Oras Alabas

Gender role affects experimental pain responses: A systematic review with meta‐analysis

Gender role refers to the culturally and socially constructed meanings that describe how women and men should behave in certain situations according to feminine and masculine roles learned throughout life. The aim of this meta‐analysis was to evaluate the relationship between gender role and experimental pain responses in healthy human participants. We searched computerized databases for studies published between January 1950 and May 2011 that had measured gender role in healthy human adults and pain response to noxious stimuli. Studies were entered into a meta‐analysis if they calculated a correlation coefficient (r) for gender role and experimental pain. Searches yielded 4465 ‘hits’ and 13 studies were eligible for review. Sample sizes were 67–235 participants and the proportion of female participants was 45–67%. Eight types of gender role instrument were used. Meta‐analysis of six studies (406 men and 539 women) found a significant positive correlation between masculine and feminine personality traits and pain threshold and tolerance, with a small effect size (r = 0.17, p = 0.01). Meta‐analysis of four studies (263 men and 297 women) found a significant negative correlation between gender stereotypes specific to pain and pain threshold and tolerance, with a moderate effect size (r = −0.41, p < 0.001). In conclusion, individuals who considered themselves more masculine and less sensitive to pain than the typical man showed higher pain thresholds and tolerances. Gender stereotypes specific to pain scales showed stronger associations with sex differences in pain sensitivity response than masculine and feminine personality trait scales.

Effects of ethnicity and gender role expectations of pain on experimental pain: a cross-cultural study.

Gender role expectations of pain (GREP) have been shown to mediate sex differences in experimental pain. Few studies have investigated the role of ethnicity in shaping GREP. The aim of this study was to examine interactions between ethnicity and GREP on experimentally induced pressure and ischaemic pain in Libyan and white British students in their respective countries.

Gender role expectations of pain mediate sex differences in cold pain responses in healthy Libyans.

Previous studies found a relationship between response to experimentally‐induced pain and scores for the gender role expectations of pain (GREP) questionnaire. Findings were similar in individuals from America, Portugal and Israel suggesting that gender role expectations may be universal. The aim of this study was to translate and validate Arabic GREP using Factor Analysis and to investigate if sex differences to cold‐pressor pain in healthy Libyan men and women are mediated through stereotypical social constructs of gender role expectations and/or pain‐related anxiety. One hundred fourteen university students (58 women) underwent two cycles of cold pressor pain test to measure pain threshold, tolerance, intensity, and unpleasantness. Participants also completed the Arabic GREP questionnaire and the Pain Anxiety Symptom Scale‐Short form (PASS‐20). It was found that Libyan men had higher pain thresholds and tolerances than women (mean difference, 95% CI: threshold = 4.69 (s), −0.72 to 10.1, p = 0.005; tolerance = 13.46 (s), 0.5–26.4, p = 0.018). There were significant differences between sexes in 6 out of 12 GREP items (p < 0.004 after Bonferonni adjustment). The results of mediational analysis showed that GREP factors were the mediators of the effects of sex on pain threshold (z = −2.452, p = 0.014 for Self Sensitivity); (z = −2.563, p = 0.01, for Self Endurance) and on pain tolerance (z = −2.538, p = 0.01 for Self Endurance). In conclusion, sex differences in response to pain were mediated by gender role expectations of pain but not pain‐related anxiety.

Understanding the gender-pain gap

315 ISSN 1758-1869 10.2217/PMT.12.34

S287 GENDER ROLE EXPECTATIONS OF PAIN PREDICT RESPONSE TO EXPERIMENTALLY‐INDUCED ISCHAEMIC AND MECHANICAL PAIN IN HEALTHY WHITE BRITISH PARTICIPANTS

References Sex and gender differences in experimental pain are well documented with women display greater sensitivity to multiple pain modalities compared with men . One of the psycho-social factors contributing to sex differences in pain is gender role. A Gender Role Expectancy of Pain Questionnaire (GREP, Robinson et al., 2001) is composed of twelve 10-cm visual analogue scales (VAS) categorised into three dimensions; Sensitivity, Endurance, and Willingness to Report Pain. For each dimension, participants were required to estimate their individual perception of pain response when compared with a typical woman and typical man, as well as stereotypical perceptions of typical men and typical woman to each other. GREP have been found to predict sex differences in response to heat (Wise et al.2002; Defrin et al., 2009) and cold (Alabas et al., 2011) pain.