability (r(64)=-.37, p< 0.01) in men only. However, there were no significant relationships between menstrual cycle phase and pain threshold, pain tolerance, sensory discriminability and pain report criterion. Discussion Consistent with overseas findings, Hong Kong women showed lower threshold and tolerance to laboratory-induced pain relative to Hong Kong men. Using the method of Signal Detection Theory, it was revealed that women showed enhanced discriminability to thermal stimuli (higher P(A)) and have more pain reports (higher B) than men. The fact that women are more sensitive to sensory changes may explain why women report more pain and seek healthcare more frequently compared to men. Cultural expectations and sex-role expectancies may explain why men showed a more stoical response to pain. Gender differences in pain report may be related to anxiety and gender differences in pain sensitivity may be related to cardiovascular functioning. A greater awareness of the factors that can contribute to gender differences in pain perception may reduce gender bias in pain assessment and pain management. The study is limited in that only young and healthy individuals participated in the study. Future studies may include clinical patients and individuals in the older age group to extend the implications of this study. Conclusion Pain is a complex multidimensional experience and gender plays an important role in affecting pain perception. The method of Signal Detection theory was instrumental in quantifying the sensory and non-sensory contributions of pain perception thereby providing a more meaningful understanding of gender differences in pain perception.

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