SEX VS GENDER IN PAIN PERCEPTION

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Recent reviews of the literature suggest that men and women may differ in their perception of pain. A number of explanations have been proposed for why women report more pain in experimental pain studies, may respond differently to analgesic medication and have a higher incidence of a number of pain conditions. Previous explanations have included possible sex differences in the organization of the central nervous system, differences in peripheral tissue composition and qualities, and the influence of sex hormones. The influence of social learning and social role expectations has been largely ignored in these studies in favor of the investigation of more first-order biological explanations of sex differences in pain responding. This project proposes to investigate the relative contribution of biological sex and psychosocially determined sex-role constructs to differences between men and women in pain responsivity. Directly comparing sex and sex-role (gender role) constructs will allow for the testing of two main hypotheses: 1) The sex differences in laboratory, experimental pain studies are influenced by gender role expectations and social learning to an equal or greater degree than first-order biological influences; 2) The discrepancy between clinical and experimental pain differences between men and women is a function of social learning influences on the willingness to report stimulation as painful which is differentially active in the two settings. This project will employ the measurement of experimental pain, clinical pain (patients with chronic facial pain), and novel pain protocols that combine laboratory psychophysics with clinically relevant stimuli to directly test the previously mentioned hypotheses. In addition, two studies are proposed which directly manipulate a leading social learning construct (gender role) to test their influences on pain responsivity in men and women.